A Pilot Clinical Case Series of Functionality-Focused Mirror Exposure in Women With Clinically Elevated Body Dissatisfaction

Body dissatisfaction is a robust risk factor for eating disorders (EDs) and body dysmorphic disorder (BDD) and is associated with decreased quality of life. Current gold-standard ED treatments often do not fully address body dissatisfaction, which may leave patients vulnerable to relapse following treatment. Mirror exposure (ME) is one evidence-based strategy shown to reduce body dissatisfaction in EDs and BDD. However, the potential of integrating this strategy with other interventions demonstrated to reduce body dissatisfaction, such as focusing on the body's functionality, remains unexplored in ED samples. This article describes the development of a novel body functionality-focused ME (FME). We describe the development and structure of the novel ME, and a pilot test for its benefits in treatment through a clinical case series of four individuals with clinically elevated body dissatisfaction and/or EDs who were receiving concurrent cognitive behavioral therapy. All four patients demonstrated clinically meaningful improvements in state body satisfaction, body checking, and body image avoidance from pretreatment to posttreatment, with nonsignificant improvements evident at longer follow-up durations (which varied across patients). Additional randomized controlled treatment research is needed to determine whether FME may improve efficacy or reduce relapse rates compared to traditional cognitive behavior therapy for body dissatisfaction and EDs.