Anxiety matters: food exposure, weight exposure, and virtual body exposure in anorexia nervosa

Abstract Background Anxiety is a core characteristic of anorexia nervosa and a target of exposure therapy, which can be optimized if we know more about the emotional and behavioral responses during exposure to anorexia nervosa relevant fear stimuli. Methods We exposed patients with anorexia nervosa and healthy controls to anorexia nervosa related fear stimuli (food, eating, weighing, and various virtual bodies) in the laboratory, and tested whether the responses of patients changed after exposure treatment. Results Patients reported more anxiety, consumed less calories, and also reacted more negatively while imagining that virtual bodies of different weights were theirs than did healthy controls. After exposure treatment, patients reported less fears and they consumed more calories while their BMI had increased. They were also more accepting of healthier weights. Conclusions Exposure to food-, body- and weight-related stimuli in the laboratory induces emotional reactions in patients with anorexia nervosa that can be targeted during exposure therapy. Exposure therapy led to symptom reduction and is a promising intervention for the treatment of anorectic fears, but more research is needed to optimize its efficacy.