A reappraisal of body perception disturbance in anorexia nervosa

Abstract

SYNOPSIS Previous research has suggested that patients suffering from anorexia nervosa tend to overestimate their body size, whereas normal females tend to be very accurate in this respect. This paper presents the results of further investigations of body perception amongst anorexic and normal females. The results, in contrast to earlier findings, indicate no such difference between groups. Detailed analysis of the data, however, points to the likelihood of certain differences between the present group of anorexic patients and previous groups. Moreover, it seems that body perception disturbance is not a consistent feature of anorexia nervosa and is only present amongst some patients at certain stages during their illness. On subdividing the anorexic group it was demonstrated that patients who vomit tend to overestimate their size more than do non-vomiters. It also seems likely that normal females are far from homogeneous in terms of body perception. In line with previous findings, a direct relationship was found between marked overestimation of body size and an early relapse. Evidence is also discussed which suggests that body perception disturbance is not specific to anorexia nervosa and may reflect an abnormal sensitivity about body size associated with such factors as the anticipation of an undesired change in weight, extreme concern about slimness and anxiety about putting on weight.

The significance of body size estimation in eating disorders: Its relationship with clinical and psychological variables

“…In other studies (but using widely different methods), BSE results were found to be related to the duration and severity of illness, psychosexual immaturity, dieting tendencies, and several psychopathological variables (Button, Fransella, & Slade, 1977;Casper, Halmi, Goldberg, Eckert, & Davis, 1979;Garner, Olmsted, Bohr, & Garfinkel, 1982;Gar- ner, Garfinkel, Stancer, & Moldofsky, 1976;Garfinkel, Moldofsky, Gardner, Stancer, & Coscina, 1978;Goldberg, Halmi, Casper, Eckert, & Davis, 1977;Meermann, Vandereycken, & Napierski, 1986;Strober, Goldenberg, Green, & Saxon, 1979;Strober, 1981;Thompson, Penner, & Altabe, 1990). Our study, however, could not determine any noteworthy correlations between the results of the different video distortion tasks and general psychological complaints and clinical variables.…”

Assessment of body size estimation: a review

“…Norris (1984) found a significant correlation between the degree of overestimation after mirror confrontation and progress in treatment, in patients with anorexia nervosa, as measured on a specially devised rating scale. In addition, research has indicated that overestimation of body size may actually predict relapse after treatment in patients with anorexia nervosa (Button et al, 1977;Crisp & Kalucy, 1974). Similarly, in patients with bulimia nervosa, body size overestimation has been shown to be associated with less progress in treatment (Norris, 1984) and overestimation of hip and waist size has been found to decrease after treatment in patients with bulimia nervosa (Birtchnell et al, 1985).…”

Perceptual Experiences in Anorexia Nervosa and Obesity*

“…Thus, results obtained by independent investigators with two different objective measures of body size perception have indicated overestimation of self-size in anorexia nervosa to be associated with poor prognosis (11,32,96), psychopathology (35), vomiting (11,22,32), and rapid weight gain (40). As yet unresolved are an understanding of the origins and stability of these perceptual disturbances and of the heterogeneity of body perceptions between patients with eating disorders.…”