Body image is defined as "the picture we have in our minds of the size, shape, and form of our bodies" (1). Paillard broadened this definition to include any perceptive activity, and noted that elaboration of the image can be subject to distortion (2).Body image has often been divided into two components: the perceptual dimension (i.e., body size estimation) and the subjective dimension (i.e., body satisfaction) (3). Within the context of obesity, the findings from various reviews have been mixed (4-7). Such mixed results may be associated with different methods of assessment, participant cohorts, and inclusion criteria. Moreover, to our knowledge, no study to date has distinguished severe obesity from obesity or investigated body perception from the front, profile angle, and back. Because additional data are needed, this study investigated body size estimation and the level of satisfaction expressed by obese patients as compared to severely obese and normal weight females.
Methods
ParticipantsWe assessed three groups of French females, aged 20-58. We included 20 obese (29.99 > BMI <40; mean = 34.69; SD = 2.41), 20 severely obese (BMI ≥40; mean = 49.67; SD = 10) and 20 normal weight (18.5 >BMI< 25, mean = 22.25; SD = 2.19) participants. The patients were on a diet during the month of testing. All three groups were matched with regard to age (F (2,57) = 1.54, P = 0.22). Informed written consent was obtained from each participant and we followed all applicable institutional and governmental regulations concerning the ethical use of human volunteers.
ProcedureThe study was conducted on a per-individual basis. The experimenter captured a digital photograph from the front, profile angle, and back of the participant. The individual in the resulting photograph was enlarged or slimmed down using a computer program (Anamorphic Micro Software, Liverpool, UK) (Figure 1). Participants were asked to adjust each photograph using the following instructions: (i) the image of yourself that you see on the screen has been modified; please adjust it so that it matches what you really look like; (ii) now please adjust the modified image, if necessary, so that it corresponds to how you would like to look. The participant carried out the task twice. At the end of the test we measured each participant's weight and height.
data analysesTo analyze data, we used the method described by Urdapilleta et al. (8). Three indexes were calculated (9): 1. The BMI, which corresponds to the actual body size of the participant. The formula is weight in kilograms divided by the square of height in meters. 2. The body perception index, which corresponds to the discrepancy between the participant's estimated image size and the individual's actual size as depicted on a photograph. The body perception index was calculated with the following formula: BMI × estimation score. 3. The body ideal index, which corresponds to the discrepancy between the desired body image and the individual's actual size as depicted in a photograph. The body ideal index was calcu...
