# A look in the mirror - body exposure in clinical practice

## TL;DR

This study explores how often body exposure is used by psychotherapists in Germany to treat eating disorders and finds it is underused despite its effectiveness.

## Contribution

The study provides new insights into the current use and barriers of body exposure in clinical practice for eating disorders.

## Key findings

- 58.3% of psychotherapists use body exposure, but only 37.3% of patients receive it.
- 56.7% of therapists using body exposure lack formal training in the technique.
- Confidence in using body exposure correlates with the number of patients treated.

## Abstract

The dissemination of evidence-based techniques is critical for the successful treatment of eating disorders in clinical practice. A growing number of studies suggests that body exposure is an effective technique to treat body image disturbance in eating disorders. However, the dissemination of body exposure among psychotherapists in clinical practice remains unclear.

An online survey was conducted among licensed psychotherapists in Germany. The dissemination of body exposure in clinical practice, psychotherapists’ characteristics (such as clinical training, attitudes towards exposure, confidence), and therapists’ experiences with benefits and side-effects of body exposure were assessed.

Data of 230 psychotherapists were analysed. More than half of them (58.3%) applied body exposure in their clinical practice. Yet, body exposure was only offered to 37.3% of their eating disorder patients. Moreover, 56.7% of psychotherapists delivering body exposure indicated that they have not received any training in this technique. Self-reported confidence in delivering body exposure correlated significantly with the number of patients treated with body exposure. Psychotherapists who applied body exposure reported minor side-effects and that the majority of their patients profited from this technique.

Our results offer insights into the dissemination of body exposure in clinical practice in Germany. Overall, body exposure is still underused considering the empirical evidence demonstrating the potential of body exposure to treat body image disturbances effectively. Moreover, with regard to potential barriers of using body exposure, our data suggest that training opportunities for clinicians may facilitate the dissemination of this technique in clinical practice.

The online version contains supplementary material available at 10.1186/s40337-025-01262-6.