Body image measurement in eating disorders.

Abstract

The current paper reviews the methods used for assessing body image in anorexia nervosa and bulimia nervosa. A major concern in the assessment of body image in the area of eating disorders has been the apparent failure to recognize the complexity of the body image construct. The development of a range of standardized measures of body image has been an important advancement in recent years; however, it would be premature to assume that any of these methods assesses body image in its entirety. Rather, each provides an operational index of one aspect of this multidimensional construct. The relationship between different dimensions of body image and their respective operational measures remains a potentially valuable area for investigation. Few studies have employed multiple measurement techniques and it is recommended that future investigations incorporate convergent measures which tap perceptual, affective and cognitive elements of the broad body image construct. Factors such as reliability and validity of the different measures of body image must be considered in planning studies with eating disorder patients. Reliability is particularly important because it sets an upper limit on validity. Most studies may be criticized for not addressing the validity of measures employed. Concurrent, convergent, discriminant and predictive validity should be demonstrated for existing as well as new methods. The issue of construct validity which remains a more general concern in the area of body image applies to the investigation of eating disorders. There is the danger that 'body image disturbances' become reified based upon group differences on a particular operational measure. Therefore, conclusions must be cautious even when inferences are drawn from measures which appear to have 'face validity'. The literature on body image in eating disorders has expanded rapidly during the past several years. Generally, it has confirmed the clinical impression that these patients display serious distortions in the feelings, attitudes and perceptions related to their bodies. Hopefully, future research will clarify the mechanisms of action of these body image disturbances and provide insights which will lead to improved treatment.