Body checking and avoidance in low weight and weight restored individuals with anorexia nervosa and non-clinical females

• We explore levels of body image anxiety, checking and avoidance in anorexia nervosa.
• We compare clinical and non-clinical samples at different weights.
• Anorexia, at all weights, showed more behavioural and affective body dissatisfaction.
• Anorexia at lower weights exhibited more avoidance and less anxiety.
• There were no differences in body checking behaviours at different weights.

Body dissatisfaction (BD) is central to the development, maintenance and relapse of anorexia nervosa (AN). BD has been conceptualized as a multi-dimensional construct incorporating behaviours, cognitions and affect, yet little is known about the impact of weight and disordered eating on these aspects. 56 ‘below DSM-IV weight criteria for AN’ (< BMI 17.5 kg/m2) and 44 ‘above DSM-IV weight criteria for AN’ (> BMI 17.5 kg/m2) individuals currently receiving treatment for an eating disorder, and 60 non-eating disordered females completed the Body Checking Scale, Body Image Avoidance Questionnaire and the Body Image Anxiety Questionnaire. As expected, females diagnosed with AN showed significantly more behavioural and affective body dissatisfaction than the control group. Patients at lower weights showed significantly more avoidance behaviours and less body image anxiety than those with anorexia at higher weights. No difference was seen in checking behaviours between these groups. Weight based differences in avoidance behaviours continued to exist even when the effects of anxiety were controlled for. Affective and behavioural aspects of BD should be considered in clinical practice at all stages of treatment.