Part IV emphasises the significance of psychological and nutritional characteristics of orthorexia nervosa to gain better insight into the construct of orthorexia nervosa. It focuses on the relationship of orthorexia nervosa with self-esteem, personality traits, eating behaviours (disordered eating behaviours, food addiction, mindful eating), health-related beliefs and behaviours (physical activity), body image, emotion regulation and dietary patterns. It also presents a potential social risk factor of orthorexia nervosa - social media use. A summation of the highlights is included at the end of this chapter. The commentary of the invited international expert (Professor Marle Alvarenga, University of Sao Paulo) provides valuable insights on orthorexia nervosa.

More women are surviving gynecological cancer with advancements in screening, diagnosis, and treatment. Survivorship care of gynecological cancer includes surveillance for recurrence of disease, monitoring for late effects of treatment, reducing the risk and early detection of other cancer, and assessment of psychosocial function. Even if the surveillance of gynecological cancer survivors has some common features, non-invasive and invasive breast, cervical, endometrial, and ovarian cancer will require an individualized therapeutic approach. Many survivors of gynecologic cancer will have long lasting effects on bone and sexual heath, so these areas should be addressed on a regular basis. In addition, it is important to use every encounter as an opportunity to assess the risk of other cancer and provide appropriate early detection. Survivorship care will also incorporate strategies to decrease the risk of other cancer through lifestyle modifications. Many female cancer survivors will have lifelong issues related to distress, body image, finance, and social support. Assessment of psychosocial issues and referral to appropriate services should be performed at every patient encounter.

• Body dissatisfaction is common, and people experience varying degrees of it. You can learn to feel better about your body, but it’s likely to require some attention to your current thought patterns and habits.

• Body image can be improved by focusing on the aspects of your body that you genuinely appreciate, are grateful for, and the ways your body enables you to experience the world.

• You can defend your body image by filtering out negative external influences, such as appearance-focused content on social media and television.

• Your body image can benefit if you think about your health habits – especially your eating and physical activity patterns – in terms of self-care rather than self-punishment.

• Our relationships with our family members, friends, and romantic partners are important to our body image and can have both negative and positive effects on our sense of self.

• Developing friendships and romantic partnerships can be an important part of your life during your teens and adulthood and can open you up to feelings of vulnerability about your appearance; experiencing some stress surrounding the initiation of relationships is common.

• Maintaining healthy relationships can contribute to your positive body image development.

• Depression, anxiety, substance use disorders and other mental health problems are often associated with body image, and are fairly common, especially among teenagers and young adults.

• A combination of genetic and environmental factors can increase your risk of experiencing a mental health problem. It is not your fault if you have any mental health problem.

• There are effective treatments for depression, anxiety, substance use disorders and other mental health problems. Usually, treatment begins with therapy with a mental health provider with expertise dealing with the particular problem you are experiencing. Sometimes medication, such as an antidepressant or antianxiety medication, can also facilitate treatment.

• How much you need to eat depends on a variety of factors including how active you are, how tall you are, your body build, and whether or not you are male or female.

• Intuitive eating offers a framework and strategies for getting in touch with your body’s sense of hunger and fullness and really enjoying what you eat.

• It’s essentially that you respect and care for your body and your mind by attending to what and how much you eat without viewing food as a source of stress.

• There are many reasons why it’s important to develop a positive body image, one of which is that by exhibiting positive body image you have the power to start to change how other people think about their bodies.

• Current attractiveness ideals and the cultural focus on our appearance can make it difficult to feel good about your how we look, but it’s important to consider small shifts in your thinking and behaviors that may help to change your life and the lives of others.

• Thinking about issues that are more important than how you look and being engaged with issues that are meaningful to you, can help you become a well-rounded, confident person. By choosing to foster your positive body image you set an example for those around you and help to lead society closer to understanding how important it is for all of us to be accepting and positive about who we are.

• Being regularly physically active is an important part of taking care of your body and nurturing a positive body image.

• Physical activity can improve not just how you feel about yourself, but your mental and physical health as well. Being regularly active can even help you live a longer life.

• There are direct links between physical activity and body image with activity likely to help you value your physical functionality and appreciate all the wonderful things that your body can do.

• Diet culture is a collection of ideas and values prizing thinness, erroneously equating health with thinness, and suggesting that our body sizes and shapes are changeable – if we just try hard enough.

• Dieting has been shown to be ineffective and is often more likely to lead to weight gain than loss over time.

• There are many negative consequences associated with following food fads and diets, from the distraction they create in our lives to the money they cost us.

• It is possible to change your eating and activity behaviors and doing so may improve your health, but may not necessarily change your body size and shape significantly.

• Body image is often defined as your thoughts and feelings about your body; these thoughts and feelings have far-reaching consequences.

• This book provides scientifically-based information to help you improve your body image, but also offers real people’s stories, common questions and their answers, myth-busting, and activities to help you develop a greater understanding of your body image.

