Posted: Nov 06, 2013 9:00 AM
 
Women who see their bodies in an unrealistic way are often shrugged off as self-conscious or narcissistic, but body dysmorphia is a real problem. Not being able to trust what you see in the mirror takes its toll on the emotional health of women suffering from this disorder.

Describing Body Dysmorphic Disorder

Almost everyone on the planet has had days where they don't like what they see in the mirror, but Bonnie Brennan, MA, LPC, Certified Eating Disorder Specialist, at Denver's Eating Recovery Center talks about how body dysmorphia can affect any area of a patient's body. In fact, the most common areas are body parts themselves and not a patient's overall appearance. She says, "BDD or Body Dysmorphic Disorder is a condition in which the individual has a perceived specific physical defect, most commonly in the areas of face or hair, rather than an overall dissatisfaction with the body or feeling of being 'fat.'"

She also addresses the idea that BDD is the main component in eating disorders, "BDD is a somatoform disorder, not an eating disorder. However, those with eating disorders may have BDD, but I do not see this very often. Those with eating disorders will usually report distress about body parts such as stomach or thighs being 'fat' or 'too big' which is different than focusing on a distinct physical defect."

Body dysmorphia isn't just "feeling fat"

Body dysmorphia occurs when 'feeling fat' and/or body dissatisfaction concerns become excessive such that they significantly interfere with a person's functioning.

John Dolores, J.D., Ph.D., Executive Director, Center for Hope of the Sierras deals with patients with eating disorders who may be suffering from BDD. He says, "For those experiencing body dysmorphia regarding their stomach, they will 'feel fat' and be dissatisfied with their body. However, body dysmorphia is more than just that. Body dysmorphia occurs when 'feeling fat' and/or body dissatisfaction concerns become excessive such that they significantly interfere with a person's functioning. For example, a woman who looks in the mirror and 'feels fat,' but still decides to go to dinner with her friends, is not experiencing body dysmorphia. The woman who looks in the mirror and 'feels fat' and then, as a result of that feeling, decides not to go to dinner with her friends, may be experiencing body dysmorphia."

One woman's struggle with body dysmorphia

Adina studied classical ballet for more than 22 years and maintained a body weight of 97-100 pounds. She says, "I became pregnant and the changes to my body were disturbing, to say the least. I would look in the mirror and see a really fat person, but I only weighed 110 lbs. After my delivery the scales would reflect one thing and the mirror would reflect another. I was huge — or at least I thought I was."

Later, Adina gained more than 145 pounds after steroid treatment for severe asthma, but the mirror is still lying to her. Adina says, "I only see the person I was at 97 lbs. I guess it boils down to when I'm thin, I look fat and when I'm fat, I look thin. Both are lies, the lies I live with."

I guess it boils down to when I'm thin, I look fat and when I'm fat, I look thin. Both are lies, the lies I live with.

Adina talks about the treatment she received at an eating disorder clinic. "One thing that helped me see my true physical self was when we were escorted to a room filled with mirrors. Once alone in the room we had to disrobe entirely and place a paper sack with eye holes over our head. We were asked to look at ourselves for 20 minutes. I believe I actually, for the first time, saw my true physical body. It looked so much different looking through the paper sack. We then asked to write about what we saw, how we felt and then share with our small group."

Unfortunately, Adina doesn't believe she will ever be "cured" of BDD. "I also believe body dysmorphia isn't curable. I think learning how to live with the lies the mirror speaks on a daily basis is where I'll find some sense of peace and remember it's a reflection — not an absolute."

Help for Body Dysmorphic Disorder

Dr. Dolores points out some symptoms that could point to BDD, "Loved ones are going to have the ability to witness many behaviors that a person suffering from an eating disorder would display. Look for strange behaviors surrounding food, such as hiding food, restricting their intake of food, cutting food into very tiny pieces or constantly using the restroom after meals."

They may obsessively check themselves in mirrors, touch or pick at the area of distress, or some may avoid mirrors all together and make attempts to hide the perceived defect with clothing, excessive makeup or jewelry.

Bonnie Brennan, MA, LPC, notes the symptoms that may be displayed by someone suffering from BDD regarding an area unaffected by disordered eating, "They may obsessively check themselves in mirrors, touch or pick at the area of distress, or some may avoid mirrors all together and make attempts to hide the perceived defect with clothing, excessive makeup or jewelry. In more extreme cases, individuals may harm themselves or engage in use of plastic surgery to correct the perceived defect."

If you suspect that you or someone you love may be suffering from BDD, Bonnie Brennan, MA, LPC, says that the first step for the sufferer must be to, "Acknowledge that their perceived defect has caused impairment or distress in their life. Consult a therapist and/or psychiatrist who specializes in the treatment of BDD. Research shows that the combination of Cognitive Behavioral Therapy and medications such as antidepressants is most effective for the treatment of BDD."

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