Clinique des Maladies Mentales et de l'Encéphale (CMME), Hôpital Sainte-Anne, GHU Paris Psychiatrie et Neurosciences, 75014 Paris, France.
Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Université Paris Cité, 75006 Paris, France.
Nutrients. 2022 Oct 26;14(21):4507. doi: 10.3390/nu14214507.
Introduction: Body image distortion is a core symptom of anorexia nervosa (AN), embodying dissatisfaction and overvaluation of body appearance and weight. Body image distortion is an important factor in the maintenance of weight loss behaviours such as compulsive physical exercise. Conversely, physical exercise seems to have an aggravating effect on body image in patients with AN, but the evidence is still poor. The aim of this study was to examine the relationship between body image distortion and physical exercise in AN in order to understand whether physical exercise may play a specific role in body image distortion beyond psychopathological severity. Methods: Forty patients with AN and 21 healthy controls were tested for body image distortion and different proxies of physical exercise. Univariate correlations tested the relationship between body image distortion and physical exercise in AN and control groups. Then, to experimentally assess the effect of exercise on body image distortion, participants were invited to rate their body image before and after a standardised effort test. Results: In the AN group, a correlation was found between physical activity and body image distortion (p < 0.01), which was still significant after controlling for psychopathological severity. No correlation was found in healthy controls. After a standardised effort, patients with AN had higher increases in body image distortion than healthy controls (almost 4 kg/m2 vs. 0.8 kg/m2) (p < 0.01). Discussion: Physical exercise may contribute to the distortion of body image in anorexia nervosa and explain the paradoxical augmentation of unhealthy exercise despite ongoing weight loss.
身体意象扭曲是神经性厌食症（AN）的核心症状，体现了对身体外貌和体重的不满和高估。身体意象扭曲是维持强迫性体育锻炼等减肥行为的重要因素。相反，体育锻炼似乎对 AN 患者的身体意象有加重作用，但证据仍不足。本研究旨在探讨 AN 中身体意象扭曲与体育锻炼之间的关系，以了解体育锻炼是否可能在心理病理严重程度之外对身体意象扭曲起到特定作用。
对 40 名 AN 患者和 21 名健康对照者进行身体意象扭曲和不同体育锻炼指标的检测。单变量相关性检验了 AN 组和对照组中身体意象扭曲与体育锻炼之间的关系。然后，为了实验评估锻炼对身体意象扭曲的影响，邀请参与者在标准努力测试前后对自己的身体意象进行评分。
在 AN 组中，发现身体活动与身体意象扭曲之间存在相关性（p<0.01），在控制心理病理严重程度后仍具有统计学意义。在健康对照组中未发现相关性。在标准努力后，与健康对照组相比，AN 患者的身体意象扭曲增加更多（几乎 4kg/m2 与 0.8kg/m2）（p<0.01）。
体育锻炼可能导致 AN 中身体意象扭曲，并解释了尽管持续体重减轻，但不健康锻炼仍增加的悖论。
