Online Training for Negative Body Image in Adolescents With Anorexia Nervosa

Comparing oneself against internalized body ideals which have extremely low BMI is seen as an important source of body dissatisfaction. The aim of this study was to investigate a novel body image training designed to shift internalized norms for body size towards less extreme positions. Effects of the intervention on body image and eating disorder symptoms were investigated in twelve adolescent girls with an eating disorder using a replicated randomized two-phase single-case experimental design. Participants (N = 12) received six 10-minute training sessions alongside treatment as usual. Participants' starting point in time for the training was randomly assigned between day 8 and 14 within the continuous 23-day study window. Participants were presented 3D images of a female model who varied in BMI, and on each presentation had to judge the model as either “thin” or “fat”. By giving feedback which challenged their judgements, the aim was to gradually increase the BMI representing the transition from thin to fat judgements, thereby shifting participants’ body size norms towards a more realistic standard. Primary outcome measures were assessed on each of the 23 days. Results showed a significant overall small effect of the training on body image. No significant overall decrease in eating disorder symptoms was found. Although these findings are promising, the small effect size and differences between participants suggest that the training procedure should be improved before further investigating this training in clinical practice.