Involvement of adverse life events in body image distortion in a patient with eating disorders

Adverse life events (ALEs), particularly interpersonal ALEs and those experienced during childhood are associated with adult psychopathology. Altered eating behaviors and body image distortion (BID) have been reported in maltreated children. This study aimed to evaluate the presence of interpersonal ALEs before the age of 13 years in patients with eating disorders (ED) and clarify its relationship with BID. This observational case–control study comprised the ED group, including 79 outpatients with ED, and two control groups, including 20 outpatients with depressive disorder and 41 participants with no history of mental illness. The presence of ALEs was determined using the Traumatic Events Questionnaire. To assess BID, the contouring drawing rate scale was used, and visual BID was distinguished from non-visual BID. Data were collected and processed using Statistical Package for Social Sciences v28. All tests were two-tailed (significance level of 0.05). Patients with ED had a higher proportion of interpersonal ALEs during childhood (P = 0.065). In the ED group, patients with interpersonal ALEs during childhood overestimated their shape (P = 0.021). The non-visual BID was significantly higher in patients with childhood ALEs. In a logistic regression model, the presence of interpersonal ALEs during childhood as an independent variable predicted visual and non-visual BID in patients with ED. During the estimation of body shape, it appears that the negative emotions experienced during childhood are shifted to the body shape itself. Thus, the BID experienced is attributed more to the unresolved emotions of the maltreated individuals than to the social pressures experienced.