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“I’m Not Hungry:” Bodily Representations and Bodily Experiences in Anorexia Nervosa

Today's post is by Mara Floris on her recent paper "“I’m Not Hungry:” Bodily Representations and Bodily Experiences in Anorexia Nervosa" (Review of Philosophy and Psychology, 2024).

Anorexia Nervosa (AN) is a severe psychiatric disorder characterized by an intense fear of gaining weight, leading to extreme food restriction and a distorted perception of one’s own body. In our paper, we explore how individuals with AN experience significant alterations in two primary domains: bodily representations and bodily experiences.

Mara Floris

Bodily Representations and Perceptual Distortions
Bodily representations refer to the cognitive and perceptual processes that help us perceive and understand our body’s size, shape, and function. In individuals with AN, these representations are often distorted, leading to body image disturbances. These disturbances manifest as an overestimation of body size—patients with AN often perceive themselves as larger than they are. This misperception is not limited to their body alone but extends to how they view food, seeing it as more substantial than it is. We also discuss the potential cognitive factors influencing these perceptual distortions, positing that they might serve as a defense mechanism aimed at reinforcing the desire to maintain or reduce body weight.

Bodily Experiences and Interoceptive Awareness
In addition to altered bodily representations, individuals with AN experience significant changes in bodily awareness and interoceptive sensitivity—how they perceive internal bodily signals such as hunger, fullness, and pain. These individuals often report a heightened sense of being "full" after consuming minimal amounts of food and experience difficulty recognizing and interpreting hunger signals. This altered interoceptive awareness might contribute to the suppression of appetite and reinforce restrictive eating behaviors. Moreover, there is a connection between interoceptive deficits and emotional dysregulation in AN, as difficulties in identifying internal states may impair emotional processing and regulation.

Cognitive Penetrability of Perception (CPP)
Our paper also delves into the philosophical debate on the Cognitive Penetrability of Perception (CPP), which posits that our beliefs, desires, and mental states can influence how we perceive sensory information. We propose that the perceptual distortions seen in AN could provide empirical evidence for CPP. For instance, the belief that "eating will make me fat" could directly impact how individuals with AN perceive their body size and the size of food portions. This interplay between cognition and perception suggests that higher-order cognitive processes might penetrate perceptual experiences in individuals with AN, leading to altered bodily representations and experiences.

Implications and Future Directions
Understanding these altered perceptions and experiences is crucial for developing more effective interventions for AN. By recognizing that these distortions are not merely cognitive or emotional but are rooted in perceptual experiences, clinicians can better tailor their approaches to address these core psychopathological features. Future research should continue to explore the multisensory nature of body perception in AN and investigate how cognitive processes influence these perceptions. Additionally, there is a need for more studies on the temporal onset of these distortions to better understand whether they precede or are a consequence of the development of AN.

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