Exploring Body Uneasiness in Severe and Enduring Eating Disorders: Insights from Clinical Practice

Introduction: Body uneasiness is a central facet of body image disturbances observed in individuals with eating disorders (EDs). This study aimed to address gaps in understanding body uneasiness in severe and enduring eating disorders (SE-EDs) and explore variations in psychopathology between individuals with different durations of the disorder. We hypothesized that patients with SE-ED might develop habitual behaviors that contribute to ambivalence toward treatment and the persistence of symptoms.

Methods: A sample of 360 ED patients was evaluated at the beginning and end of a specialized intensive rehabilitation program. All patients completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Body Uneasiness Test (BUT). They were divided into two groups: SE-ED (> 7 years) and acute (aED, < 3 years) duration.

Results: Compulsive self-monitoring showed a significant change between the start and end of treatment, differing between groups, with a larger change observed in SE-ED (p < 0.048). In SE-ED, it was associated with lower chances of dropout (p = 0.044), opposite to aED (p = 0.009). Treatment responses were primarily related to eating psychopathology, further highlighting differences between the two groups.

Conclusions: This study underscores the possible presence of a habit in SE-ED and the importance of tailoring interventions to address unique needs based on the duration of the disorder. Furthermore, it highlights the need for further research to improve treatment outcomes in SE-EDs.