Body issues

Body Dysmorphic Disorder is a serious mental health issue

According to Psychotherapist and Eating Disorder Specialist Heidi Mack
Image by: Christine Blais
According to Psychotherapist and Eating Disorder Specialist Heidi Mack

I was a little shocked when a fourth-year student confessed to me that she thought she looked like a “short little fat girl.”

She stands a mere few inches above five feet, but with her tiny frame and slender waist it seemed as though she was describing someone else.

This isn’t uncommon. In fact, according to the Social Issues Research Centre, more than half of women see a distorted image of themselves when they look in the mirror. It’s also a problem for many men.

“I’ve talked to friends who were insecure but instead of it being a positive thing where you learn about each others discomforts and feelings it was more about reinforcing with each other and that there was an ideal image and we didn’t have it,” the student said. “One of my best friends was a larger girl, tall and bigger-boned, so her constantly looking in the mirror and pointing out faults and flaws taught me to do the same.”

This kind of banter, where individuals discuss their flaws, is referred to as ‘fat talk.’ A 2007 study at Appalachian State University found that if one member of a group expresses that she hates her thighs, other members feel obligated to chime in with their own body qualms. The study also found that the group had a better overall opinion of the members who contributed to the ‘fat talk’ than those who abstained.

While ‘fat talk’ can contribute to poor body image, it’s by no means the only culprit. Some studies point to the media but the student I spoke to rooted her concerns in a personal experience.

“I started doing ballet when I was two so it was always ‘tuck in your stomach, stand up straight, look like a ballerina,” she said. “You would get measured for your costume early on in the year and then close to competition they’d put you on a diet to make sure it looked nice.

“When I was dancing competitively I was in really great shape and felt great about my body. When stopped dancing I lost that body but my understanding of what I should look like was still based on dance,” she said. “[Sometimes] I’d skip meals because I felt uncomfortable with my size and I didn’t want people to see me eating meals. I’d be so hungry by the end of the night that I’d eat an unnecessary amount of food and then make myself throw up.”

Kingston-based Psychotherapist and Eating Disorder Specialist Heidi Mack told the Journal via email that these are disordered eating symptoms.

While individuals with negative body image may present disordered eating symptoms, Mack said that this does not mean they necessarily have an eating disorder and that eating disorders can stem from a number of causes besides body image.

It is still important, however, to recognize that negative body image can have very real affects.

A 2006 study done at Bradley Hospital, Butler Hospital and Brown Medical School analyzed 208 adolescent inpatients. They found that those with shape or weight preoccupations presented more acute symptoms in areas like depression and anxiety compared to other adolescents with psychiatric disorders but who do not have body image concerns.

Many of the patients with body image concerns suffered from body dysmporphic disorder (BDD). The very disruptive disorder is characterized by an intense obsession with a minor or imagined flaw, like a slightly crooked nose. The researchers, however, expanded their definition of the disorder to include the more common, weight-related BDD.

The study found that while a very serious condition, weight related BDD is severely underdiagnosed.

“This is likely due to clinicians’ lack of systematic questioning about BDD, as well as patients’ embarrassment and reluctance to reveal their symptoms, which may be particularly characteristic of adolescents,” the study said.

Nonetheless, Mack said there can be certain clues that a friend has a negative body image.

Clues can include asking too many questions about whether they look fat, not wanting to go out, being anxious about sexual intimacy from a body perspective, counting calories and not wanting to be seen in certain attire.

“[It] can affect confidence, self esteem, social life, love life, [it] can raise anxiety [and it] can contribute to harmful behaviors of dieting,” she said.

The student I spoke to said that she could relate.

“I hate hooking up with people for the first time because I think people expect me to be really skinny cause I’m such a tiny person and then I’m not when I take off my clothes,” she said. “I don’t like situations where I’m expected to wear revealing clothing, like going to the beach. I hated when crop tops were the biggest thing in fashion.”

Certain situations worsen negative body image, but others can help improve it.

“Usually, if I put on a dress and heels I’ll feel better about myself because I’ll like what I’m wearing,” the student said. “Working out and eating healthy [also] makes me feel better.”

While many people wish they had bigger biceps or a smaller booty, Mack said body image becomes a real issue when it starts to interfere with someone’s life.

“Does this preoccupation with food, weight and shape take up so much of one’s time and social life and sleep and work time that it affects their happiness and their dedication, and concentration and love life, for example?”

Mack said you can help a friend improve their body image by keeping the conversation away from weight and complimenting achievements instead of looks.

“Tell her that fat is not a feeling. Help her understand that not liking one’s body is a deflection from other pain and sadness and underlying issues mostly of wanting to fit in, belong and be loved,” she said.

“Like the poet Mary Oliver says: ‘what do you want to do with your one precious life?’ If the answer is be sad and unhappy about your body forever then go for it—my guess is that there are things much more important and pressing in life.”

If you want to talk to someone about body image contact HCDS at 613-533-2506 or Heidi Mack at 613-544-4037

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