The nature and extent of body-image disturbances in anorexia nervosa and bulimia nervosa: A meta-analysis

Abstract

Although body-image disturbance is among the diagnostic criteria for anorexia nervosa and bulimia nervosa, the nature and extent of this disturbance have not been precisely identified. This is the purpose of this first meta-analysis of extant research on body image and eating disorders. Using contemporary techniques, the meta-analysis systematically examined 66 studies (from 1974 to 1993) of perceptual and attitudinal parameters of body image among anorexics and bulimics relative to control groups. Attitudinal body dissatisfaction, both questionnaire and self-ideal discrepancy measures, produced substantially larger effect sizes than did perceptual size-estimation inaccuracy. Body dissatisfaction measures, whether global or weight/shape related, differentiated bulimic and anorexic groups (with bulimics having more dissatisfaction), whereas perceptual distortion indices did not. Somewhat larger effects occurred with whole-body than with body-part size-estimation assessments. Size distortion among patients with eating disorders appears unlikely to reflect a more generalized sensory/perceptual deficit. Scientific, conceptual, and clinical implications of these findings are delineated.