In adolescent girls with anorexia nervosa (AN), body dissatisfaction and self-esteem are related to negatively biased perceptions about their bodies, not their actual weight, according to a study published this week in the Journal of Eating Disorders.
“Low self-esteem and high body dissatisfaction are pivotal risk factors for eating disorders that are closely linked and mutually reinforce each other in both non-clinical samples and individuals with eating disorders,” wrote Linda Lukas, M.Sc., of University Hospital Ludwig-Maximilians-University in Munich, Germany, and colleagues. “These risk factors might play a particularly important role in adolescents, who are in a critical stage of identity formation and subject to rapidly changing perceptions, thoughts, and feelings about their developing bodies. This leaves them especially vulnerable to constant comparison to the unrealistic images portrayed in the media.”
Lukas and colleagues recruited 40 adolescent girls with AN and 40 without any mental disorders ages 12 to 18 (median age 15). The researchers calculated participants’ BMI, assessed their body dissatisfaction using the Body Shape Questionnaire, and assessed their self-esteem using the Rosenberg Self-Esteem Scale. Participants’ interpretation bias was determined using the Scrambled Sentences Task, in which they were presented with scrambled sentences relating to their bodies (such as “my fat bottom find attractive I”); participants then had to rearrange the sentences using five of the presented words, with each sentence allowing them to choose a positive (“I find my bottom attractive”) or negative (“I find my bottom fat”) solution. The researchers then calculated participants’ interpretation bias based on how often they created negative sentences relative to positive ones.
Among participants with AN, BMI did not predict self-esteem or body dissatisfaction, while body-related interpretation bias was a significant predictor of both. A more negative interpretation of participants’ bodies was associated with higher body dissatisfaction and lower self-esteem, regardless of BMI. In contrast, among those without AN, both BMI and interpretation bias were significant predictors of self-esteem and body dissatisfaction, suggesting that both actual weight and perceptions of their bodies are linked to body dissatisfaction and self-esteem.
“These cognitive biases may distort how adolescents with AN perceive their bodies, preventing them from experiencing their bodies as thin, even when they are underweight, and may reinforce their belief that their bodies are flawed, unattractive, and not thin enough, thereby perpetuating their high body dissatisfaction and low self-esteem,” the authors wrote. “Addressing the dysfunctional cognitions related to one’s body may facilitate interrupting dysfunctional associations between low self-esteem, body dissatisfaction, and disordered eating behaviors.”
For related information, see the Psychiatric News Special Report “Youth With Eating Disorders—Time Is of the Essence in Achieving Remission.”
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