A pilot body image intervention programme for in-patients with eating disorders in an NHS setting

Background: Body image distortion, a distressing problem that precipitates eating disorders, remains a struggle for patients after other symptoms are controlled. Despite a strong physical aspect there is little recognition of physiotherapy intervention. This study aims to assess the effect of a tailored physiotherapy intervention programme for patients with eating disorders in an NHS in-patient unit. Methods: The intervention programme, targeted at known, potentially modifiable factors relevant to body image distortion in 7 patients, used touch, massage, drawing exercises and listening skills. Patients received 8 to 38 sessions determined by length of stay on the unit. Self-drawings were completed at each session and a body shape questionnaire (BSQ-34) and a self-assessment silhouette scale in the first and last sessions. Findings: Self-drawings showed improved comparative proportions of body areas. Initial silhouette scores of more than 5 out of 10 reduced to less than five. There was a reduction in BSQ-34 questionnaire scores for all patients, and to less than half for 3. Conclusions: This pilot study suggests that a tailored programme based on principles of physiotherapy can help to improve body image perception and satisfaction. It draws attention to the potential of physiotherapy intervention programmes in the UK.