I would like to highlight and share my experiences of a condition that affects many people, no matter their size, shape, creed or colour, in the hope that someone who hasn’t previously aired their troubles finds resonance and may look to reach out or find solace from reading my words.
WHAT IS BODY DYSMORPHIC DISORDER (BDD)?
The condition is Body Dysmorphic Disorder (BDD). BDD is an anxiety disorder that causes a person to have a distorted view of how they look. The most common areas for BDD centre around body fat, body size and shape, and skin imperfections.
Feelings generated from a lack of contentment with one’s body are experienced by most people at some point in their lives but these feelings of discontentment will come and go. Body Dysmorphic Disorder on the other hand is something that stays with a person for a long period of time, is one of the first things that a person wakes up to think about and, significantly, can stay with a person even with constant reassurance and if the original area of worry significantly reduces or goes away. An example of this would be a person who loses weight to become lean and defined but who still believes they are fat notwithstanding the success they may have had in lowering their body fat levels, edging themselves closer to a point where they thought they would be content.
WHAT ARE THE IMPACTS OF BDD?
As you can imagine, BDD can have a significant impact on daily life, sapping energy, happiness and drive. Having BDD does not mean the person is vain or self-obsessed; its impacts are deep-rooted and can be incredibly distressing, leading to work, social and relationship issues as well as illnesses such as bulimia, agoraphobia, depression and anorexia.
It is more common in people with a history of social phobia, obsessive compulsive disorder (OCD), anxiety and a pressure to achieve. Moreover, it is more prevalent in developed societies where aspirational social comparison (made so easy now through the instant global communication provided by the internet) and anonymous discrimination through social media are rife.
A person with BDD constantly thinks about an area they see as imperfect and spends a long time trying to conceal or eliminate their supposed defect. They can become so distressed that they can decide to stay inside, avoid social occasions, worry about ramifications excessively, and avoid mirrors as they know that seeing what they see will make them sad.
The cause of BDD is not clear. It may be nature or caused by a chemical imbalance in the brain but past life experiences and up-bringing play as big a part in its development as any genetic influence.
MY PERSONAL EXPERIENCE OF BDD
I experienced BDD up to my early 20s and it can still rear its head to this day. No matter what people say to me about how I look, no comment will ever be as strong as the comments that appear in my mind, and I know my thoughts are constantly damning and negative about my looks. I must say that my friends and family have always been a wonderful support but this exemplifies how much BDD is built from within. Many people who do not experience BDD can view the situation from the outside and think that it’s incredibly sad that someone has to feel as they do with BDD when, in their mind, the person has no imperfections. But only those who actually experience BDD will understand how the internal struggle impacts almost every decision you make. Someone can be the most confident, successful and handsome person to the entire world, but they can still feel low and in a constant mental battle with themselves every day.
MY FACIAL BDD
My BDD started when I had bad acne and imperfect teeth as a teenager. Rarely would I ever receive a comment about it from anyone else – I was fortunate that teenage bullying in this area passed me by – but every day I wanted to hide my face. I would sit in seats in the classroom where I knew the harsh white light wouldn’t cast a shadow on my acne – I would not go to some restaurants because I knew it had harsh lighting that would show my skin more. I would wear concealer from 14 years old but would apply it from 2 metres away from a mirror without my contact lenses so that I didn’t see the extent of my spots; and I believed that a small spot would stand out in a crowd and would be the downfall of my success academically and in relationships that day, month or year. Knowing I had a big spot on my face made me avoid eye contact, made me cut conversations short and meant I created an unspoken dialogue for what I thought the person was saying in their head: “Look at that massive spot” or “I don’t want to know someone who looks like that”.
As my skin cleared up with a strict regime, I objectively realised that my friends, relationships and success endured the years of my acne. I achieved straight A grades, I was made Head of School, I achieved in sport and music, and I had a great group of friends. But even when the acne cleared up, my BDD didn’t. To this day I can still see scars on my face where other people don’t, I think a spot puts me down in other people’s estimations. Back then, my BDD then transferred from my face to my body.
