Body image flexibility and embodiment in eating disorders: a mixed-methods approach combining network analysis and pilot exposure protocol

Objective: Body image (BI) disturbances are central to the psychopathology of eating disorders (EDs), where body dissatisfaction and disembodiment often co-occur, exacerbating negative body image experiences. We aimed to examine body image flexibility and embodiment in women with EDs and a general population (GP) sample. Method: Data were collected from 172 participants, including 103 GP women and 69 women with EDs. Standardized questionnaires measuring body uneasiness, interoceptive awareness, and body image acceptance were administered. Additionally, a pilot group therapy intervention targeting body image concerns was evaluated with 24 ED participants. Results: Findings suggest that significant differences in embodiment-related features emerged (self-regulation and body trust), while both groups reported similar levels of interoceptive awareness. Network analysis revealed distinct patterns of partial correlations between variables within each group, with higher centrality for body image concerns and weight phobia in EDs. In contrast, the GP group exhibited stronger connections between embodiment features such as attention regulation and body image acceptance. The pilot intervention showed promise in improving body image flexibility and reducing body image concerns. Conclusions: These results underscore the importance of fostering body image flexibility and embodiment in the clinical treatment of EDs, suggesting potential pathways for enhancing therapeutic interventions.