Neuroscience, Brain Imaging, and Body Image in Eating and Weight Disorders

Several neuroimaging studies have explored structural and functional brain differences in eating and weight disorders (EWDs). Some of them have focused on body image disturbance to elucidate neural correlates of this puzzling feature of EWD patients. To date, the neuroimaging technique most frequently used in EWDs is magnetic resonance imaging (MRI), and the majority of the neuroimaging studies have investigated anorexia nervosa (AN). Overall, it can be assumed that posterior parietal areas, insula, prefrontal cortex, and EBA have a specific and interconnected role in body image distortion in AN. Insula alterations have also been found in bulimia nervosa and obese patients. The areas mentioned above are involved in visual body perception and body awareness in healthy subjects. In particular, event-related fMRI studies, using body-related tasks, and resting-state MRI studies have mainly shown that the alterations of the posterior parietal areas seem to be related to altered visual body perception and the insula alterations seem to be involved in altered body awareness and negative attitudes towards the body. Interestingly, structural MRI studies have also found grey and white matter vulnerability in the posterior parietal areas in AN patients. Neural correlates of body image distortion remain poorly investigated in bulimia nervosa, binge-eating disorder, and obesity. More neuroimaging research is needed to improve our knowledge of the neural correlates of body image distortion in EWDs and enhance the efficacy of the extant treatment approaches and strategies for EWDs. In particular, further neuroimaging studies should also explore spatial reference frames in EWDs.