Changes in body image during cognitive-behavioral treatment in women with bulimia nervosa

Carol B. Peterson, Suzann Wimmer, Diann M. Ackard, Ross Crosby, Lisa C. Cavanagh, Sara Engbloom, James E. Mitchell

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


The purposes of this study were: (1) to examine multidimensional aspects of body image of individuals with bulimia nervosa (BN) at pre-treatment, post-treatment, and at follow-up, compared to a group of participants without BN; and (2) to investigate whether measures of body image predicted outcome at post-treatment and follow-up. The clinical sample consisted of 109 females with BN who were enrolled in a 12-week cognitive-behavioral group treatment program. Participants were assessed at baseline, at the completion of treatment, and at 1- and 6-month follow-up visits. The 82 females who comprised the non-bulimic sample were assessed at comparable time intervals. At baseline, the participants with BN reported greater body dissatisfaction and overestimated body size to a significantly greater degree than the comparison group, and reported a significantly smaller ideal size relative to perceived size. Results at the end of treatment indicated significant improvement in self-reported attitudinal disturbance and size overestimation, with continued reductions at follow-up. Logistic regression analyses did not demonstrate a predictive relationship between body image measures at baseline and outcome at post-treatment or follow-up, or between post-treatment and follow-up. Implications for treatment include specifying the source of body image-related distress and enhancing treatment efforts for perceptual and attitudinal aspects of body image.

Original languageEnglish (US)
Pages (from-to)139-153
Number of pages15
JournalBody Image
Issue number2
StatePublished - May 2004

Bibliographical note

Funding Information:
The authors wish to thank Dorothy Hatsukami, Ph.D., Gloria R. Leon, Ph.D., and Auke Tellegen, Ph.D. for their generous guidance in conducting this research project. This research was supported in part by the Center Grant for Eating Disorders Research from the McKnight Foundation, the Minnesota Obesity Center Grant #P30 DK50456, R01 MK59100, R01 MK/DK 58820, R01 MK 59674 from the National Institute of Health, Rockville, MD, Training Grant T32DAO7097.


  • Body image
  • Bulimia nervosa
  • Cognitive-behavioral treatment
  • Psychotherapy


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