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Persistent Body Image Disturbance — MRCPsych Paper B MCQ

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ModerateEating DisordersPersistent Body Image DisturbanceMRCPsych Paper B

A 24-year-old woman with anorexia nervosa has completed nutritional rehabilitation. Her weight has remained within a healthy range for 8 weeks, and her physical observations and blood tests are normal. However, she continues to overestimate her body size, repeatedly checks her abdomen and experiences intense fear of further weight gain. Which statement best describes this presentation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Body-image disturbance may persist after weight restoration and requires continued eating-disorder-focused psychological treatment

Explanation lettering: C = shown as B · D = shown as C · B = shown as D

B is correct. Weight restoration is necessary for recovery from anorexia nervosa but does not itself establish full psychological recovery. The continuing overestimation, body checking and fear of weight gain demonstrate residual body-image disturbance, which can remain prominent after physical restoration and should be addressed through ongoing eating-disorder-focused psychological treatment. NICE recommends that CBT-ED address body-image concern, maintaining processes and relapse prevention. A and C incorrectly equate a healthy weight with resolution of the eating-disorder psychopathology. D is incorrect because medication should not be used as the sole or primary treatment for anorexia nervosa. E is too absolute: persistent psychological symptoms do not mean nutritional rehabilitation has failed, although they indicate that treatment and monitoring should continue.

Reference: Croce SR et al. Examining Facets of Body Image Disturbance Across Anorexia Nervosa Illness and Recovery Stages. European Eating Disorders Review. 2026. https://pubmed.ncbi.nlm.nih.gov/41919673/