Body Dysmorphic Disorder after Weight Loss

Body Dysmorphic Disorder (BDD) is a condition whereby the individual is preoccupied with their image, in particular with any perceived flaws in appearance.  Traditionally associated with individuals who want to have a limb amputated due to it feeling foreign and not part of them, it is now recognised that people with eating disorders or weight issues can also suffer with this condition.  Indeed, individuals who have lost weight are particularly vulnerable to remaining dissatisfied with their body image due to perceived defects in their appearance.  They have become so used to scrutinizing their body and being scrutinized by others that even after they have achieved their desired weight, they remain hyper alert to the slightest signs of bodily imperfection.  Not only will they still see their previous selves when they look in the mirror, but they may also perceive new flaws with different areas of their changing body.

So, how do you know if you have BDD?  Individuals with BDD feel the urge to continuously check their appearance in the mirror or even in reflective surfaces such as shop windows.  They frequently seek reassurance about their appearance, check for skin defects with their fingers, pick their skin to make it smooth, and compare themselves to others.  We are all fallible to this, but for someone with BDD it becomes a compulsive and time-consuming behaviour.  This preoccupation is incredibly distressing and can disrupt everyday life, resulting in social isolation, depression, and extreme anxiety.  At its worst, it is an incapacitating condition that severely reduces self-esteem and sense of worth.

Fortunately, there is help available. Cognitive-behavioural therapy (CBT) has been found to be particularly effective for treating BDD.  This is a combination of psychotherapy and behaviour therapy that helps you challenge your negative thoughts about yourself.  The process helps you develop new ways of thinking and coping to help you see yourself more realistically. For people who have lost a lot of weight, either through surgery or diet, CBT helps you to adjust your thinking in line with the new you.  CBT can be delivered individually or in groups and you can be referred by your GP.  If you are concerned that you are suffering with BDD and this is preventing you enjoying your new body, contact your GP straight away.  You can learn to accept and love yourself!

Categories: Counselling, Health, Psychology

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4 replies

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  3. This is a major issue I’m going through now. It’s almost like it came out of nowhere. I’ve been overweight my entire life. I eventually topped out somewhere slightly over 520lbs in 2007. I spent the next 7 years binging and purging at a higher rate than I had ever done before. In 2014 I was around 430lbs and something changed. I had enough and over the next 11 months I completely changed my lifestyle and dropped to 230lbs. Without weightloss pills or surgery. The only surgery was an apronectomy where 10 lbs of excess skin which use to be my stomach was removed. That was in June. In September I started having issues with still thinking I was severely overweight and wanted to start purging to lose weight. I’m always paranoid people are making fun of my weight, I have a hard time at the gym, I swear I sometimes see the “old me” in reflections, I still think I’m 500 lbs, even though I know I’m only 215 lbs. I check me weight on the scale a couple times a day. Some people have laughed when I tried having serious discussions about this. I finally had enough because it was triggering my old anxiety and depression. I talked to my doctor and I’m set up to see a psychologist very soon. This is a very real issue and many people don’t believe it.


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