Evidence for a perceptual mechanism relating body size misperception and eating disorder symptoms

  • Joanna AlexiEmail author
  • Romina Palermo
  • Elizabeth Rieger
  • Jason Bell
Original Article
Part of the following topical collections:
  1. Personality and eating and weight disorders



There are known and serious health risks associated with extreme body weights, including the development of eating disorders. Body size misperceptions are particularly evident in individuals with eating disorders, compared to healthy controls. The present research investigated whether serial dependence, a recently discovered bias in body size judgement, is associated with eating disorder symptomatology. We additionally examined whether this bias operates on holistic body representations or whether it works by distorting specific visual features.


A correlational analysis was used to examine the association between serial dependence and eating disorder symptomatology. We used a within-subjects experimental design to investigate the holistic nature of this misperception. Participants were 63 young women, who judged the size of upright and inverted female body images using a visual analogue scale and then completed the Eating Disorder Examination-Questionnaire (EDE-Q) to assess eating disorder symptoms.


Our findings provide the first evidence of an association between serial dependence and eating disorder symptoms, with significant and positive correlations between body size misperception owing to serial dependence and EDE-Q scores, when controlling for Body Mass Index. Furthermore, we reveal that serial dependence is consistent with distortion of local visual features.


Findings are discussed in relation to the broader theories of central coherence, cognitive inflexibility, and multisensory integration difficulties, and as providing a candidate mechanism for body size misperception in an eating disorder population.

Level of evidence

Level 1, experimental study.


Eating disorder symptoms Serial dependence Body inversion effect Cognitive inflexibility 



JA and JB designed the study. Testing and data collection were performed by JA. JA and JB analysed the data and drafted the manuscript. JA, JB, RP, and ER provided critical revisions and approved the final manuscript for submission.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. Furthermore, there are no competing financial interests.

Ethical approval

This research was approved by the University of Western Australia’s Human Research Ethics Committee and performed in accordance with their guidelines, rules, and regulations.

Informed consent

Informed written consent was obtained from all individual participants included in the study.

Data availability

The datasets created and analysed during the current research are available from the corresponding author on reasonable request.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.School of Psychological ScienceUniversity of Western AustraliaCrawleyAustralia
  2. 2.Australian Research Council, Centre of Excellence in Cognition and its DisordersUniversity of Western AustraliaCrawleyAustralia
  3. 3.Research School of PsychologyAustralian National UniversityCanberraAustralia

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