Body checking

Body checking is a compulsive behaviour related but not exclusive to various forms of body dysmorphic disorders. It involves frequently collecting various information about one’s own body in terms of size, shape, appearance or weight.[1] Frequent expressions of this form of behaviour entails for example mirror checking, trying to feel one’s own bones, pinching the abdomen, frequent body weight measurement and comparing your own body to that of others.[2] Studies have shown that an increased rate of body checking correlates with an overall increased dissatisfaction with the own body.[3]

Characteristics
Body checking can involve a person measuring their own body with measuring tapes.

Compulsive body checking can be observed in many forms. Some of the more common signs are:

  • Constant weighing[4]
  • Constantly checking oneself in the mirror[5]
  • Recording bodily changes[5]
  • Feeling areas of the body to check that they haven’t changed[1]
  • Measuring body parts[1]
  • Comparing the body to other peoples bodies[4]

Compulsive body checking behaviors are considered to overly emphasize the importance of one‘s body and its shape, which often occurs as a symptom in people with obsessive–compulsive disorder and eating disorders like anorexia nervosa and bulimia nervosa.[6] Checking behaviors are common among those groups, because body checking temporarily induces stress relief and thereby reinforces the habit. In the long term it contributes to increased overall body dissatisfaction and can prevent full recovery.[6]

Components

Cognitive

People who engage in body checking tend to have discrepancies between their own body ideals and their subjective representation of their bodies. The desired body ideals are created by comparing oneself to other people and making upward comparisons.[7] These upward comparisons are often perpetrated by the use of social media, where it is easy to find pictures of one's desired body. Since social media pictures are often edited and people try to present themselves perfectly, body ideals are often very extreme and impossible to achieve.[8] Additionally, people with eating disorders have a disturbed image of their body, subjectively perceiving themselves as less attractive than they are.[9]

Affective

A negative image about one's own body is linked to several negative feelings or emotions, such as anxiety (of being judged about one's body), shame (about your own body), anger/ aggression (at yourself or others for looking the way they look) and fear (of becoming even less attractive).[10][11][12][13] Self-objectification theory can be used to explain these affective responses. People with body image disturbances often look at themselves from a third-person view, reducing their self-worth to the way they look. If their appearances do not match their expectations some or all of the above emotions can be experienced.[14]

Diagnosis

Body checking becomes problematic when it causes distress, has a negative impact on a person’s mood, causes withdrawal from social interactions, when it disrupts someone's daily functioning at work or outside of it. This can lead to an eating disorder or the worsening of an existing one. A healthcare provider can offer treatment recommendations to help with uncontrollable body checking behavior.[1] The diagnostic assessment for body checking includes asking about personal and family medical history and performing a physical exam. The healthcare provider can refer the person to a psychologist or psychiatrist for further assessment. These mental health professionals can then diagnose a patient with body dysmorphic disorder (BDD) by evaluating the person’s attitude, behavior, and symptoms.[15]

Treatments

Body checking is most commonly a symptom of eating disorders (ED) and body image disturbance (BID).[16] Treatments of EDs and BID involve treatments for body checking. Isolated research regarding body checking treatments without relating disorders is rare, as most individuals experience (severe) body checking in relation to their ED. Treatment of ED is mostly multidisciplinary, containing psychological as well as medical treatments.[17]

Treatments used with body checking are:

  • Psychotherapy can be used to treat eating disorders and symptoms such as body checking.[18][19][20][21]
  • Family therapy. Improvements of symptoms like body checking in people with EDs after family therapy have been shown in several cases, but there is little evidence yet for the effectiveness of family therapy on EDs.[22][23]
  • Cognitive behavioral therapy is a treatment that aims to teach how to recognise and change harmful thought patterns that lead to negative actions, such as body checking. Regarding EDs and BID, it focuses on reducing negative self-evaluation, body checking behaviour and self-objectification.[17]
  • Acceptance and commitment therapy. Pilot studies of acceptance and commitment therapy have shown significant increase in body satisfaction and decrease in body checking in trials with patients with BID.[24]
  • Mirror exposure entails organised exposure to body image, typically in forms of standing in front of a mirror. A study investigating in the effects of mirror exposure on BID found significant results regarding a decrease in body checking as a result of mirror exposure.[25]

