Body-image distortion in anorexia nervosa

Findings from an increasing number of functional MRI (fMRI) studies, conducted (based on the symptom provocation paradigm) over the past 15 years and recently reviewed, provide valuable insights into the neural basis of BID in AN. The neural bases of the affective component of BID in AN support an altered emotional response to unpleasant (for example, self-distorted fat image) stimuli. Furthermore, in the few available fMRI studies based on a word paradigm a variation in amygdala response was absent — making the involvement of this brain region less clear but suggesting the greater relevance of self-perception and the mechanism of body image construction. Collectively, we now have a rich conceptual framework and empirical data for understanding BID in AN, but also a set of open questions that could provide further contributions to the knowledge of its complexity and valuable insights to further improve the effectiveness of existing prevention and psychotherapeutic interventions.