Body image is a complex construct, often used in the clinical context of describing a patient's cognitive perception of their own body. The medical concept began with the work of the Austrian neuropsychiatrist and psychoanalyst

Paul Schilder Paul Ferdinand Schilder (February 15, 1886, Vienna – December 7, 1940, New York City) was an Austrian psychiatrist, psychoanalyst, and medical researcher. Schilder's research work in both neurophysiology and neuropathology, coupled with an activ ...

, described in his book ''The Image and Appearance of the Human Body'' first published in 1935. The term "body image" was officially introduced by Schilder himself and his widely used definition is: “body image is the picture of our own body we form in our mind, that is to say the way in which the body appears to ourselves”. In research with the term “body image” we currently refer to a conscious mental representation of one’s own body, which involves affects, attitudes, perceptual components and cognition. On the contrary, the term "

body schema Body schema is an organism's internal model of its own body, including the position of its limbs. The neurologist Henry Head, Sir Henry Head originally defined it as a postural model of the body that actively organizes and modifies 'the impressions ...

" was initially used to describe an unconscious body mental representation fundamental for action. Keizer and colleagues (2013) suggest the following definition: " ody schema isan unconscious, sensorimotor, representation of the body that is invoked in action". In light of recent scientific developments regarding the

multisensory integration Multisensory integration, also known as multimodal integration, is the study of how information from the different sensory modality, sensory modalities (such as sight, sound, touch, smell, self-motion, and taste) may be integrated by the nervous sy ...

of body sensations, the distinction between body image and body schema appears simplistic and probably no longer useful for scientific research and clinical purposes. Engaging in social comparisons, particularly upward comparisons to individuals perceived as superior, can negatively affect self-evaluations and body image. Research indicates that exposure to idealized media images, such as models embodying cultural beauty standards, often leads to unfavorable body-image outcomes. Specifically for women, who are more likely to engage in upward appearance comparisons. Individual differences play a crucial role in which appearance comparison tendencies occur. Identifying modifiable risk factors linked to appearance comparisons is crucial for reducing their frequency and preventing body dissatisfaction. The Identity Disruption Model suggests that early adverse experiences, such as abuse or neglect, can disrupt identity development, leading to low self-concept clarity and an increased tendency to compare oneself to others.

Clinical significance

In the clinical setting, body image disturbances are relatively frequent and involve both psychiatric and neurological disorders. Disturbances in the perception of one's body are present in psychiatric disorders such as: *

anorexia nervosa Anorexia nervosa (AN), often referred to simply as anorexia, is an eating disorder characterized by Calorie restriction, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. Individuals wit ...

bulimia nervosa Bulimia nervosa, also known simply as bulimia, is an eating disorder characterized by binge eating (eating large quantities of food in a short period of time, often feeling out of control) followed by compensatory behaviors, such as self-indu ...

binge eating disorder Binge eating disorder (BED) is an eating disorder characterized by frequent and recurrent binge eating episodes with associated negative psychological and social problems, but without the compensatory behaviors common to bulimia nervosa, OSFE ...

* psychotic spectrum disorders *

body dysmorphic disorder Body dysmorphic disorder (BDD), also known in some contexts as dysmorphophobia, is a mental disorder defined by an overwhelming preoccupation with a perceived flaw in one's physical appearance. In BDD's delusional variant, the flaw is imagined ...

body integrity dysphoria Body integrity dysphoria (BID), also referred to as body integrity identity disorder (BIID), amputee identity disorder or xenomelia, and formerly called apotemnophilia, is a rare mental disorder characterized by a desire to have a sensory or ...

(not included in

DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiat ...

). *

Cotard's syndrome Cotard's syndrome, also known as Cotard's delusion or walking corpse syndrome, is a rare mental disorder in which the affected person holds the delusional belief that they are deceased, do not exist, are putrefying, or have lost their blood or i ...

Body image disorders are common in eating disorders and are referred to as "

body image disturbance Body image disturbance (BID) is a common symptom in patients with eating disorders and is characterized by an altered Body image, perception of one's own body. The onset is mainly attributed to patients with anorexia nervosa who persistently t ...

". Disturbances in the body image are also present in neurological conditions such as: *

somatoparaphrenia Somatoparaphrenia is a type of monothematic delusion where one denies ownership of a limb or an entire side of one's body. Even if provided with undeniable proof that the limb belongs to and is attached to their own body, the patient produces elab ...

unilateral neglect Hemispatial neglect is a neuropsychological condition in which, after damage to one hemisphere of the brain (e.g. after a stroke), a deficit in attention and awareness towards the side of space opposite brain damage (contralesional space) is obse ...

Alice in Wonderland syndrome Alice in Wonderland Syndrome (AIWS), also known as Todd's Syndrome or Dysmetropsia, is a neurological disorder that distorts perception. People with this syndrome may experience distortions in their visual perception of objects, such as appear ...

Measurements

Attempts by researchers to measure variances in body image include the FAI index, developed in a 2014 study (Zaccagni 2014). The FAI (feel-status minus actual-status inconsistency) index is used to assess someone's weight perception. FAI scores range from -3 to +3: Negative FAI values mean weight status underestimation, positive FAI values mean weight status overestimation and a FAI score of 0 means a realistic perception of one's weight status. The study found that women tend to have positive FAI values (overestimating their weight) while men had negative FAI values (underestimating their weight). Further studies have used the FAI index to study body image among natives and immigrants in Italy and North Africa. Another study (Zaccagni 2020) developed a refined version of the FAI index, called the FAI^FAT index. This index (feel-fat-status minus actual-fat-status inconsistency) was meant to address possible fat status perception inconsistencies by

bioelectrical impedance analysis Bioelectrical impedance analysis (BIA) is a method for estimating body composition, in particular body fat and muscle mass, where a weak electric current flows through the body, and the voltage is measured in order to calculate impedance ( resist ...

(BIA).

References

{{Reflist13. Vartanian, L. R., Pinkus, R. T., & Fardouly, J. (2025). ''Self-concept clarity and appearance comparisons in everyday life''. ''Body Image An International Journal of Research'', 52 Medical terminology Symptoms and signs of mental disorders Neurology Neuroscience

Clinical significance

Measurements

See also

References