Eating disorders aren't, of course, the only disorders to feature a distorted body image. Another illness whose major diagnostic criteria is an inability to perceive yourself accurately is body dysmorphic disorder (BDD). Thought to be closely related to OCD, BDD is diagnosed when a person spends an inordinate amount of time worrying and obsessing over a particular body part not looking "right."
While some people with BDD might just obsess about this problem, others take drastic measures to "fix" the problem. A woman worried about her skin may wear heavy makeup, have surgery or laser treatments, or even refuse to leave the house. A man who feels his nose is too big may have repeated plastic surgery or even break his own nose to try and "fix" things.
Although BDD is tremendously debilitating, many people perceive it as vanity-on-overdrive, a view remarkably similar to the view of eating disorders as a diet-gone-too-far.
Says researcher Kieran O'Connor, who studies this disorder:
"It's as if these people are looking at themselves in a mirror that deforms their image," says O'Connor, who completed his clinical training in England. "They'll carry on an internal conversation and convince themselves that there's a problem with their bodies, although it's not based in reality. I've seen people who have flagrant physical flaws, yet are preoccupied by a completely different aspect of their appearance."
These internal conversations, this pseudo-brainwashing from within, reminds me of eating disorders. When a sufferer says "I feel fat!" believe them. That is his or her reality. However absurd it may seem, when a person is otherwise normal-looking or even dramatically underweight, he or she sees fat. No, it's not rational, and that's the point. They didn't reason themselves into it, and you can't reason them out.
Moreso, I think the connections to BDD and OCD will prove very important to teasing out how and why eating disorders (especially anorexia) develop. O'Connor says of BDD, "The source is difficult to pin down – whether genetic, parental influence or stress – but the consequences can be serious, including suicide."
Two small pet peeves about the otherwise easy-to-read, enlightening article:
- The best way to help a person break free from an OCD-esque behavior is not to figure out why it happened but to figure out how to stop it. Cognitive-behavioral therapy is the only proven way to help reduce obsessions and compulsions. Analysis can come later.
- Anorexia is not caused by bad body image. Poor body image can precede an eating disorder, sure. But it doesn't cause it. Most women I know dislike or misperceive their bodies- but most of them don't have an eating disorder. Bad body image really kicks in as the eating disorder progresses.