Adjunctive graded body image exposure for eating disorders: A randomized controlled initial trial in clinical practice

Objective Graded body image exposure is a key component of CBT for eating disorders (EDs). However, despite being a highly anxiety-provoking intervention, its specific effectiveness is unknown. The aims of this initial study were to investigate the feasibility and preliminary effectiveness of individualized graded body image exposure to a range of feared/avoided body image-related situations in a sample of partially remitted ED patients. Method Forty-five female adult participants were randomly assigned to maintenance treatment as usual (MTAU) only or MTAU plus five sessions of graded body image exposure. Results The graded body image exposure intervention led to large improvements in body avoidance as measured by two different methods. In addition, there was evidence of a significant impact of body image exposure on the overvaluation of shape, but not weight, 5 months after treatment. Discussion Taken together, the current results provide evidence of the feasibility of adjunctive individualized graded body image exposure within a clinical treatment program and suggest that graded body image exposure reduces body avoidance behaviors in partially remitted ED patients. Our findings suggest that individualized graded body image exposure shows promise as an intervention targeting the overvaluation of shape in EDs. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:494–504)