# The body interior in anorexia nervosa: from interoception to conceptual representation of body interior

## TL;DR

This study explores how people with anorexia nervosa perceive their body's interior and finds no strong link between interoceptive awareness and body representation.

## Contribution

The study introduces a novel approach combining drawing tasks and lexicometric analysis to investigate interoception in anorexia nervosa.

## Key findings

- No significant differences were found in interoceptive awareness or body interior representation between anorexia nervosa patients and healthy controls.
- The anorexia nervosa group showed a stronger representation of bones in their drawings.
- No correlations were found between interoceptive awareness, body representation scores, and body interior representation.

## Abstract

Body image disorders are well documented in anorexia nervosa (AN); however, knowledge of interoceptive awareness (IA) in this population remains poor. This descriptive study investigated whether and how the representation of the interior of the body may have an impact on IA.

The representations and knowledge of the body interior were evaluated with a drawing task in 34 women with AN and 34 healthy controls (HCs). A lexicometric analysis was performed on the vocabulary used to describe the drawn body parts in a structured interview. It was assumed that the conceptual representation of the body interior could be affected by or influence IA. Thus, the relationship between IA, measured with the heartbeat task and the ischemia-induction test, and the drawings was explored. Other scales, such as those of body shape, awareness or satisfaction, were used to assess affective representations of the body.

The drawing, lexicometric and IA results were similar in the two groups. No correlations were found among IA, body representation scores and representation level of body interior. Only the representation of bones by the AN group was significantly different.

Increased visual attention to the skeleton or greater awareness of bone health could explain the stronger representation of bones in the AN group. The psychophysical therapy received by some AN participants (73%) did not seem to have influenced IA. Our results do not support a relationship between IA and the representation of the body interior.

Clinical trial registration:https://clinicaltrials.gov/, identifier NCT03988218.