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OBJECTIVE: To assess body image disturbance as a composite of three aspects (distortion, discrepancy, and dissatisfaction) in obese subjects before and after weight loss. Disturbance was then related to race, gender, binge eating behavior, and age of onset of obesity. METHODS: Eighty-two obese outpatients (24 males, 58 females) completed the Stunkard Figure Rating Scale (FRS). A Disturbance score was derived from the weighted sum of distortion, discrepancy, and dissatisfaction. The measures were repeated 4 weeks after starting a medically supervised liquid formula diet. RESULTS: Prior to weight loss, race (r =.28, p =.01) and gender (r =.25, p =.02) were each predictive of disturbance, with Caucasians and men having the most disturbance. Binge eaters exhibited more discrepancy (p =.03) and dissatisfaction (p =.005) than non-binge eaters. Early-onset subjects demonstrated more discrepancy than adult-onset subjects (p =.02). Following weight loss, disturbance scores decreased for all groups (p =.009). However, early-onset subjects still showed more discrepancy (p =.002) and more dissatisfaction (p =.005) than adult-onset subjects. DISCUSSION: Body image disturbance was viewed as a composite of three aspects. Prior to weight loss, the high disturbance score in Caucasians may be due to them experiencing greater cultural pressure to be thin. The men may have exaggerated their degree of obesity because of less denial of being overweight than women. Following weight loss, disturbance decreased for all groups but remained elevated for those with early onset, possibly because of a persistent self-image from adolescence.
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