Short-term functions and long-term consequences of body checking as a transdiagnostic phenomenon across eating disorders, body dysmorphic disorder, and illness anxiety disorder : a systematic review

Abstract

Body checking refers to the repeated evaluation of one’s own body. As a safety mechanism, it is prevalent in various mental disorders, including eating disorders, body dysmorphic disorder, and illness anxiety disorder. While the type and manner of body checking behavior may differ between these disorders, cognitive-behavioral models highlight similar mechanisms underlying this behavior. According to the models, body checking is assumed to arise in response to negative affect, offer immediate relief, and increase psychopathology in the longer term as a mechanism of negative reinforcement. The objective of this review is to empirically evaluate these assumptions for eating disorders, body dysmorphic disorder, and illness anxiety disorder. Therefore, we conducted a systematic literature review across four electronic databases, with N = 43 studies meeting the inclusion criteria. The assumption that body checking occurs in response to negative affect was supported. However, findings regarding its short- and long-term role in maintaining negative affect were inconsistent. Therefore, our results may suggest the need to re-evaluate the etiologically proposed negative reinforcement mechanism of body checking in eating disorders, body dysmorphic disorder, and illness anxiety disorder. To facilitate the interpretation of study findings, future studies should distinguish between short- and long-term effects of body checking.