Tag Archives: body dysmorphia

Anorexia Nervosa & Body Dysmorphia

photo used under a creative commons license, flickr user Ken Doerr

Many patients with anorexia nervosa experience body dysmorphia; they feel that they are much larger than they actually are. Recently, a study was published that investigated whether this overestimation of body size is a symptom of the eating disorder or if it is a general impairment in perception.

The study involved fifty participants; 25 of the participants had anorexia nervosa, 25 participants were control participants. Participants were well-matched based on age and level of education. Within a test room, each participant was presented with a door. The participant had to judge whether the door was wide enough for them to pass through. Presented with the same door, the participant then had to judge whether the door was wide enough for another person in the test room to pass through.The participants with anorexia nervosa significantly overestimated their ability to pass through the door in comparison to the control group, suggesting that overestimation of the passability ratios in participants with anorexia nervosa are likely to be caused by an overestimation of their own body size and shape.

The study concluded that the overestimation in participants with anorexia nervosa occurred because the central nervous system had not yet registered that the participants body was emaciated; the central nervous system had an outdated image of the participants body in it’s pre-anorexic state.


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Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2012, Dr J Renae Norton. http://edpro.wpengine.com’

Source: Guardia D, Conversy L, Jardri R, Lafargue G, Thomas P, et al. (2012) Imagining One’s Own and Someone Else’s Body Actions: Dissociation in Anorexia Nervosa. PLoS ONE 7(8): e43241. doi:10.1371/journal.pone.0043241

iTherapy – Integrating the iPhone into Therapy

iPhone Therapy

photo used under creative commons license

I recently read an article by Dr. Weissman of the Chicago Institute of Psychoanalysis that introduced the concept of using an iPhone in the treatment of anorexia and body dysmorphic disorder.

Times are changing faster than ever. Technological advances, such as the introduction of the iPhone, have drastically changed the way we communicate and perform everyday activities. We can easily observe our everyday lives via the video and photo component of the iPhone. Weissman believes that this component of iPhone technology could be an effective tool in the treatment of the body dysmorphia that often accompanies anorexia.

Many of my patients that are in treatment for anorexia also experience some level of body dysmorphia; they see an obese person looking back at them in the mirror even though they are drastically underweight. Today, body dysmorphia is typically treated through psychotherapy, nutritional support and medication. For some patients, these approaches have limited success rates.

When a patient talks to me about the “obese person” that they see in the mirror, I often introduce a body image exercise involving “photo-therapy”. I ask the patient to take a photograph of themselves and bring it to their next treatment session. Oftentimes, when the patient returns and we talk about the photograph, the same body that was once described as being “fat” and “obese” is now described as being “underweight” and “malnourished”.

Weissman explains that when an anorexic patient looks in the mirror, their self perception is instantly fused with a distorted body image. The brain is so overwhelmed by this distortion, that it cannot process the image of the “real” body. The brain becomes trapped in this optical illusion, this distorted view. In contrast, when an anorexic patient sees his or her self in a photograph, the brain first acknowledges that there is a person in the photograph, it then focuses on the physicality of the photographed person. The brain then sends the message to the patient that they are the person in the photograph.

Integrating iPhone Therapy into the treatment of anorexia could definitely be a powerful tool in overcoming the body dysmorphia associated with anorexia. Based upon psychotherapy techniques developed by Frieda Fromm-Reichmann in Principles of Intensive Psychotherapy I, the steps below are Weissman’s suggested approach to integrating the iPhone into treatment:

  1. Patient and therapist look at patient in the mirror. Patient describes what they see.
  2. Therapist takes a photograph of the patient with iPhone. Patient describes what s/he sees.
  3. Therapist and patient discuss the differences between the description of the patient in the mirror and the patient in the photograph.
  4. A photograph of the patient standing beside the therapist is taken. Patient describes the image of the therapist. If the patient see distortion in the therapists image, the therapist and patient develop a jointly shared description of the therapist.
  5. Patient describes image of self. If patient sees distortion, the therapist and patient develop a jointly shared description of the patient.

Weissman points out the importance of the therapist not correcting the distorted view of the patient. If the patient does experience distortion in the photograph, the therapist should remind the patient that they both agreed on the description of the image of the therapist in the same photograph. It is necessary that the therapist and patient try to come to an agreement on the description of the patient.

Weissman predicts that utilizing this iPhone exercise will lead to an eventual reduction in the amount of distortion that the patient experiences when looking in the mirror. A combination of iPhone Therapy, Cognitive Behavioral Therapy (CBT) and nutritional counseling may lead to the patient gaining the important ability to maintain a healthy weight with little outside assistance. If the therapist successfully teaches the patient to be able to independently perform this exercise on a regular basis, there could be a drastic drop in relapse rates.

Sources: “Photo-Therapy: A Promising Intervention in Anorexia Nervosa?”

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Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2012, Dr J Renae Norton. http://edpro.wpengine.com’