Drug Treatment of Body Image Disturbance in Mental Disorders

No drug has an approved indication for eating disorders and body dysmorphic disorder with the exception of fluoxetine for bulimia nervosa (BN) and lisdexamfetamine for binge eating disorder (BED). This chapter reviews the studies which explicitly reported body image disturbance or body image dissatisfaction as primary or secondary measures of outcome. The clinical target of ameliorating body image disturbance with drugs may be realistically reached in BN and body dysmorphic disorder (BDD), while is less convincing in anorexia nervosa (AN), where drugs are hardly useful, and in BED. The model of BDD may suggest that higher dosages of selective serotonin reuptake inhibitors (SSRI) than those usually recommended may be helpful. In any case, we know that body image disturbance is particularly resistant to therapy, and thus it can probably be faced with a combined treatment where psychotherapy has an essential role.