Elsevier

Biological Psychiatry

Volume 58, Issue 12, 15 December 2005, Pages 990-997
Biological Psychiatry

Original article
Functional Neuroanatomy of Body Shape Perception in Healthy and Eating-Disordered Women

https://doi.org/10.1016/j.biopsych.2005.06.001Get rights and content

Background

Abnormalities in perception and evaluation of body shape are a hallmark of eating disorders.

Methods

Brain responses to line drawings of underweight, normal weight, and overweight female bodies were measured with functional magnetic resonance imaging in 9 women with bulimia nervosa, 13 with anorexia nervosa, and 18 healthy women. Participants rated the stimuli for fear and disgust.

Results

In the three groups, the lateral fusiform gyrus, inferior parietal cortex, and lateral prefrontal cortex were activated in response to body shapes compared with the control condition (drawings of houses). The responses in the lateral fusiform gyrus and in the parietal cortex were less strong in patients with eating disorders compared with healthy control subjects. Patients with eating disorders rated the body shapes in all weight categories as more aversive than did healthy women. In the group with eating disorders, the aversion ratings correlated positively with activity in the right medial apical prefrontal cortex.

Conclusions

Processing of female body shapes engages a distributed neural network, parts of which are underactive in women with eating disorders. The considerable variability in subjective emotional reaction to body shapes in patients with eating disorders is associated with differential activity in the prefrontal cortex.

Section snippets

Participants

Twenty-two patients with eating disorders were recruited from the inpatient (n = 9) and outpatient (n = 13) services of the South London and Maudsley Trust. Eighteen healthy women (CO) were recruited by advertisement and screened for abnormal eating habits (underweight, binge-eating, self-induced vomiting, purging) and neurological or psychiatric disease. Lifetime diagnosis and inclusion criteria were ascertained with the structured EATATE interview, based on the Eating Disorder Examination (

Subjective Ratings of Stimuli

The ratings of fear and disgust were highly correlated for all categories of stimuli (Pearson’s .71 <r < .94), and hence an average of these two is reported as a measure of “aversion” (Figure 1). Images of bodies were rated as more aversive by patients than by control subjects [F(2,117) = 25.9, p < .001; Contrast I: t(1,117) = 6.6, p < .001]. This was true for all three categories of body shapes [underweight: t(1,37) = 3.1, p < .01; normal: t(1,37) = 4.1, p < .001; overweight: t(1,37) = 6.7, p

Discussion

Previous research has indicated that the processing of body image is underpinned by neural systems involved in analyzing perceptual aspects of the human body (EBA; Downing et al 2001) and in representing a person’s own body schema (right parietal cortex; e.g., McGlynn and Schacter 1989). In the present study, the pattern of brain response to female body shapes is consistent across different categories of stimuli (underweight, normal, overweight) and across groups of participating women (with or

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