References
  1. Stanborough RJ (16 October 2020). White MA (ed.). "Body Checking: What Is It and How Can You Stop?". Healthline. Retrieved 2022-05-18.
  2. "Body Checking: What is it and how do I stop?". Central Coast Treatment Center. Retrieved 2022-05-18.
  3. Ekern B (2020-10-30). "What is Body Checking and Why is it Dangerous?". Eating Disorder Hope. Retrieved 2022-05-18.
  4. Pono A. "What is Body Checking, Why is it Harmful, and How Do I Stop?". Hawaii Eating Disorder Treatment Center. Retrieved 2022-05-15.
  5. "Body Checking: What is it and how do I stop?". Central Coast Treatment Center. Retrieved 2022-05-15.
  6. Savin J (2020-10-14). "How to tell if you're body checking (you may not even realise you're doing it)". Cosmopolitan. Retrieved 2022-05-15.
  7. "Self-Discrepancy Theory and Body Image" (PDF). Retrieved 2022-05-15.
  8. Fardouly J, Vartanian LR (June 2016). "Social media and body image concerns: Current research and future directions". Current Opinion in Psychology. 9: 1–5. doi:10.1016/j.copsyc.2015.09.005.
  9. Mond JM, Hay PJ, Rodgers B, Owen C (May 2007). "Recurrent binge eating with and without the "undue influence of weight or shape on self-evaluation": implications for the diagnosis of binge eating disorder". Behaviour Research and Therapy. 45 (5): 929–938. doi:10.1016/j.brat.2006.08.011. PMID 17010307.
  10. Levinson CA, Rapp J, Riley EN (December 2014). "Addressing the fear of fat: extending imaginal exposure therapy for anxiety disorders to anorexia nervosa". Eating and Weight Disorders. 19 (4): 521–524. doi:10.1007/s40519-014-0115-6. PMC 4183728. PMID 24691784.
  11. Goss K, Allan S (July 2009). "Shame, pride and eating disorders". Clinical Psychology & Psychotherapy. 16 (4): 303–316. doi:10.1002/cpp.627. PMID 19639646.
  12. Kartal Yağız A, Kuğu N, Semiz M, Kavakçı Ö (2016). "[The Relationship Between Anger Expression, Body Image and Eating Attitudes in Social Anxiety Disorder]". Turk Psikiyatri Dergisi = Turkish Journal of Psychiatry (in Turkish). 27 (1): 15–22. PMID 27369681.
  13. Espeset EM, Gulliksen KS, Nordbø RH, Skårderud F, Holte A (November 2012). "The link between negative emotions and eating disorder behaviour in patients with anorexia nervosa". European Eating Disorders Review. 20 (6): 451–460. doi:10.1002/erv.2183. PMID 22696277.
  14. Calogero RM (2012). "Objectification Theory, Self-Objectification, and Body Image". Encyclopedia of Body Image and Human Appearance (PDF). pp. 574–580. doi:10.1016/B978-0-12-384925-0.00091-2. ISBN 9780123849250.
  15. "Body Dysmorphic Disorder: Symptoms, Causes, Diagnosis, Treatments". Cleveland Clinic. Retrieved 2022-05-17.
  16. Shafran R, Fairburn CG, Robinson P, Lask B (January 2004). "Body checking and its avoidance in eating disorders". The International Journal of Eating Disorders. 35 (1): 93–101. doi:10.1002/eat.10228. PMID 14705162.
  17. Delinsky SS, St Germain SA (2012), "Anorexia Nervosa", Encyclopedia of Body Image and Human Appearance, Elsevier, pp. 8–14, doi:10.1016/b978-0-12-384925-0.00002-x, ISBN 9780123849250
  18. Locher C, Meier S, Gaab J (March 2019). "Psychotherapy: A World of Meanings". Frontiers in Psychology. 10: 460. doi:10.3389/fpsyg.2019.00460. PMC 6448000. PMID 30984050.
  19. American Dietetic Association (December 2006). "Position of the American Dietetic Association: Nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and other eating disorders". Journal of the American Dietetic Association. 106 (12): 2073–2082. doi:10.1016/j.jada.2006.09.007. PMID 17186637.
  20. Gelin Z, Fuso S, Hendrick S, Cook-Darzens S, Simon Y (March 2015). "The effects of a multiple family therapy on adolescents with eating disorders: an outcome study". Family Process. 54 (1): 160–172. doi:10.1111/famp.12103. PMID 25243337.
  21. Wilson GT (July 1999). "Cognitive behavior therapy for eating disorders: progress and problems". Behaviour Research and Therapy. 37: S79–S95. doi:10.1016/S0005-7967(99)00051-0. PMID 10402697.
  22. Glenn E, Freeman DS (January 1993). "Multigenerational Family Therapy". Family Relations. 42 (1): 108. doi:10.2307/584934. ISSN 0197-6664. JSTOR 584934.
  23. Dare C, Eisler I, Russell G, Treasure J, Dodge L (March 2001). "Psychological therapies for adults with anorexia nervosa: randomised controlled trial of out-patient treatments". The British Journal of Psychiatry. 178 (3): 216–221. doi:10.1192/bjp.178.3.216. PMID 11230031. S2CID 9230712.
  24. Pearson AN, Follette VM, Hayes SC (February 2012). "A Pilot Study of Acceptance and Commitment Therapy as a Workshop Intervention for Body Dissatisfaction and Disordered Eating Attitudes". Cognitive and Behavioral Practice. 19 (1): 181–197. doi:10.1016/j.cbpra.2011.03.001. ISSN 1077-7229.
  25. Delinsky SS, Wilson GT (March 2006). "Mirror exposure for the treatment of body image disturbance". The International Journal of Eating Disorders. 39 (2): 108–116. doi:10.1002/eat.20207. PMID 16231342.
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