Body image concern and treatment outcomes in adolescents with anorexia nervosa

Int J Eat Disord. 2019 May;52(5):582-585. doi: 10.1002/eat.23031. Epub 2019 Jan 31.


Objective: To ascertain the role of baseline measures of body-image concern (BIC) in changes in body mass index (BMI) centile and psychopathological outcomes associated with intensive enhanced cognitive behavioral therapy (CBT-E) in adolescents with anorexia nervosa (AN).

Method: The BMI centile of 62 adolescent patients with AN was recorded at four time-points over 12 months, and Eating Disorder Examination interview (EDE) and Brief Symptom Inventory (BSI) scores, were recorded at admission and discharge from CBT-E. Changes in three BIC components, namely "Preoccupation with shape/weight", "Fear of weight gain" and "Feeling fat", were assessed at admission and discharge.

Results: CBT-E was associated with a significant improvement in outcome variables and BIC components. Among completers, 96.4% reached an end-of treatment BMI centile corresponding to a BMI ≥ 18.5 at 18 years, which fell slightly to 78.7% and 80.4% at 6- and 12-month follow-ups, respectively. Baseline "Preoccupation with shape/weight" and "Feeling fat" predicted improvement in BMI centile over time, and all three baseline BIC components independently predicted end-of-treatment EDE Eating Concern subscale score. Baseline "Feeling fat" also predicted end-of-treatment EDE Dietary Restraint subscale and BSI scores.

Discussion: These findings highlight the importance of assessing and addressing body image when managing adolescent patients with AN.

Keywords: adolescent; body image; cognitive behavioral therapy; eating disorder psychopathology; fear of weight gain; feeling fat; inpatient treatment; preoccupation with shape or weight.

MeSH terms

  • Adolescent
  • Anorexia Nervosa / psychology*
  • Body Image / psychology*
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Humans
  • Treatment Outcome