Awareness of body dimensions in anorexia nervosa: cross-sectional and longitudinal studies

Synopsis Patients suffering from anorexia nervosa usually exhibit extreme concern over their physical size and weight. This tendency, noted by many observers, has been variously interpreted. However, few experimental studies of this phenomenon have been reported. In the present paper an objective technique for determining bodily perception is described, together with a series of studies involving investigation of bodily perception in anorexia nervosa. In the first study a group of anorexia nervosa patients was compared with a group of normal female controls, results showing that, unlike the controls, the patients exhibited marked overestimation of the width of their own body. Moreover, this tendency was found not to extend to perception of physical objects. The results of a second study showed that the overestimation of body width was less marked when the patients were required to gauge the size of a female model. In addition, they were found to be remarkably accurate in assessing physical height, both of themselves and of the model. A third study explored the effects of refeeding on the patients' tendency to see themselves as abnormally wide (and fat). The findings showed that this tendency decreased as patients put on weight. Moreover, the degree of overestimation of body width exhibited by patients was found to bear a relationship to their progress after discharge from hospital: when this persisted after weight gain, a subsequent relapse was more likely.