Mindful Mirror Exposure in the Treatment of Eating Disordered Patients

Eating disorders are generally viewed as severe psychiatric disorders that
typically affect girls and young women, and tend to develop into chronic
conditions. Body image disturbance is a core diagnostic feature, as well as a
robust risk factor for the development of eating disorders and a predictor of
relapse.
A specific treatment intervention targeting body image is body exposure by
means of mirror confrontation. The results of a single (controlled) trial,
concerning the outcome of mirror exposure treatment for a population of eating
disordered patients, are promising. However, as some authors suggest, there may
be a negative impact on mood an self-esteem. Therefore further studies on this
subject are warranted. Especially in the case of anorexia nervosa, a disease
still lacking a 'treatment of choice' due to weak evidence for efficiacy of
avialable treatments.

Primary objective: to determine the effect of Mindful MirrorExposure in the
treatment of eating disordered patients.

RCT

A group of patients recieving treatment as usual (TAU) for the duration of six
months will be compared to an intervention group that receives TAU for six
months also, but with added Mindful MirrorExposure (MME) within the first three
months.
MME involves 8, individual, weekly sessions during which the subject is placed
in front of a full-lenght mirror, and is instructed to observe her body, to
describe it, from head to toe, and to be nonjudgmental. The goal of the
intervention is to reduce body-anxiety, and to promote body-acceptance.

Filling in short psychological questionnaires (3x50 min. in total) and
measurements of lenght and weight will place a mild burden on patients.
Weighing the available evidence it is most likely that patients will benefit
from this intervention, with regards to body image, body anxiety and
self-esteem. A negative impact on mood and self-esteem is conceivable, but
expected to be mild to moderate (taking the specifity of the intervention into
account) and well manageable within the context of a specialized eating
disorders unit with well-trained staff. Considering that the disorder mostly
affects girls and young women - the incidence of anorexia nervosa in the
Netherlands appears to be increasing- it's of vital importance to include
minors in the research population, making the results of the study as well as
subsequent treatment recommendations applicable to this group of young
patients, so they too may benefit.