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A Psychophysiologically Controlled Exposure Treatment of Severe Body Image Distortion in Eating Disorders

Although body image problems are a major prognostic factor in the course of eating disorders, its treatment has received little attention in the research literature. We present two psychophysiologically controlled cases of intensive exposure treatment with conflicting outcomes. Pre-post treatment assessments included measurements of body size estimation, body related avoidant attitudes and body dissatisfaction. In case 1, although dissatisfaction and avoidant attitudes decreased, body size overestimation remained basically unchanged. Case 2 did not improve. Psychophysiological recordings showed a covert avoidance of treatment stimuli. We discuss the pros and the cons of the treatment, and the implications for the use of exposure therapy in body image disorders.