Elsevier

Comprehensive Psychiatry

Volume 48, Issue 2, March–April 2007, Pages 118-123
Comprehensive Psychiatry

Body image in patients with eating disorders and their mothers, and the role of family functioning

https://doi.org/10.1016/j.comppsych.2006.08.003Get rights and content

Abstract

Objective

Little is known about body images of mothers of patients with eating disorders. In this study we investigated body image in patients with eating disorders and in their mothers, and the relationship of their body images with family functioning.

Methods

A computer program was used that allows modeling perceived and desired body images of patients and their mothers. Patients and mothers estimated their own body images and mothers estimated the images they have of their daughters with eating disorders. The selected images were compared to anthropometric data and family functioning according to the Family Assessment Measure. Data from 29 patients with the diagnosis of anorexia nervosa and 20 patients with bulimia nervosa are presented.

Results

Both in patients with anorexia and in patients with bulimia, aspects of family functioning were associated with mothers' and daughters' perceptual body size distortion and body dissatisfaction. Mothers' perception of family functioning predicted daughters' perceptual body size distortion and body dissatisfaction in the total sample of 49 patients.

Conclusion

Body images of mothers and mothers' perceptions of family functioning may provide additional information for the treatment of patients with eating disorders.

Section snippets

Background

Among other factors, negative family relationships have been hypothesized to be associated with the development of anorexia and bulimia nervosa [1]. A negative, conflictual atmosphere within the family and a low level of cohesion and expressiveness have been identified as typical for families with a daughter with an eating disorder [2], [3], [4], [5], [6], [7], [8], [9]. Family dysfunction, however, does not seem to be a discriminating factor in the etiology of eating disorders. General family

The somatomorphic matrix

A computer program adapted to our purposes, the somatomorphic matrix [28], was used. The program allows an assessment of muscularity and body fat of men and women's body image. The instrument presents the subject with a drawing of a female body that she can “morph” through 10 levels of muscularity and body fat (share of body fat in percent of total body mass). We asked each patient and her mother to choose images representing her best estimate of her own body and of the body she would like to

Differences between groups

Statistically significant differences between the 2 groups of patients were found in terms of actual body and perceptual body size distortion and body dissatisfaction. Patients with anorexia nervosa most strongly overestimated their bodies. Body dissatisfaction (perceived minus desired body) was found in anorexic patients indicating an ideal body slightly bigger than the perceived body. Patients with bulimia nervosa only slightly overestimated their bodies and wished to have a body clearly

Discussion

The obtained differences between the 2 patient groups are in line with findings in previous reviews [48], [49], [50], [51]. Patients with bulimia nervosa were more dissatisfied with their body than patients with anorexia nervosa. Patients with anorexia nervosa overestimated their bodies to a much greater extent than patients with bulimia nervosa. These results confirm the validity of the methodology used in this study. The result that the anorexic patients' desired body is slightly bigger than

Acknowledgment

We are indebted to Amanda El-Khoury, Andreas Mohr, Lena Raykowski, Beate Schmidt, and Vera Tadic for their contribution to this study.

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