High Rates of Body Image Dissatisfaction Shown in Patients With Epilepsy

Body image dissatisfaction was shown to be the strongest unique contributor for poor quality of life in patients with epilepsy, signaling the potential need for targeted psychological treatments.

Body image dissatisfaction, a marker for reduced quality of life (QOL), showed elevated levels of prevalence among adults with epilepsy, according to study findings published in Epilepsy & Behavior.

As a known risk factor for reduced QOL, epilepsy and its treatments have been shown to cause physical changes in patients (eg, skin rashes, unwanted weight changes) that can then lead to detrimental physiological outcomes such as embarressment, self-consciousness, and body dysmorphia.

“Although related to self-esteem, body image chiefly concerns how we subjectively see our physical bodies—good and bad. Body image dissatisfaction comprises unhappy, unrealistic, and maladaptive evaluations of one’s appearance, and in the general population is associated with a host of adverse emotional outcomes,” said the study authors.

“Together, these physical aspects of epilepsy and its treatment could reasonably be speculated to undermine the body image of people with the disease, yet to date, there has been no such empirical investigation.”

Researchers conducted a prospective analysis of patients with and without epilepsy to further examine the adverse impact of body image dissatisfaction. A total of 63 adults with epilepsy and 48 age- and gender-matched healthy controls were recruited for the analysis from a tertiary epilepsy program at Austin Health, Melbourne, as well as from newsletters and social media.

Pariticipants were assessed via an online survey that examined self-reported demographic and medical information and the following psychological measures: trait (long-term) body image dissatisfaction, state (current) body image dissatisfaction, body image impact from epilepsy, mood, and QOL.

Between-group analyses were conducted to compare measures of body image dissatisfaction, as well as clinical and psychosocial factors. The associations between rates of body image dissatisfaction and depression scores, QOL, and epilepsy-related factors were also examined.

Compared with controls, patients with epilepsy reported significantly elevated levels of trait body image dissatisfaction across the dimensions of appearance evaluation, body areas satisfaction, and self-classified weight (P = .02), but no significant differences were observed regarding state body image dissatisfaction (P > .05).

Among participants with epilepsy, all facets of body image dissatisfaction were strongly associated with reduced QOL, heavier body weight, depressive symptoms, medical comorbidities, and a belief that epilepsy hindered their ability to attain a healthier physique.

Furthermore, multiple regression analysis findings revealed that body image dissatisfaction was the strongest unique contributor to poor QOL in the epilepsy group (β = 0.46; P ≤ .001), above and beyond the contribution of current depressive symptoms (β = 0.34; P ≤ .01).

Researchers noted that the majority of female participants make generalization of findings to men with epilepsy difficult. The self-reported nature of the epileptological data was also cited as a potential limitation of the study findings.

“This is the first study to highlight the high rates of body image dissatisfaction among adults with epilepsy, and the significantly detrimental impact it has on patient well-being,” concluded researchers. “It also opens novel avenues for psychological interventions in epilepsy that focus on enhancing positive body image as a means of holistically improving the often-poor psychological outcomes for people with this condition.”


Alessi N, Coleman H, Rayner G. Body image dissatisfaction: A novel predictor of poor quality of life in epilepsy. Epilepsy Behav. 2023 Mar 6;141:109149. doi:10.1016/j.yebeh.2023.109149

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