A pilot study into the body image perception of eating disorders (ED) patients has championed the innovative use of three-dimensional (3D) laser scanning, highlighting that it could offer the basis for new treatment interventions.
The study has been carried out in collaboration between Robert Gordon University, the University of Aberdeen and the NHS Grampian Eating Disorder Service (NGEDS).
The team undertook the study with a group of female EDS outpatients suffering from Anorexia Nervosa (AN), Bulimia Nervosa (BN), Eating Disorders Not otherwise specified (EDNOS) and a control group. Both 2D digital photography – which is widely used in the treatment of ED patients today – and 3D scanning were used.
Dr Arthur Stewart, of the Centre for Obesity Research and Epidemiology (CORE) from RGU’s Institute for Health and Welfare Research, was the principal researcher of this pilot study, which was funded by the Chief Scientist Office and has recently been published in the British Journal of Psychology.
The study aimed to test the acceptability among ED patients to participate in 3D scanning, and to acquire novel data on the comparison between 2D imaging (measuring area from the frontal view only as is standard in current practice) and 3D scanning (measuring volume of all aspects of the body) and the corresponding 2D assessment of perception and dissatisfaction of patient body image.
The researchers found that the volume-area relationships differ between AN, BN and control groups and concluded that treatment tools based on 2D representations might fail to completely depict the true size of specific body regions.
Dr Stewart explained: “All existing methods for estimating perception accuracy or body dissatisfaction are based on 2D images, and the literature abounds with poorer estimations such as line drawings or silhouettes which are not specific to the patient in question.
“Quantifying body shape via 3D scanning could offer a highly robust scientific platform from which to establish which body regions patients are dissatisfied with and so develop the basis for new treatment interventions of EDs.”
The pilot also sought to investigate the willingness of patients to be scanned. Of the 71% of patients who agreed to be scanned, none failed to complete the procedure. As such, compliance among patients was considered high, despite patients’ anxiety due to their body image issues.
Mindful of the limitation of this pilot study, Dr Stewart added: “Although 3D scanning holds the promise for being a better technique because it more fully represents the actual person in question, the process of patients confronting actual 3D representations of themselves is likely to make those with body image issues anxious. In addition, software approaches for assessing perception or dissatisfaction using a 3D shape (as opposed to a 2D photograph) are infinitely more complex.
“3D scanning does not measure perception or dissatisfaction but merely captures 3D shape accurately. However, we know that ED patients do not see their own shape accurately, and we have used 3D modelling software to create an ‘orbit camera’ view of the person which will enable visual appraisal of 3D shape to be possible. This is what we aim to establish in the current phase of the study in a therapeutic setting.”
“When we have learned from the patients’ experience of this, we will be able to design a clinical trial which investigates the value of this new approach in treating ED patients involving other centres across Scotland and beyond. The feasibility of introducing this novel approach to the treatment of ED patients, is likely to be assisted by the reducing cost and increasing resolution of portable 3D scanners.”
Commenting on the value of continued research into the treatment of eating disorders, Dr Stewart concluded: “The evaluation and treatment of body image disturbance is recognised as being very important to the effectiveness of ED treatment programmes. As the obesity epidemic continues, the media perpetuates stereotypical ideals of body shapes which are unattainable for the vast majority of people. As a result, body image concerns remain of great clinical importance, and the incidence of eating disorders is likely to increase in the future. We sincerely hope our efforts to bring 21st century technology to bear on the problem might yield part of the solution for some of these patients.”
Dr Arthur Stewart was interviewed about the pilot study on BBC Radio 4’s All in the Mind on Tuesday 22 May, 2100 GMT (repeated on Wednesday 23 May 1530 GMT). The interviewed can be listened to online at: http://www.bbc.co.uk/programmes/b01hxh7b
High resolution images of Dr Arthur Stewart operating the 3D scanner at Robert Gordon University are available from Andrew Youngson on request.
Notes to Editors:
The study was carried out in collaboration between:
- Centre for Obesity Research and Epidemiology - Robert Gordon University
- Aberdeen Centre for Trauma Research - Robert Gordon University
- School of Psychology – University of Aberdeen
- NHS Grampian Eating Disorder Service – Royal Cornhill Hospital
- Medical Statistics Team, Section of Population Health – University of Aberdeen
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