In a book on eating disorders I recall an anecdote relating back to World War 2 and interviews with people that survived various camps while extremely malnourished. Several people we're completely out of touch with how skinny they were. The book had a very women-centric perspective so the only stories pertained to women perceiving themselves as curvaceous (in the positive sense) despite being very skinny. Their body image was distorted from being so underfed but unlike a person presenting with something like anorexia the way they viewed their body was not as "hateful".