Bodily experiences in multiple sclerosis: functional neurological symptoms, body image dissatisfaction, and disordered eating behaviors. A narrative review

Multiple sclerosis (MS) is a chronic disease of the central nervous system, associated with a range of physical, cognitive, and psychological difficulties. Beyond classical neurological symptoms, disturbances in bodily experience, including functional neurological symptoms, somatization, body-image disturbances, and disordered eating behaviors, represent an underrecognized, yet clinically relevant dimension of the disease. This narrative review synthesizes evidence from adult and pediatric populations, highlighting the frequent co-occurrence of these disturbances with MS and their associations with psychological symptoms, reduced quality of life, and functional impairment. Across studies, these manifestations appear to be shaped by a complex interplay of psychological vulnerability (e.g., depression, anxiety, perceived stigma, and low self-esteem), disease-related characteristics (such as disability level and disease course), and contextual factors including stress and treatment experiences, rather than being solely attributable to neurological pathology, such as demyelinating lesions, axonal damage, or brain atrophy. Notably, the relationship with objective disease markers is often modest or inconsistent, underscoring the importance of considering non-organic contributors to bodily experience. The limited available literature suggests that disturbances in bodily experience represent a clinically relevant yet underexplored dimension of MS, particularly in pediatric populations, warranting greater attention in both research and clinical assessment.