Does over‐ or underestimation of body shape influence response to treatment in patients with anorexia nervosa?

Patients who either significantly overestimated (n = 17) or underestimated (n = 6) their body shape were selected for further investigation from a series of 33 consecutive inpatients diagnosed as having anorexia nervosa. Their cognitive, affective, and optative body images and their assessment of the physique of a normal weight for height person were measured using a videocamera with a distorting lens on two occasions, 5 weeks apart. Weight gain was monitored on a daily basis. There was no significant difference in the rate of weight gain between the two groups. Although the underestimators significantly improved their cognitive response, the overestimators failed to do so. The clinical implications of these findings are discussed.