Body Dysmorphic Disorder

I thought I would take some time to write about body dysmorphic disorder, and the relation it can have to eating disorders. Many times, these two disorders go hand in hand, but not always.

You can have body dysmorphic disorder without having an eating disorder and vice versa.

Body dysmorphic disorder, also known as BDD, is an obsessive preoccupation with one’s appearance. Individuals with BDD have a distorted view of what they look like.

Although eating disorders are more prevalent among females than males, BDD affects the sexes equally.

One subtype of BDD is muscle dysmorphia (MD), which is a preoccupation with muscularity even among those who are well built. Typically, these individuals engage in bodybuilding and are at risk for the abuse of anabolic steroids (The Body Image Workbook, 2008).

What are Some Signs of Body Dysmorphic Disorder?

According to the International OCD Foundation, there are many different repetitive behaviors that an individual might engage in that are signs of BDD such as:

• Excessive mirror checking
• Seeking reassurance from family or friends
• Excessive comparison with others
• Excessive skin picking or hair pulling
• Feeling the “flawed” body part or running one’s fingers over the body part to check it (i.e. Checking for size change)
• Taking excessive selfies to check one’s appearance
• Having elaborate beauty/makeup regimens to hide the perceived defect
• Wearing clothes to hide the “flawed” body part
• Constantly seeking new enhancements (i.e. Botox, teeth whitening, etc.)

This is not an all inclusive list, but a good idea of what BDD can look like in individuals.

The key word is excessive. I am in no way saying that all people that engage in these behaviors suffer from BDD.

My Experience With BDD

I have always struggled with body dysmorphic disorder alongside my eating disorder.

The more I struggled with my eating disorder, the worse my BDD got.

I completely lost touch with reality. I had no idea what I looked like.

Regardless of losing or gaining weight, I was always convinced that I was big, gross, and fat.

I frequently wore sweatpants and loose fitting clothes to hide my “problem” areas.

I obsessively looked at Instagram models wishing to be thin and pretty like them.

I constantly body checked.

Body checking refers to an obsessive thought and behavior about appearance.

Examples of Body Checking

• Pinching or wrapping hands around stomach, waist, arms or thighs
• Frequent weighing
• Obsessively looking in the mirror
• Frequently trying on certain clothes to make sure they still fit

I weighed myself multiple times a day.

I obsessively checked for a thigh gap.

I checked my wrists. How many fingers could I wrap around them?

Sometimes body checking TEMPORARILY relieved my anxiety; other times, it dramatically increased my anxiety.

I hated how I looked in pictures. I couldn’t believe I was “that big.”

I remember my dietician telling me that I would just have to trust her about my appearance because I could not physically see myself correctly. My perception was completely distorted.

She always told me that when I recover, my body dysmorphia would be the last thing to go.

She was right.

How is my BDD now that I am recovered?

The way I see myself now, compared to when I was sick with my eating disorder, is significantly better. I definitely have days where I feel bloated or “bigger”, but that is normal.

Everyone has these feelings and experiences.

I no longer seek out eating disorder behaviors as a result of having these thoughts and feelings. I simply acknowledge them and move on.

Prior to being recovered, if I felt huge I would restrict or binge and purge or overexercise or take laxatives. I would do anything to temporarily feel better.

Some days are more challenging than others, but over the years I have gained a lot of knowledge as to what can trigger my BDD.

A lack of sleep, my menstrual cycle, alcohol, and big life changes, such as starting a new job or moving, are a few factors that frequently affect my BDD.

When I experience body dysmorphia, I am able to take a deep breathe, pull back from the situation and ask myself, “What is really going on?” I know that I am not physically getting bigger. I just feel bigger because I am overwhelmed and anxious.

It took me a long time to get to this place.

Be patient with yourself if you are trying to recover from an eating disorder and your body dysmorphia is really intense.

Over time it will get easier. However, to be honest, it gets a lot more difficult when you first enter recovery and stop using your behaviors, before it gets better. But, it will get better.

Keep pushing through.

It is well worth it.

Don’t give up.