Distorted: What Is Body Dysmorphia?

Simply being born female in our society is to grow up being told your worth as a person is tied to how slim and attractive you are. Even for those of us lucky enough to have evolved parents, the message is still driven home by the world at large.

Padma Lakshmi

Body Dysmorphic Disorder, or body dysmorphia, is a mental illness which involves obsessive focus on a perceived flaw or flaws. It affects between 5-7 million adults in the United States and is deeply troubling for the people who experience it.

Before I get into this, I want to preface by saying that I truly and honestly believe that we should all love the bodies that we are in; something that I’m working on every day. That said, it’s hard to undo the programming that you’ve received since birth.

We live in a society that tells us that fat people have no value. That being thin is the only way to be valuable and lovable; to be wanted. We see it on our televisions, in our magazines, and on social media. It’s shoved in our faces at every turn, then we are shamed for not loving ourselves more.

I’m going to level with you here. This post is going to hurt me; I’m about to point out “flaws” that I actively try to hide. I had never even heard of body dysmorphia until recently. Even then, I heard it used in context with eating disorders like anorexia and bulimia. That said, I have had a complicated relationship with my body for the last 20 years.

Body dysmorphic disorder develops due to genetic and environmental factors. OCD is a very common comorbidity with body dysmorphia. The obsessive thinking and intrusive thoughts from OCD often taking their aim at the perceived flaws that you see.

Body Dysmorphia

Here’s the thing with body dysmorphic disorder: it allows you to still see the parts of you that are good. I can fully admit that I have a great ass and gorgeous hair, but I can’t get my mind to wrap around the fact that other people will be able to see that past my perceived flaws.

Here are some of the ways that body dysmorphia shows up in my life:

• Being preoccupied with my perceived flaws, even when others can’t see them or barely notice them. So, here’s the part where I tell you about the things that I hate about my body. Firstly, my lower abdomen. I hate the way it is shaped. My weight has been on a yo-yo string for most of my adult life, but no matter the number on the scale, I despise this part of my body to a point that it takes up space in my head.
  
  Secondly, my teeth. This one hurts particularly bad. I used to have a beautiful smile. My teeth were perfect, due to years of braces and dental work, and I had a glowing smile. However, through a series of unfortunate events, I had to get teeth pulled and crowns put on. My smile just isn’t the same. It’s all I can see when I look at pictures of myself. Likely no one else notices and still just sees a glowing smile, but it makes me feel actual emotional pain every time I see it.
• Having a strong belief that these defects make me ugly or deformed.
  I have the belief that these flaws somehow make me not good enough. Like people will feel tricked when they meet me in person. That they will find me unattractive and repulsive. Logically, I know that this is not the case, but tell it to my disordered brain.
  
  It gets so bad sometimes that I actually let myself believe that these physical flaws completely invalidate all of my knowledge, talent, skills, and compassion. It makes me feel like less of a person; less deserving of love and acceptance and more likely to face rejection.
• Frequently checking in the mirror or avoiding mirrors altogether.
  I rotate back and forth between these too. When checking, I scrutinize my body, imagining what I “should” look like or what I want to look like. On the same token, it’s not unusual for me to avoid looking at it in the mirror, even covering up to avoid it.
  
  Both experiences are distressing. I don’t want to scrutinize myself, but it feels almost compulsive.
• Trying to hide or disguise the body part.
  Going out of your way to hide or disguise a body part. I rarely smile in pictures anymore. When I see a photo of myself smiling, I almost always hate it. It doesn’t look like me, I don’t think. The reality is, my smile doesn’t look that different. No matter, I can’t get past it. It hurts my heart.
  
  I also rarely take a picture that isn’t from the waist up. Even then I’m extremely selective about what pictures survive. When I see pictures of me from when I was young and quite svelte, I again feel that nagging emotional pain. It literally makes me hurt.
• Avoiding social situations.
  When I am at home, I can wear clothes that I am comfortable in. I have no one to impress. That is not always the case when I am out. I am embarrassed by my weight gain and would rather stay home than have people see me the way that I am.
  
  Some times are worse than others. Obviously, when I weigh more, I am also much more self conscious. There have been times when I wouldn’t leave the house at all unless I absolutely had to, solely because of what I looked like.
• Trying to “fix” the body part.
  This can include anything from dieting to waist trainers to plastic surgery. I’ve tried two of those and would try the third if I had the money.
  
  Honestly, I would get my teeth completely redone if I were a more financially secure woman. There are even other procedures I would consider. That’s not something I ever thought I would be open to, but the urge to perfect my flaws is strong; the idea that life would be easier is pervasive.

Often these thoughts are pervasive and we genuinely believe that life would be better if the flaws were fixed. Some part of me knows better and I hate that I think it, but I can’t help but believe that it’s true. Don’t we live in a society that just automatically places more value on attractive people? I know I’m guilty of it myself.

The only real treatments for body dysmorphia are Cognitive Behavioral Therapy and SSRIs. Tragically, CBT doesn’t always work for people with ADHD and I have had a hard time finding success with it. That said, I’m still working on it. I want to love myself. I want to have the same confidence in my physical presence as I do in my mind, my capacity for empathy, and my skills and abilities.

To be clear, this issues don’t just happen when I’m at my biggest. No matter when I stand on the scale, I beat myself up. I often look at pictures of myself at smaller sizes and remember hating my body so much. Truly believing that I was unattractive and not worth anyone’s time. It was unfair of me to do to myself. I deserved more love than that. I deserve more love than that now.

The Aftermath

So, I want to be really honest about this. Body dysmorphia goes beyond just being unhappy with your body or noticing a few pounds. It causes real and intense emotional pain and shame. I heard someone say once that guilt is what you feel when you’ve done something wrong, but shame is what you feel when you believe that you are wrong. No one should ever feel that they are made wrong.

I worry all the time that my body issues will somehow bleed over to my daughter. I try not to criticize myself in front of her, but I also try not to praise myself for things like weight loss in her presence just the same. I want her to have a healthy relationship with her body and to feel strong and confident, no matter what she looks like.

I believe in body positivity, as I said before. I wish I had the courage and the self-esteem to love my body with reckless abandon. I hope that one day I get there and, until I do, I’ll keep trying to find ways to love and appreciate all of me. I deserve to love my body as much as I adore my mind. It makes me sad that I don’t.