Body Image Disturbance and Binge Eating Andrea S. Hartmann, Merle Lewer, and Silja Vocks Abstract Body image disturbance is one of the diag- nostic criteria for anorexia and bulimia nervosa, but not for binge-eating disorder (BED). Nevertheless, a disturbed body image is also present in patients with BED. In particular, the cognitive-affective compo- nent of body image disturbance, which encompasses overvaluation of shape and weight, body dissatisfaction, and dysfunc- tional body-related information processing, is more pronounced in individuals with BED than in weight-matched controls. There is no evidence regarding a perceptual body image disturbance, and findings on body-checking and avoidance behaviors are inconclusive with respect to whether these characteristics are associated with BED rather than with obe- sity. However, not only BED, but also other eating disorders, which feature binge eating behavior, i.e., bulimia nervosa and the binge eating/purging subtype of anorexia nervosa, are characterized by dysfunctions in these body image facets. In sum, body image dis- turbance might be a worthwhile treatment tar- get, and initial research has illustrated the efficacy of body image-related interventions in patients with BED or binge eating behav- ior. However, future studies are warranted to investigate the add-on effects of body image- related interventions to existing state-of-the- art treatments and to identify subgroups of individuals with BED or binge eating who benefit the most from these treatments. Keywords Body image disturbance · Body size perception · Body image dissatisfaction · Body-related cognitive biases · Weight and shape concern · Checking and avoidance behavior Learning Objectives In this chapter, you will: • Learn about the relevance of body image disturbance to binge eating-related psychopathology. • Gain an overview of the different components of body image disturbance and their association with binge eating (disorder). • Identify how body image disturbance can be tackled therapeutically. A. S. Hartmann · S. Vocks (*) Section of Clinical Psychology and Psychotherapy, Institute of Psychology, Department of Human Sciences, Osnabrück University, Osnabrück, Germany e-mail: andrea.hartmann@uni-osnabrueck.de; silja. vocks@uni-osnabrueck.de M. Lewer Mental Health Research and Treatment Center, Ruhr- University Bochum, Bochum, Germany e-mail: merle.lewer@ruhr-uni-bochum.de # Springer Nature Switzerland AG 2020 G. K.W. Frank, L. A. Berner (eds.), Binge Eating, https://doi.org/10.1007/978-3-030-43562-2_13 181