• Having a positive body image doesn’t mean feeling good about yourself every second of every day, but it does mean that you respect and care for your body.

• Keep a flexible view of what you eat and provide your body with nutrients to support your physical health without compromising your psychological health by worrying about what you eat.

• You can eat any and all foods but do your best to eat foods that are nutritious, including plenty of fruits and vegetables.

• Eating nutritious foods is one important way to care for your body and can help you develop a positive body image.

This chapter explores the ways in which young children develop their self-concept in relation to their body image and discusses some of the influencing factors that condition children to perceiving favourable body images over unfavourable body images. The chapter incorporates discussions relating to ‘thinness’, and goes beyond this aspect to consider the effects of perceived anomalies and injuries on a child’s body satisfaction and positive self-concept. In addition, we discuss ways to support children in developing a positive self-concept in relation to body image, and to promote their wellbeing using the revised Belonging, Being and Becoming: The Early Years Learning Framework for Australia (V2.0) (EYLF) (Australian Government Department of Education [AGDE], 2022).

Body image concerns can be a significant barrier to treatment for individuals with eating disorders (EDs) and impact upon relapse risk. Body image difficulties can be challenging for clinicians and tend to be a lasting source of pain for ED patients. For ED with OCD, behaviors typically seen in ED presentations may be exacerbated. Body dissatisfaction and dysmorphia are common in EDs and often linked to sociocultural factors such as societal pressure and media representation. The media is heavily implicated in the prevalence of body dissatisfaction due to the amounts of misleading health advice and trends on social media which make people more anxious, aware, or insecure about their bodies. Media and political environments often underrepresent and stereotype women, people of color, and LGBTQ+ individuals, which can perpetuate negative stereotypes and biases that further marginalize people due to appearance. Given the widespread nature of body dissatisfaction and cultural messages that link a person’s worth to appearance, it is not surprising that people with OCD may become obsessed with these issues. This can make treatment more challenging, particularly when OCD and EDs are comorbid.

Our step-by-step clinician guide continues with Session 2 – the Eats! a fun exploration of the sensations that constitute hunger, fullness, thirst, and utter deliciousness! Every session from this one forward begins with a Henry Heartbeat investigation, which helps children (a) expend their energy so that they can focus on the remainder of the session, and (b) become comfortable and proficient with raising and lowering arousal, a foundation of self-awareness and emotion regulation. The ritual of homework review is introduced: new things learned about the body between sessions are added to the Body Map. Children meet new characters including Georgia the Gut Growler, Solomon Satisfied, and Umm-ma Una. Children and parents conduct investigations such as learning to sense their changing energy from food as they eat, whether food tastes more delicious if you eat it slowly – and more. A body wisdom might be: “your body tells you how much energy you need if you learn to listen.” Following Body Brainstorms, families begin the first two steps of the Body Clues Worksheet to practice monitoring what they are feeling and what their bodies might be communicating. With worksheets, workbooks, and coloring pages, the investigators are off to explore the week ahead!

Functional abdominal pain (FAP) is one of the most common medical complaints children present to their pediatricians. Despite the prevalence of FAP as well as its early onset, treatments for young children are particularly rare. Young children are just beginning to learn about the complex messages that their body communicates. Yet, pain can contribute to a fear of the body and an attempt to avoid these important signals. This chapter describes the background and rationale for a new approach to pain for young children, one that conceptualizes the sensitivity to pain and other experiences of the body as a superpower rather than a vulnerability - “sensory superpowers!” We train children to be Feeling and Body Investigators (FBI), individuals who have awe-inspiring curiosity and responsivity towards the many wise communications from their bodies and who respond to these messages with dexterity and skill. The end result is children who are not only fearless about pain, but also who are adept at emotion awareness and regulation. They are Feeling and Body Investigators!

This chapter is where the action starts! We provide a step-by-step guide for clinicians to lead the introductory session for FBI including sample dialogues and examples of how to integrate the therapeutic materials provided (e.g. parent/child workbooks, worksheets, and coloring pages). Therapists are given accessible language to present the case formulation of visceral hypersensitivity as a collection of sensory superpowers that enable children to experience the world and their bodies through a lens of curiosity and excitement rather than fear. Children and parents begin their training as body detectives, Feeling and Body Investigators that harness these superpowers. Children create a “Body Map” a tracing of the child’s body that summarizes the many wisdoms of the body. Children are introduced to their first body characters. Examples include Henry Heartbeat, Samantha Sweat, and Gassy Gus. Children perform their first Body Investigation, a Henry Heartbeat exploration in which they compare strategies to raise and lower their heartbeat. A resulting body wisdom might be: my heart is smart- it knows to beat faster or slower depending on what I need. Body Brainstorms worksheets facilitate generalization of new learning to the outside world. Families are given home-based practices and worksheets to reinforce what they learn.