Trigger warning: This post contains descriptions of body dysmorphic disorder and mental illness.
While having dinner with a friend last week, I became fixated on two things: how beautiful I thought she was, and what she was eating. Regarding the first of my observations, she has what I consider my naturally "ideal" body type in that she's thin and petite, but rarely exercises. While she was giddy about the cheese fries she was putting into her mouth, I felt irrationally guilty for my un-cheesy, less-fun version of her order. Old habits die hard.
Even by my own standards, I had no reason to feel guilty. I had woken up at 5 a.m., run three miles (as I’d been doing for weeks), and fit in a killer leg workout. On my commute home from dinner with my friend, I ended up re-routing my Uber to my gym, where hopped on a treadmill and ran until my ribs hurt. I sent a Snap of myself on the treadmill to the same friend, and she replied with a single word in all caps: "WHY?" The word jolted me to the realization that I was obsessing about my body again.
For years, I didn't know I had a problem
Body image has always been a struggle for me. I stand at 5'1", and my friends have used the words "petite," "athletic," and "strong" to describe my body type. I, on the other hand, use the phrases "I need to lose weight" or "I need to get toned" when asked to describe myself. I exercise once or twice a day. I live for the feeling of being drenched in sweat, the hard-won lightness of weights I once swore were too heavy for me, and the physical heat that radiates from the areas of my body I am working hard.
My insecurity about my body peaked when I was in college. I'd been skipping classes to go to the gym and making myself sick from taking too many thermogenic fat burners at once. At the same time, I was at the height of my fitness, a point where I was mostly lean muscle and lifting my heaviest. My roommates asked me to train them, and the guy I was dating told me I looked sexier than ever. Still, I found myself staring at mirrors and thinking I was humongous. I obsessed over the times I strayed outside of my very strict diet and fixated on my waist in any reflective surface I passed.
One day, a health professional told me to consider that I could be body dysmorphic. I didn't know what to say except that I felt attacked and criticised for my lifestyle. But there was something very familiar about the idea that I was consumed by fear of never attaining my ideal body, and that scared me.
I found myself staring at mirrors, and fixated on my waist in any reflective surface I passed.
I went home and began to skim through old photos of myself. When I found one of me in my favorite flannel shirt, I thought, "Wow, I was so skinny then." The flannel was an extra small, and yet when I had posed for that photo, I had felt like a whale. I remembered what the doctor had said. I had a problem.
Body dysmorphic disorder (BDD) is an exhausting state of mind. "While many of us have negative thoughts about our body image from time to time, there are cases where it can cause significant distress and prevent someone from functioning in their daily life," Michelle Miller, a psychologist and clinical assistant professor of child and adolescent psychiatry at NYU Langone Health, tells me. "Body dysmorphic disorder involves a preoccupation with one or more perceived flaws in an individual's appearance. However, other people do not observe what the person with BDD sees in their appearance." My negative thoughts revolve around my body type. This fixation is the monster fueling my obsession with my physical fitness, wreaking havoc on my self-esteem, and hindering my ability to function throughout the day.
While my BDD is focused on my physique, the disorder can take other forms. Someone who has it might fixate on the thought that their nose, lips, or breasts are somehow deeply flawed, and become obsessed with "correcting" them. "Individuals with BDD engage in repetitive behaviors, such as frequently looking in the mirror, touching a particular part or parts of their body, asking others for reassurance about how they look, picking at their skin, grooming, obtaining cosmetic procedures, and comparing themselves to others," Miller says. "Those types of behaviors are done excessively and take up a significant amount of time, from around an hour or two a day to almost every waking moment."
I can acknowledge that I'm already healthy. I just have to work on believing it.
BDD can be treated with cognitive behavioural therapy (CBT), in which patients learn to challenge frequent negative thoughts and reduce repetitive behaviours. Miller also notes that certain medications such as SSRIs can be helpful in treating BDD if anxiety or depression are playing a role.
How I stay grounded
In grappling with my dysmorphia, I've found two things that help me the most. First, I actively educate myself about my body and how to treat it right. I'm studying for my personal training certification, learning balanced approaches to fitness and nutrition. This knowledge base helps me take a step back and reassess my actions. I'm more able to recognize when I'm overexerting myself or viewing my body in an irrational way, and I can acknowledge that I'm already healthy. I just have to work on believing it.
The second thing I do is surround myself with body-positive people who help me keep perspective and realize when my self-talk is getting distorted. I have a former college roommate who rolls her eyes at my negative comments and reminds me that my body is perfect the way it is, a best friend who checks in to see what I've learned from my personal training textbook that day, and a sister who tells me my outfit looks great (and that it's time to get out the door already). They remind me that I am more than my insecurities. They remind me that I am enough.