Anorexia & Bulimia Sufferers
Anorexia Nervosa sufferers believe in things that are impossible, such as a desperate need to lose weight to look like “Kate Moss” or their favourite celebrity. But most are already so underweight they would have to acquire body fat over many weeks to match an idol they have only seen in photographs. How could such a bizarre belief happen? Evidence already exists that Anorexia has distinguishing genetic markers.* But what if there was an identifiable physical causal effect that could be easily detected?
For some, anorexia might begin when a vulnerable young person sees themselves looking overweight in a photograph.**Though already slim, they believe the image is an accurate representation of how the world really sees them. So they decide to quickly lose weight to “improve” their appearance. And so begins a vicious cycle of starvation and negative visual feedback that can degenerate into a life-threatening illness.
This participant was a healthy first year psychology student, with a Body Mass Index of 18. She was the second slimmest person photographed for these studies and yet was assessed as overweight by almost all respondents to three of her five experiment photographs. BMI 18 is thought to be the lowest healthy weight for a young female.*** Low BMI scores are highly correlated with anorexia and a range of serious health issues. But in photographs taken from more than 1.1 metres away (as in the centre and right side photos above), all of the female participants were judged to be significantly overweight. Even those females with the lowest measured BMI:
The slimmest participants had highest overweight estimations (relative to their actual BMI), but had the least body fat to lose should they attempt to make themselves look slimmer in photographs.
Malnutrition has a well-recognised but largely unstudied side effect: 2D vision. After the easiest fats have been burned, a starving body will purge the smallest muscles of protein and mass before moving to the larger stores of energy elsewhere. The first muscles to lose strength are the tiny eye muscles controlling the ultra-fine ocular vergences that allow us to see with stereo vision. The result is stereo-acuity failure: The brain cannot control stereopsis, leading to double-vision that can be so disturbing it is immediately shut down by auto-suppression. The brain will suppress vision from the weakest eye and stable monocular vision quickly returns. But this is always at the cost of shape, size and accurate distance perception, even with both eyes open and seemingly functioning perfectly. If a person with suppressed 3D vision looks at their own reflection in a mirror, they will see themselves flattened and fattened like a 2D photograph: through one eye only and with 40% lower resolution. This can happen even when the subject reports no change in their vision.
The experiments reported on this website show without question that 2D female faces are always perceived as significantly fatter than 3D faces. It is possible that a tragic side effect of anorexia is that as people lose weight, they also lose the ability to see that they have lost weight. My research (and the example above) shows it is often the most underweight faces and necks that are mis-perceived as carrying the most body fat (as a percentage of their actual weight). So they will appear fatter in photographs than an identical twin who is actually heavier and healthier in reality. It is possible this phenomena also occurs with mirror images. Clinical psychologists however still treat anorexia as a “failure of body concept, rather than body percept.” They never consider the significance of malnutrition on vision and possible stereo acuity failure, or how 2D perception will affect both mirror images and photographic representations. This may explain why for some suffers, what they actually see in the mirror is not considered as relevant to their diagnosis. Their condition may be misrepresented as a failure of “body concept” and therefore indicative of an underlying mental incapacity.
I was grateful that so many students, friends and university staff volunteered to be photographed for these studies. All were offered the chance to see their photographs in advance of them being used in the experiments and could withdraw permission at any time. The debriefing and consent process however often revealed a disturbing behaviour: Even when it was explained what the camera will fatten representations of normal, healthy and correct BMI bodies, some women fixated on their heaviest representations. They could not assess the slimmer images as having the same “photo reality” as the most overweight pictures. “I understand what you are saying, but I still really need to lose weight” was heard far too often to be by chance from healthy and average weight respondents.
It was for that reason I chose to use the title “Body Image Distortion in Photography” for these experiments. BID is a phenomena well studied by psychologists specialising in eating disorders, but has never before been applied to the perception of photographic portraiture or figure studies. It is also the reason why the questionnaire used at the end of the later experiments assessed people’s opinions about the accuracy of general photography “when photographing people and general scenes.” The main finding was that women were 9 times more likely to mistrust photographs than male respondents. And if those women were to review these experiments, they would find scientific evidence to support an opinion rejected by the vast majority of males.
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*** One student volunteer scored BMI 17 and her image was excluded for ethical reasons. The ethical and practical implications of studying this aspect of Body Image Distortion theory has meant it has not been investigated so far. However, the simple fact that malnutrition adversely affects vision should be considered both by those considering losing weight and by those who have to treat the many victims of chronic and self-induced weight loss.