Transdiagnostic body dissatisfaction: comparing adolescents with anorexia nervosa and depression during body exposure

TL;DR

This study compares body dissatisfaction in adolescents with anorexia and depression, finding similar patterns and showing that a computer-based intervention helps reduce it.

Contribution

The study demonstrates that body dissatisfaction is a transdiagnostic issue and that computerized body exposure is effective for both anorexia and depression.

Findings

Both groups showed increased body satisfaction and reduced anxiety and disgust during the intervention.

An attentional bias toward unattractive body parts was observed but not changed by the intervention.

The results suggest body dissatisfaction is a shared phenomenon across anorexia and depression.

Abstract

Body dissatisfaction (BD) is a risk factor for and a maintaining factor of Anorexia nervosa (AN). Furthermore, BD is associated with depressive symptoms. Body exposure (BE) was found to be an effective intervention for reducing BD. The current study aimed to investigate similarities and differences in BD between patients with AN and depressive symptoms and the efficacy of a computerized BE in those adolescents.

We compared adolescents with AN (n = 36) to adolescents with depression and high body dissatisfaction (n = 21; DBD group). BD was assessed with questionnaires; valence ratings were obtained for different body parts. Emotion ratings and gaze patterns towards the own body were assessed during each session via rating scales and eye-tracking.

Satisfaction with several body parts increased and anxiety and disgust decreased throughout the intervention in both groups, with no significant differences between them. An attentional bias towards the three most unattractive body parts was found, expressed via longer viewing times; however, it was not modified by the BE intervention.

The similarities between adolescents with AN and highly body dissatisfied ones with depression in terms of BD, emotional reactions to and gaze patterns on one’s own body suggest a transdiagnostic phenomenon of BD. The results suggest that a computer-based BE is an effective intervention for reducing BD.

The study was pre-registered in the German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS), ID number DRKS00024675.

The online version contains supplementary material available at 10.1186/s13034-025-00939-9.

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