“To Your Eyes my Body is Perfect, but I Want to Disappear”. The Effect of Body Image Shame on the Relation Between Perfectionistic Self-Presentation and Body Checking-Avoidance After Recovery From Eating Disorders.

Abstract

Eating disorders (EDs) are severe psychopathologies associated with higher relapse rates, compared to other DSM-5 diagnoses. Body image disturbances play an important role in the maintenance of EDs. These manifest in behavioural and psychological symptoms following recovery, such as body checking-avoidance and perfectionistic self-presentation. However, the mechanisms by which these variables operate after recovery are unclear. Therefore, the present research aimed to test a mediation model for ED symptoms involving perfectionistic-self presentation, body checking avoidance, and the mediator body image shame. Fifty-three women recovered from EDs (MBMI = 21.88; SD = 2.88), aged between 18 and 50 years completed self-report measures via an online survey which included standardized measures of eating pathologies, perfectionistic self-presentation, shame and body checking-avoidance. Findings indicate that perfectionistic self-presentation and shame are strongly associated with body checking-avoidance. In line with the hypothesis, results also show that body image shame is a significant mediator in the relation between perfectionistic self-presentation and body checking-avoidance and thus, constitutes a key maintaining factor of body checking-avoidance behaviours. Overall, these findings have important implications for clinical practice since they point toward the need to revise the current first-line intervention programmes to include modules that besides focusing on healthy BMI restoration also address the psychological and behavioural factors that maintain EDs.