Body shape and weight concerns are considered core features of eating disorders (EDs); however, it is still debated whether subjects with anorexia nervosa (AN) also present distortion of the body perception with respect to those with bulimia nervosa (BN).

To demonstrate differences in behavioral response patterns to their own distorted and undistorted body images in subjects with and without EDs.

To characterize the perception of body images in EDs.

We recruited 15 female subjects with AN, 13 subjects with BN and 22 healthy controls (HC). All subjects were presented with their own body images, distorted according to the body shape questionnaire score (BSQ), an index of body dissatisfaction, and control stimuli including own non-distorted and “scrambled” body images. Each image type was presented 80 times in a randomized order and contained one, two or three body images; subjects were asked to press a button when two body images of any kind appeared.

Although BN patients had the highest score on the BSQ (131.4) as compared with AN (111.1) and HC (97.58) subjects, AN patients committed significantly more omissions (6.34%), with respect to BN (2.23%) and HC (1.54%) subjects. Furthermore, AN patients needed a significantly longer time to process distorted body images (670.7 msec, on average), with respect to BN (650.1 msec) and HC (579.6 msec) subjects.

Our preliminary data confirmed the presence of a body distortion bias in AN subjects and suggest that it is independent from the degree of body dissatisfaction.