"I don’t want to look back on myself in ten years and wonder why I didn’t get my ass off the couch and make a difference starting now," a commentor wrote in response to my blog post on body dysmphoria. It's been ten years since I first stepped on a stationary bicycle -- a decision that has changed my life.
But has the very act of going to the gym, the stimulation and satisfaction now become any activity that may be referred to as an addiciton?
What is BDD?
Body Dysmorphic Disorder, or BDD, occurs when one can't stop thinking about a flaw with your appearance. It is a disorder characterized by physical symptoms that cannot be explained by an actual physical disorder. In a nut shell (ha ha), the disorder is supposedly “imaginary.”
How is it caused: BDD is similar to an eating disorder in as much as they both center around body image. BDD suffers, unlike those with an eating disorder, are more concerned with a specific body part. It typically manifests during teen years and affects both men and women equally.
So, can being fit -- and staying fit -- lead to BDD? I posed this question to three individuals in the field of psychiatry:
Dr. Kim Dennis, medical director and board certified psychiatrist at Timberline Knolls Residential Treatment Center
Libby Neal, MA, LPC, Executive Clinical Director of Training and Education. Rosewood Centers for Eating Disorders
Dr. Stacey Rosenfeld, a licensed clinical psychologist
Can being fit -- and staying fit -- lead to body dysmorphic disorder (BDD)?
Dr. Kim Dennis: For some people, it starts with a normal interest in being healthy and fit, and develops into an obsession that interferes with major areas of normal functioning on a day to day basis. With severe BDD, we have seen women who have multiple cosmetic surgeries, costing thousands of dollars, and none of them are ever sufficient to solve the problem with their perception of their appearance. Many people in the behavioral health field believe that it is a combination of life experiences and a genetic predisposition that eventually can lead someone to have full-blown BDD.
Libby Neal: I don’t think one has anything to do with the other. It seems genetic predisposition is the determining factor. People with BDD focus on one, small part of their body, such as the nose, ears or stomach. Studies show, these people actually see sizes and shapes in a distorted manner. For example, a long term research study at UCLA found that a person with BDD sees the size of their hand as being much larger than it actually is. This seems to be consistent with other body parts as well. This in turn kicks in enormous anxiety and depression.
Dr. Stacey Rosenfeld: Being or staying fit can't cause BDD, as we know that most people who practice regular fitness don't develop BDD. However, for those with a predisposition to the disorder, it is possible that beginning a fitness program and spending significant time focusing on appearance/shape may contribute to the emergence of symptoms.
People often say that they only want to lose ten pounds or they have ugly fat here (points to neck or tug on their arms). Assuming they were to lose those “ten pounds of ugly fat,” what is the likelihood that more perceptual fat would appear?
Dr. Kim Dennis: For people with BDD, it is the rule that the focus would soon shift to another area of their body. People with body image disturbances of all kinds rarely have anything wrong with their physical bodies. Many times, what they perceive as their physical body is actually emotional memory stored in the tissues of their bodies and in their brains.
Libby Neal: If a person loses enough weight to go below 80% BMI, their perceptions change and they believe they are over weight no matter how much they lose.
Dr. Stacey Rosenfeld: For many, thin is a moving target. We see this consistently in eating-disordered populations. Patients lose the weight they had set out to lose and then, at the new goal weight, still see themselves needing to lose more. For those with BDD, the unhealthy focus on certain body parts may shift over time (as they "resolve" one feature through fitness, cosmetic surgery, etc., they may move onto another).
Based on societal influences, do you think instances of body dysmorphia have increased or decreased? Click here to read the rest of this story.
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