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Documentazione "Body Image

Body Image Assessment in Eating Disorder Patients

Il Body Image Revealer è un software in grado di simulare in maniera

naturale e realistica i cambiamenti del corpo in condizioni di
sovrappeso e sottopeso. Lo strumento è stato sino ad ora
utilizzato per la ricerca sull’immagine corporea nei pazienti affetti da
disturbi dell’alimentazione, obesità e disturbo da dimorfismo
corporeo.Lo strumento può essere considerato come uno specchio
virtuale che riproduce fedelmente l’immagine corporea della persona
in trattamento.Utilizzando questa proiezione e valutando le modifiche
effettuate dai pazienti è possibile individuarne il grado di

Step 1: al soggetto viene scattata una foto mediante una fotocamera

digitale connessa al computer.

Step 2: in videoproiezione a grandezza naturale1 l'immagine del soggetto

viene presentata sia partendo da una simulazione di sovrappeso, sia di
sottopeso ai fini di una valutazione delle distorsioni dell'immagine
corporea e la gravità dell' insoddisfazione corporea.

Step 3: L’operatore pone alcune domande al paziente che deve

rispondere correggendo l'immagine simulata mediante la pressione di
alcuni pulsanti sul comando a distanza (come pensi di essere? Come
senti di essere? Come pensi che gli altri ti vedano? Come vorresti

Anche se le correlazioni fra videoproiezione speculare,1 a 1 e monitor LCD sono
molto alte

Testing a new digital method to assess body image in eating

disorder patients: a multi-centric pilot study

A pilot study was designed to develop and test a new digital computer-based
assessment method aiming at evaluating the body image distortions in eating
disordered patients.
The instrument’s algorythm is able to recognize different body parts and can
simulate over- and underweight by means of the subject’s own picture taken
previously with a digital camera.
67 female patients (mean age 24 +\- 7) from both the Eating Disorder Unit of
the University Psychiatric Center KU Leuven Campus Kortenberg (Belgium)
and Villa Garda’s Clinic (Italy) and 42 female controls (mean age 23 +\- 4)
were tested with this new technique together with EDI2, SCL90 and BAT.
Significant differences were found between the eating disorder sample and
the control group in the cognitive (how do you think you really look like) and
affective (how do you feel you are) tasks with the digital technique.
Remarkably, the results showed also significant differences between Italian
and Belgian patients in the meta-cognitive task.
In support of the convergent validity of this new technique, measures of
Cognitive, Optative and Affective Tasks, were positively correlated with their
equivalents from the questionnaries subministered.

Articolo presentato ad Alpbach (Austria)

Netzwerk Esstoerungen
Austrian Society for Eating Disorders International Congress
L’articolo e’ consultabile anche via internet a questo link:

Body image assessment in eating disorder patients:

testing a new digital method

Body image disturbances have been a challenge for both researchers and
therapists working with eating disorders in the last thirty years.
A extreme preoccupation with the body in combination with a general fear to
gain weight is often cited as a causal and/or maintaining factor in eating
For too long, research on body perception in eating disorders has been
focusing on accuracy of body size estimation in a rather simplistic way.
There is a strong need for a new and valid instrument in body image
assessment methods.
The present study reports on the development of a body image assessment
instrument combining a sophisticated subject's image simulation technique
and simplicity of administration.
Furthermore, we report on a pilot study, testing a new digital system in
hospitalized eating disorder patients of the University Center St-Jozef
(Belgium) and Villa Garda's Clinic (Italy). Women with clinical eating disorders
(n = 66) and normal controls (n = 34) were asked to estimate their actual
(cognitive task), subjective (affective task), perceived by others (meta-
cognitive task) and ideal (optative task) body size while using the computer-
based simulation technique on a video screen.
In the cognitive and meta-cognitive tasks significant differences between
patient group and control group were found.
It is argued that this new method is able to assess the perception of body size
and body dissatisfaction.
Articolo presentato a Barcellona (Spagna) all' AED Congress
Academy for Eating Disorders International Congress

L’articolo e’ consultabile anche via internet a questo link:

A structured morphing technique

for the assessment of body image

Body image is a broad multi-faceted concept that refers to perceptions,

cognitions,attitudes and behaviours (Trautmann, Worthy & Lokken, 2007)
towards subject’s own body. It represents the way in which a person perceive
their own body and it does not necessarily correlate to objective measures of
attractiveness, or the subjective opinions of others.
A negative body image is a core feature to the onset of an eating disorder
(DSM-IV, American Psychiatric Association, 1994) and even if a negative
body image may predispose individuals to the development of these
disorders, the “desire for thinness” is so prevalent among women without
eating disturbances that it has been identified as a “normative discontent”
(Rodin, Silberstein and Striegel-Moore, 1985).
This issue suggests that not only people suffering of an eating disorder but
also those without an eating dysfunctional behaviour will benefit from an early
body image assessment method.
The aim is to present a digital simulation technique that is able to manage
subject’s own images taken by a digital camera in order to estimate the actual
(cognitive task), felt (affective task), supposed by others (meta-cognitive task)
and desired (optative task) body size.

