Body image - it's 'healthy' people who are deluded

We’re all going to die and there’s nothing we can do about it. Depressing? Well, it’s been argued that depressed people are the sane ones because they see the world for how it really is. Now consider this – a study has found people with eating disorders have an accurate perception of how attractive their bodies look to other people. In contrast, healthy controls are the ‘deluded’ ones – they think their bodies look far more attractive to other people than they really do.

Anita Jansen and colleagues took photos of 14 women with eating-disorder symptoms and of 12 healthy controls, all wearing underwear only. A panel of 24 men and 64 women then looked at the photos and, without knowing which women had eating disorder symptoms, rated the women’s bodies for attractiveness. The photos didn’t show the women’s faces.

Although the bodies of the women with eating disorder symptoms and the healthy controls did not differ on objective measures (such as body mass index and waist to hip ratio), the panel rated the bodies of the women with eating disorder symptoms as significantly less attractive than the control women’s bodies. This would have come as no surprise to the eating disorder women – their ratings of their own appearance closely matched the ratings they received from the panel.

But even though the healthy controls’ appearance was rated higher than the eating disorder women, they would have been upset – the appearance ratings they gave themselves were much higher than the ratings given to them by the panel. “This points to the existence of a self-serving body-image bias in the normal controls”, the researchers said. “Self-serving biases or positive illusions are prototypical for healthy people, they maintain mental health and help to protect from depression”.

So, what are the implications of this research for helping women with eating disorders? Lead researcher Anita Jansen told The Digest about research into a possible cognitive intervention: “We have started a training for people who are dissatisfied with their looks, to expose them to their own bodies and to teach them to focus on the (self-defined) beautiful parts of their bodies only and to describe them in very positive terms. Focusing at the beautiful parts instead of the ugly ones makes them happier and more satisfied with their bodies is our experience until now”.
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Jansen, A., Smeets, T., Martijn, C. & Nederkoorn, C. (2006). I see what you see: The lack of a self-serving body-image bias in eating disorders. British Journal of Clinical Psychology, 45, 123-135.

Link to NICE guidelines for the treatment of eating disorders.

Link to discussion of this study, via Mind Hacks.

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