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Open Access Highly Accessed Open Badges Research article

Attitudinal and perceptual factors in body image distortion: an exploratory study in patients with anorexia nervosa

Amanda Waldman12, Rachel Loomes1, Victoria A Mountford2 and Kate Tchanturia12*

Author Affiliations

1 King’s College London, Division of Psychological Medicine, Institute of Psychiatry, London, UK

2 South London and Maudsley NHS Foundation Trust, London, UK

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Journal of Eating Disorders 2013, 1:17  doi:10.1186/2050-2974-1-17

Published: 3 May 2013



Body image disturbance is a core feature of anorexia nervosa (AN). Attitudinal and cognitive biases as well as fundamental perceptual differences have been hypothesized to play a role in this disturbance.


This study investigated body image dissatisfaction and distortion, haptic perception and perfectionism in 30 patients with AN and 31 age-matched healthy controls. Participants completed perceptual tasks and self-report measures.


As predicted, participants with AN scored significantly higher on body dissatisfaction, perfectionism measures and had greater body distortion (as assessed by a body size estimation task). Cognitive–affective factors and perfectionism were highly correlated with body image distortion in AN. No significant differences were found between groups on the generic perception task.


Findings did not confirm the hypothesis of fundamental perceptual inefficiencies in body image disturbance in individuals with AN. Despite renewed interest in fundamental perceptual factors implicated in body image disturbance, these findings suggest that it continues to be important to focus treatment on cognitive affective biases versus fundamental perceptual inefficiencies.

Anorexia nervosa; Eating disorder; Body image; Haptic perception; Perfectionism; Body dissatisfaction