MY PHYSICAL BDD
For people who have seen my physically, whether at 6% or 15% body fat as I have fluctuated between for the last decade, please know that not a day used to go by without me being unhappy with the way my body looked. I am 6ft (183cm), currently 12 stone (76kg) and around 10% body fat and, in the past when I was at this level or even lower in weight and body fat, I was not satisfied with the level of fat I had. For no reason I understand, I would look in the mirror, grab hold of skin folds, tense muscles that were ‘not defined enough’, suck in my stomach or push out my stomach in a sadistic regime that lead to disappointment.
I could be sitting on the train, or standing waiting for the bus and would tense and feel my stomach to see if any fat had magically melted away since the morning. I would try and justify why I ‘looked fat’: “have I worked out too much and not eaten enough, does my body need to reboot…or have I not worked out enough and eaten too much, do I need to step up my efforts?” These would be questions that would plague me every hour, as would the belief that not having my exact gram for gram tried and tested diet would mean that I would put on body fat. I have avoided some social situations before because I have felt unhappy with how trousers fitted me that day and because I didn’t want to eat and drink what was being offered for fear of putting on fat.
One trouble with alleviating BDD is that no one can tell you that you’re right or wrong. They can try, but they would be wrong to do this. Someone can be 30 stone and believe that if they were 20 stone, this would make them happy. Whereas bodybuilders can be 10% body fat in the off season and believe they need to lose 5% before their competition in 6 months’ time to be where they want to be. Both these people are no more right or wrong than the other. As long as what you want to look like doesn’t make you ill and doesn’t negatively impact the lives of others around you, whatever you want to be is fine. Thus, it is not trying to change your mindset about what is right and what is wrong that necessarily gives you peace from BDD; rather, it is the taking control of how you can get yourself on the road from where you are now to where you want to be that matters.
HOW TO GET OVER BDD
I have become much better with my BDD, and this is not though a lack of trying. I had my teeth straightened, I continue to have a strict facial cleansing regime to keep spots at bay, and I am very aware of the food and exercise I have on a daily basis. But this is the sort of control I needed to take to get myself out of my internal struggles. It is often the people who crave self-control that experience BDD as they do not feel they have a grip on how they look and feel. Thus, if you give this person realistic control, create priorities for how you want to look and feel, and, for body image issues, put your faith in a nutrition advisor, exercise professional and therapist to create a step-by-step progressive approach, you have a good chance of reducing or eliminating your BDD and creating a path for success.
For me I know that, at the moment, the leaner I am, the happier I am, and that this overarches all other enjoyments I have in life from indulging in food and drink to sitting watching some TV. Thus, I know where my efforts need to lie to keep a balance between each component I want to have in my life whilst still coming out on top with my body image. However, I still can still experience some difficulties when I’ve temporarily increased water, carbohydrate or salt consumption and feel soft and bloated one day. To rectify it, I take ownership of how I feel and put in small daily and weekly exercise and nutrition steps to get back to the balance I prioritise. Because I have put in these steps, I know I am back in control and I know that I’m on the way to where I want to be.
PRIORITISATION AND PROGRESSIVE STEPS
Crucially, I have found that it is the acceptance of a continual journey with different forks in the road that helps BDD rather than wanting to ‘succeed’ in getting from A to B – people like us will never be satisfied even if we get to B. Thus, put a plan in place and continue to re-assess your goals every month and year based on your priorities at that time. This way, nothing will take your self-control away from you and you’ll always be on the right track to somewhere. One thing to take home: don’t try and let other people’s words and support be the only thing to try and get you out of BDD – the person that you are probably won’t look for sympathy because you actually don’t want to draw attention to any issues you have. Rather, do something for yourself and create a journey with support from professionals who can view your milestones and limitations objectively alongside your closest supporters who will cheer you on in your own direction.
I was fortunate to have the right help and drive to take me from a position of daily dissatisfaction in my looks to being able to have skin, teeth and body that has enabled me to hit one of my goals of doing photographic modelling. But most importantly, for the majority of time, my step-by-step approach has helped me be happy on a daily basis, even with my ‘defects’ that I was born with. Sometimes just maturing as a person and gaining confidence with more experience under your belt can beat BDD; other times it’s taking a stand and doing something that will make you feel better. But either way, this article has been written for those who know the feelings I have described, or who know someone who may share these feelings, to say that, whatever you think of me physically, I have been there too and that I can extend a hand of understanding if you need it.
Chris James MA O.A. Dip
Director – Head of Fitness and Nutrition
Fitness Body Pro