Having comments in a document would not cause:
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the picture prints at about 1/8 size
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especially when, as the OP says:
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If I have drawn a line or shape on top of the picture, those graphics print at the correct size while the picture is small.
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Even where comments may affect the printout - which only occurs when you have the 'Final-Show Markup' option checked (in combination with others), the overall reduction for the document itself, including any images, is only about 1/5-1/4 (i.e. the document prints at about 3/4-4/5 full size).