Sense of Body- An Interdisciplinary Summer School on Body Representation

Bologna , Italy- June 2008

Effects of Exposure to Thin Media Images

in Young Females
Body dissatisfaction in young females has been shown to be a causal risk
factor for dieting, negative body image, and increases in eating disorder
symptoms. A poor body image has also been related to negative affect and low
levels of self-esteem in females.
Research has shown that women’s ideal body images are influenced by
exposure to diet messages and thin media images. However, studies that
explored this phenomenon compared groups of healthy females exposed vs.
non-exposed to thin media images, exclusively by means of questionnaires or
silhouettes ratings. Such methods have low test-retest reliability.
Our experiment studied the effects of exposure to physique salient (PS) vs.
physique non-salient (PNS) media images and the moderating influence of
perceived body discrepancies. We used a digital assessment method called
Body Image Revealer (BIR), consisting in a digital simulation technique capable
of manipulating a picture of the participant, previously taken by a digital camera,
to simulate a thin/fat body.
Participants included 53 female students (mean age 22 +/- 2 yrs.) recruited
over a six-month period. They were asked to fill EAT26, EDI2, EDES, and BAT
questionnaires in order to exclude women with a negative body image and/or an
eating disorder. Women’s height and weight were measured to calculate
Quetelet’s Body Mass Index [BMI; the ratio of weight (kg) to height (m) squared]
and to exclude women with a BMI value outside the 18,5-24,5 range. Three (3)
participants were excluded because of high scores in the aforementioned
questionnaires and two (2) because of low/high BMI values.
To define a baseline, participants’ perceived bodies (PB) and ideal bodies
(IB) were assessed using the BIR. The retest was managed after 5 minutes,
consisting of a second BIR session following the presentation of PS vs. PNS
media images taken from magazines that girls read. Images were chosen
according to a poll subministered all over the nation before the experiment. PS
images consisted in advertisement pictures of swimsuits, clothes and underwear
with the presence of thin models. PNS pictures consisted in advertisement
pictures of a car, cans of dog food and a wristwatch.
Higher PB scores were associated with the exposure to PS images. This
effect was positively correlated with the Body Mass Index. The analysis of IB
scores indicated that participants increased their desire for thinner bodies after
exposure to PS images, especially swimsuits and underwear. This effect was
positively correlated with age.
Results suggest that media images portraying thin models elicit negative
perceived discrepancies and a desire for thinness greater than images that are
considered neutral or physique non-salient. This can be detrimental for women’s
body images and could be prodromic for an eating disorder in young females.

16th Kanizsa lecture: Trieste Symposium on Perception and Cognition

(31 October 2008)

Selective visual attention for body parts

during body image assessment
using a digital method

INTRODUCTION: Body image is a broad concept that refers to perception,

cognition, attitude and behaviour toward one’s own body. It represents the
way in whch the personal bodily appearance is perceived (Cash & Pruzinsky,
2004). In the present study, we combine a digital method for body image
assessement, i.e. Body Image Revealer (Mian & Gerbino, 2009) and eye
movements registration (Eye Tracker, ASL), as an index of visual attention.

The aim of this pilot study is to explore if observers focus on specific body
parts when they evaluate and adjust previously distorted images of their
METHOD: Frontal pictures of 9 female informed volunteers (mean age
(mean=18,11 ± 1,45 years)were taken at a standard 2.5 m distance. Subjects’
weight (mean=53,63 ± 3,30 Kg) and height (mean=162 ± 4,53 cm) were
determined. Only subjects with a normal Body Mass Index (i.e. between 18,5
and 24,9; mean=20,46 ± 1,48 Kg/m2) were included. Validated questionnaires
for the assessment of eating and body image disturbances were also
administered: subjects with scores at questionnaires indicating a possible
eating disorder were excluded. Each participant received 18 trials divided in 4
tasks using the Body Image Revealer: they were presented with a distorted (in
different trials either under- and over-weight simulation) picture of their body
and were requested to adjust (i.e. enlarge or reduce) the image until it fits
with: a) how they see they are (cognitive task); b) how they feel they are
(affective task); c) how they would like to appear (optative task); d) how they
think others see them (metacognitive task). Eye movements were recorded
and fixation time for different body parts (thigh, abdomen, thorax, arms, head)
of the shown picture was measured.

RESULTS: Compared to previous studies using the Body Image Revealer in

normal controls (E. Mian, Dalle Grave, Vanderlinden, Pieters, & Probst, 2006;
E. Mian & Gerbino, 2008; E. Mian & Gerbino, 2009),the present subjects
showed no distortion in body image perception (overestimation of body size)
and normal levels of body image dissatisfaction (Rodin, Silberstein, &
Striegel-Moore, 1985). In details, mean scores were: in the cognitive task=
2,7 % +/- 7,6; in the affective task= 7.5 % +/-10.7; in the optative task= ,
-9.4% +/-15.6; in the metacognitive task=8.3 % +/- 10.9.
Eye movements data show that female subjects spent more time looking their
thighs when estimating the size of the whole image of their body in
comparison to all other body parts, suggesting that the thigh is a critical
landmark for body perception in young women.

CONCLUSION: Further research is planned in the near future in order to

confirm the present results. The sample size will be enlarged and male
subjects will be recruited in order to evaluate gender differences. This set of
data will be used as a normative sample to be compared with patients
suffering from anorexia nervosa and bulimia nervosa.

17th Kanizsa lecture: Trieste Symposium on Perception and Cognition

(30 October 2009)