Nonweight-related body image concerns among female eating-disordered patients and nonclinical controls: Some preliminary observations

Objective: Eating disorders(ED) have been classically associated with a con cern about body shape and size that manifests mainly as an intense fear of weight gain (DSM-IV criteria). To further examine the nature of the body im age disturbance in ED, we surveyed the prevalence of nonweight-related body image concerns among ED patients and nonclinical controls. Method: We exam ined 53 women IM +/- SD age: 28.1 +/- 6.8 years) with anorexia nervosa and/ or bulimia nervosa (DSM-III-R criteria) and 73 randomly selected nonclinica l women (M +/- SD age: 30.2 +/- 6.6 years) from the community. The particip ants rated (by checking a "Yes" or "No" whether they were satisfied with th e appearance of the following body regions: their skin, teeth, jaw, nose, e yes, ears, hair, and height and completed the Drive for Thinness (DT) and B ody Dissatisfaction (BD) subscales of the Eating Disorders Inventory (EDI). Results: The frequencies of dissatisfaction with the appearance of various physical attributes among the ED patients versus the nonclinical controls were as follows: skin: 79.2% vs. 52.1%, p = .002; teeth: 62.3% vs. 39.7%, p = .012; jaw: 24.5% vs. 9.7%, p = .026; nose: 45.3% vs. 24.7%, p = .015; ey es: 22.6% vs. 12.3%, p = .12; ears: 20.8% vs. 2.7%, p = .001; hair: 52.8% v s. 39.7%, p = .14; and height: 28.3% vs. 13.7%, p = .04. As expected, the M +/- SD DT(EDI): 14.0 +/- 6.1 vs. 3.5 +/- 4.6, p < .0001 and the M +/- SD E D (EDI): 19.7 +/- 5.8 vs. 10.1 +/- 7.3, p < .0001, were both higher in the ED group. Furthermore, greater dissatisfaction with nonweight-related body image was associated with higher DT and ED scores. Conclusion: The higher p revalence of dissatisfaction with appearance of most of the nonweight-relat ed physical attributes is probably an indication of the core ego deficits t hat are often present in ED and an index of the severity of the overall bod y image disturbance in these patients, and not indicative of another condit ion (e.g., body dysmorphic disorder) as the current nosology (DSM-IV) sugge sts. (C) 2000 by John Wiley & Sons, Inc.