Introduction: Body image is a multidimensional concept. It encompasses a perceptual componentthat is the subjective estimation of body size. Subjects with obesity were shown to estimate accuratelytheir own body size, but also to overestimate or underestimate it. These contrasting results may bedue to differences in samples but also in the methods used to assess the accuracy of body size perception.The aim of this narrative review was thus to summarize the results of studies that investigatedthe estimation of body size in subjects with obesity and to explore the above mentioned differencesbetween studies in order to explain the mixed findings.Development: Very different methods were used to assess body size perception in subjects withobesity. Studies differ also in sample size and used different control groups. Most of them comparedsubjects with obesity to healthy-weight individuals or to subjects with restrictive eating disorders.Conclusions: The heterogeneity of studies that assessed the perception of body size in subjects withobesity do not allow to draw definitive conclusions about the variables that are involved in the divergingresults. Further investigations should manipulate the putative factors within study and explore alsosubgroup differences as well as correlations, in order to better define which subjects’ characteristicsdetermine a misperception of body size.
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