Float Therapy Improves Body Image in Patients With Anorexia Nervosa

A nonpharmaceutical treatment may help how patients with anorexia nervosa view their body image.

A nonpharmaceutical intervention appears to hold promise in assisting individuals with anorexia nervosa (AN) to enhance their body image and alleviate anxiety levels. Floatation-REST (Reduced Environmental Stimulation Therapy), commonly known as float therapy, demonstrated a notable reduction in body dissatisfaction and anxiety levels among patients with AN compared to those who received usual care, according to a study published in eClinicalMedicine, which is part of The Lancet Discovery Science initiative.

“This breakthrough offers a new therapeutic direction in treating anorexia nervosa,” said Sahib Khalsa, MD, PhD, who serves as the director of Clinical Operations at the Laureate Institute for Brain Research (LIBR) in Tulsa, Oklahoma, and is the senior author of the study. Float therapy involves floating in a shallow pool of warm water that is saturated with Epsom salt all within a controlled environment that is devoid of light, sound, and humidity fluctuations. 

Between March 16, 2018, and February 25, 2021, the study enrolled 68 participants: 45 in the floatation-REST arm and 23 in the standard care arm. In addition to usual care, participants in the float therapy group underwent twice-weekly 60-minute pool sessions for 4 weeks. The study found that those who received float therapy reported immediate and repeated reductions in body image dissatisfaction and an improvement in anxiety levels. 

Immediately after the intervention, researchers observed a reduction in body dissatisfaction among the floatation-REST group pre- to post-session, which was not seen in the standard care group (Δm = −0.44, 95% CI −0.56 to −0.30, P = 0.0001 vs Δm = 0.02; 95% CI −0.17 to 0.20, P = 0.87).  Six months post-intervention, the floatation-REST group continued to exhibit lower levels of body dissatisfaction (Δm = −0.91; 95% CI −1.37 to −0.45, P = 0.0020) while the care as usual group reported no change in body dissatisfaction (Δm = 0.35; 95% CI −0.28 to 0.98, P = 0.96) relative to baseline. There were no adverse events related to the trial during the study.

The large anxiety reductions induced by float therapy in these patients suggest that this tool presents a potent opportunity to treat anxiety via non-pharmacological means in anorexia nervosa.

Similarly, there was a significant reduction in State-Trait Anxiety Inventory scores from pre- to post-session for the floatation-REST group (Δm = −15.75; 95% CI −17.95 to −13.56, P < 0.0001), but not for the care as usual group (Δm = −0.01, 95% CI −3.10 to 3.13, P = 0.99).

Dr Khalsa noted that anxiety is a prevalent condition in anorexia nervosa and often “does not respond well to standard anxiolytic medications such as benzodiazepines.” He added, “The large anxiety reductions induced by float therapy in these patients suggest that this tool presents a potent opportunity to treat anxiety via non-pharmacological means in anorexia nervosa. Additional research is needed to examine the anxiolytic effects of float therapy in other eating disorders.”

Emily Choquette, PhD, a coauthor of the study and clinical psychologist and postdoctoral scholar at LIBR, highlighted the potential of these findings to pave the way for novel treatment modalities for eating disorders. “These findings also make way for new forms of treatment for eating disorders which, in conjunction with traditional treatments, may help to alleviate diagnostic features of AN that are more difficult to treat, such as body image. The reliable and sustained effect of floatation-REST on body image dissatisfaction suggests that it may be studied as a tool to augment the effectiveness of traditional psychotherapies.”

This article originally appeared on Clinical Advisor


Choquette EM, Flux MS, Moseman SE, et al. The impact of floatation therapy on body image and anxiety in anorexia nervosa: a randomized clinical efficacy trialeClin Med. 2023; August 29. doi:10.1016/j.eclinm.2023.102173