Mirror Exposure Therapy for the Treatment of Body Image Disturbances in Eating Disorders: Evidence, Modes of Action, Approaches

Body image problems are a core feature of eating disorders. Therefore, improving body image is considered a central therapeutic goal in treating eating disorders. Various empirical findings point to mirror exposure as an effective means to reduce body-image disturbances. This review article presents the current state of the scientific literature on mirror exposure therapy for eating disorders. In particular, we systematically review efficacy studies separately for nonclinical, body-dissatisfied groups of patients with and without obesity as well as for different eating-disorder groups. Furthermore, we discuss different approaches to mirror exposure in detail. The review article provides evidence that mirror exposure therapy leads to positive changes regarding the cognitive-affective and behavioral components of body image in high-risk groups of persons with increased body dissatisfaction as well as in groups of patients with eating disorders. However, there is an overall lack of randomized-controlled trials that examine the efficacy of mirror exposure therapy with sufficiently large samples - particularly with anorexia nervosa. The article concludes with a discussion of possible modes of action, (contra) indications, and an outlook for future research.