Disturbed body image in patients with eating disorders

OBJECTIVE: The authors attempt to answer the question of whether patients with eating disorders experience more distortions in body image than do individuals without eating disorders. METHOD: The study group was composed of 214 women out of 230 patients consecutively admitted to an inpatient eating disorders program. Twelve men and four patients with atypical eating disorders were excluded from study. The 214 patients were divided into three groups: 87 with anorexia nervosa alone, 72 with anorexia and bulimia nervosa, and 55 with bulimia nervosa alone. The comparison group was composed of 61 women drawn from 125 consecutive participants in a survey of university students. Fifty- six men were dropped from the comparison group, along with eight women who fulfilled diagnostic criteria for eating disorders. Each subject used a three-dimensional measure to rate her body size and stated her desired body size at seven points: left biceps, left calf, left thigh, waist, abdomen, hips, and bust. The subjects' measurements at each of these points were taken. Distortion in body image was calculated as the subject's perceived body size divided by her actual body size. All subjects were also given a battery of tests of intelligence, skill, and memory. RESULTS: All three patient groups differed significantly from the comparison group in distortions in body image. Most but not all patients with eating disorders had distortions in their body image. CONCLUSIONS: If replicated, these findings would suggest that the diagnostic criteria regarding disturbance of body image for both anorexia and bulimia need to be revised.