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Review
. 2024 Jan 13;29(1):8.
doi: 10.1007/s40519-023-01632-6.

The primacy of ocular perception: a narrative review on the role of gender identity in eating disorders

Affiliations
Review

The primacy of ocular perception: a narrative review on the role of gender identity in eating disorders

Livio Tarchi et al. Eat Weight Disord. .

Abstract

Background: Phenomenological research has enriched the scientific and clinical understanding of Eating Disorders (ED), describing the significant role played by disorders of embodiment in shaping the lived experience of patients with ED. According to the phenomenological perspective, disorders of embodiment in ED are associated with feelings of alienation from one's own body, determining an excessive concern for external appearance as a form of dysfunctional coping. The purpose of the present narrative review is to address the role of gender identity as a risk factor for EDs in the light of phenomenological approaches.

Methods: Narrative review.

Results: The current study discusses the interplay between perception, gender identity, and embodiment, all posited to influence eating psychopathology. Internalized concerns for body appearance are described as potentially associated with self-objectification. Furthermore, concerns on body appearance are discussed in relation to gendered social expectations. The current review also explores how societal norms and gender stereotypes can contribute to dysfunctional self-identification with external appearances, particularly through an excessive focus on the optical dimension. The socio-cultural perspective on gender identity was considered as a further explanation of the lived experience of individuals with ED.

Conclusions: By acknowledging the interplay between these factors, clinicians and researchers can gain a deeper understanding of these disorders and develop more effective interventions for affected individuals.

Level of evidence: Level V narrative review.

Keywords: Eating and feeding disorders; Embodiment; Gender identity; Phenomenology; Psychopathology; Socio-cultural factors.

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Conflict of interest statement

The authors declare no potential conflict of interest.

Figures

Fig. 1
Fig. 1
Conceptual summary of key phenomenological concepts. The “physical body” (Koerper) is the material, third-person view of one’s own body. The “lived body” (Leib) represents the lived experience of it. A third dimension can also be described, which is the first-person view of one’s own body when it is looked by the other (“lived-body-for-others”). Coenesthesia is the integration of perceptual stimuli originating from the body, the foundation of one’s conscious appraisal of their own body. The “gaze of the Other” is an external point of view, subjectively experienced. It acts as a “filter” or “mirror”, through which one’s own body is experienced
Fig. 2
Fig. 2
Proposed novel framework of interactions between embodiment and gender identity. The “gaze of the Other” can play a dual role. On one hand, it may exert a violent action, subjugating one’s own visual dimension as the forefront component of the self. On the other, reassuring, offering a cohesive representation of the self. The “lived-body-for-others” can thus become an external validation of one’s own gender identity, or impose socially sanctioned gender expectations, which may be experienced as distressing at the individual level

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