Body‐image distortion and eating disorder: A reconceptualization based on the recent literature

Despite a substantial body of research over the last two decades the nature and role of body‐image distortion in the variety of eating disorders is unclear. The purpose of the present paper is to review the evidence and largely on the basis of more recent work to suggest a reconceptualization of the problem. Five sets of studies/observations, which are described in this paper, have led us to the following formulation: individuals suffering from either anorexia or bulimia nervosa do not have a fixed and implacable distorted image of their own bodies, but rather have an ‘uncertain, unstable and weak body‐image’, and that in making size estimation judgements they err on the side of caution and in consequence exhibit a bias towards overestimation of body size. It is further proposed that this judgemental bias is primarily influenced by social and cultural factors. The therapeutic implications of this reconceptualization are briefly highlighted.