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Body Dysmorphic Disorder and Chronic Illness

Something I don’t talk about very often is body dysmorphic disorder (BDD).

Body Dysmorphic Disorder: A mental illness involving obsessive focus on a perceived flaw in appearance.

The flaw may be minor or imagined. But the person may spend hours a day trying to fix it. The person may try many cosmetic procedures or exercise to excess.

People with this disorder may frequently examine their appearance in a mirror, constantly compare their appearance with that of others, and avoid social situations or photos.

There are a few reasons I hesitate to talk about it…

  1. I didn’t even know there was a name for what I’ve experienced since my pre-teen years, until a few years ago.

  2. A subjectively “thin” person talking about body positivity can be damaging to the body positivity movement

  3. BDD recovery is a long road. It can be easily reactivated and to be honest, I don’t know that I’ll ever fully be “recovered.”

  4. I’m always afraid of being offensive, or people thinking I don’t think people who are fat are beautiful (I do). BDD and every other eating disorder aren’t logical, and for me, only impact my judgement of myself, not others.

This year I have been both the thinnest I’ve ever been, and the heaviest. That’s what chronic illness has the power to do.

I wish I could tell you I didn’t enjoy how thin I was earlier this year (even if it was because I was sick), but I did get a thrill out of it. Old habits die hard.

Then started the months upon months of needing steroids in order to keep my chronic head pain at bay. All bets are off when you’re on prednisone (which I talk about in another blog).

I wish I could tell you I rose above the weight gain and haven’t allowed it to impact my mental/emotional state, but I can’t.

Having my body change so rapidly was shocking, discombobulating and terribly activating. In moments I’ve been able to laugh about it, and in many ways, I don’t care that much about it, but the more I’ve puffed up, the harder it's been to hold fast to my BDD recovery practices.

Chronic illness makes you feel like you have very little control over your body. You need certain medications in order to function, but those medications have side effects that often, aren’t that bad. But sometimes they are. Prednisone is not something you take and experience no side effects. It’s a beast.

When I start to feel like I’m losing control of my body (or anything for that matter), I start hyper-focusing on things I think I can control. Often this has manifested in what I eat and how often I workout.

At some point in my youth, I took on the belief that anything I ate would immediately show itself on my body. My stomach bloated so often and so easily, I interpreted that as fat. I learned that if I ate as little as possible, I could mostly maintain my flat stomach.

I got a thrill from feeling hungry. It made me think I was winning.

I didn’t know I had endometriosis. I didn’t know that having endo meant also having what we refer to as “endo belly.” My belly really would expand and be different sizes every day, but I didn’t know a medical condition was causing it. My brain programmed it away as weight gain, and reprogramming that is a challenge.

So, I spent all of my teen years and most of my 20s obsessing over my weight, while acting like I wasn't and instead, had it all together.

During my freshman year of college I probably gained 5-10lbs (maybe). Realizing this sent me into a BDD tailspin. It was bad enough that I wouldn’t even eat an extra cherry tomato if I’d already reached whatever ridiculously low amount of calories I allotted for the day.

What I saw in the mirror, and how I felt about my body, was not at all in line with reality. Seeing photos of myself from back then is almost shocking because I can clearly see I wasn’t overweight, and yet, I adamantly thought and felt I was.

Before I was put on steroids this year, I would’ve told you I had a pretty solid handle on my BDD, and all-in-all, I did.

I enjoy staying active. I’ve never had a terrible diet. I’m someone who likes to be on the move. All of these things are conducive to having a healthy body. Even still, I’d occasionally find myself working out as a punishment for a few bad days of eating.

Regularly I have to remind myself that moving my body and staying active is supposed to be enjoyable. That doesn’t mean it’s not hard sometimes, or that I don’t have to push myself, but there’s a distinct difference between pushing yourself and punishing yourself. That’s a line I’ll likely be toeing forever.

I’m glad this weight gain happened this year, and not several years ago because now I’ve done the work and I have the tools to coach myself through the mental olympics that come with BDD.

Last weekend I’d had enough. The weather is changing, it’s getting cold, and my usual cold weather go-to clothes are all too tight. Wearing ill-fitting clothes makes you overtly aware of your body pretty much every minute of the day. I couldn’t take it anymore.

So, I went shopping (I do not enjoy shopping).

After I acquired all my new items (Adidas tracksuits for the win), I went home and took all the clothes I can’t wear right now out of my closet and dresser, put them in a bin and moved them to the attic.

Out of sight, out of mind.

I immediately felt better.

I forgot what it was like to be both comfortable and feel confident in my clothes.

I relayed this to my therapist during our session this week (I got an A+, btw). I also told her I was thinking about doing an underwear photoshoot to try and boost my confidence, so she gave me some homework.

She told me to first find photos of women who I think have bodies comparable to mine. Then I was to do my photoshoot and once I was done, put my pictures side by side to the ones I found and see how accurate I am about my body.

Post-photoshoot I can say I was somewhat accurate but also not. Meaning - I see my body as looking different than it actually does. My perception is skewed.

To further confuse things, I find full-figured women to be wildly attractive. So, why am I so hell-bent on my body needing to look a certain way?

It’s like there are 2 feuding people in my brain. One says - You’re sexy AF the way you are and the other one says - but only if you stay thin.

I hate this shit. It’s infuriating. I don’t want to waste brain space on the aesthetic of my body. I hate how our culture causes this to happen, but alas, here we are.

Doing that photoshoot was helpful.

After getting past feeling awkward and like I didn’t know what to do with my hands or my face, I found my groove and managed to take quite a few photos I didn’t hate. In fact, I found myself reviewing them and thinking, “Damn, you look pretty sexy in these photos.”

I’m on a mission to learn to love and accept my body at every size because I will likely always be fluctuating. Chances are, I’m going to be on and off steroids for the long haul and won’t always be able to maintain a steady weight. I don’t want to spiral every time I put on lbs.

If I have to choose between maintaining a number on the scale, or being able to function every day - I choose being able to function every day.

It’s not easy to have to relearn who you see when you look in the mirror. It’s startling, but it’s still me.

For me, feeling out of control of my body is probably the hardest part about my health challenges. I hate that feeling of disconnect. But I also know how to get myself through it without back peddling into toxic behaviors.

If you’re a chronic illness warrior who’s also in recovery for any kind of eating disorder, I see you. I know it’s tough. I know it’s frustrating. But I promise, you can do hard things.

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