An fMRI investigation of emotional processing of body shape in bulimia nervosa

Objective: Cognitive‐behavioral theories of eating disorder etiology emphasize the role of body‐oriented self‐schemas. Examination of brain regions associated with self‐referencing, such as medial prefrontal cortex (mPFC), during processing of body‐related stimuli can thus be utilized to evaluate such theories. Method: Twelve women with bulima nervosa (BN) and 12 comparison women underwent functional brain imaging while viewing images of women with either thin or overweight bodies in a self‐referencing context. Results: For thin bodies, there was no significant mPFC activation for either group. For overweight bodies, mPFC activation was significantly greater for BN patients, with a focus in subregions associated with emotional processing. Discussion: These findings are consistent with cognitive models of eating disorders which posit that negative body‐related stimuli are more central to self‐schemas and more emotionally provocative in persons with eating disorders, lending support to treatment and prevention interventions that emphasize body overvaluation as a primary target of change. © 2011 by Wiley Periodicals,Inc. (Int J Eat Disord 2012)