The Unbearable Weight on Your Mind: The Physiological Dimension of Body Image Disturbances

The ideal body, according to Western society's standards of physical appearance, has become increasingly thinner. Body image disturbances, a phenomenon often associated with today's society's standards of thinness, are common among obese and eating-disordered subjects, and have recently been documented in normal weight subjects. The aim of this review is to propose a new biological interpretation of body image disturbances, not presenting them as a mere consequence of society's pressure to be thin, but as a result of body weight regulation. Early in life, a "set-point-related body image" that may be described as a schematized representation of one's body weight set-point, would be created by the central nervous system. This unconscious representation of one's body size and mass, would later act as an internal reference in processing weight relevant information. External cues concerning body weight (e.g. visual information regarding one's body shape) as well as internal cues (e.g. moving one's body against gravity) would both be compared, by the central nervous system, to the set-point-related body image. A difference between actual body size and setpoint-related body image could generate an "error signal" that would lead to body image disturbances. These disturbances, reflecting the error signal of the regulatory system, would in turn trigger corrective metabolic and behavioral mechanisms working to return body weight to set-point.