I stumbled across a news article about how 'Phantom fat' can linger after weight loss when I was on Twitter (do you follow me on Twitter? Click here to start following ED Bites!) and I was struck by how much this seemed to describe what was going on in eating disorders. The article quoted a women who had lost a significant amount of weight over the past two years, and how
every morning when she looks in the mirror while getting ready for the day, she sees her former, heavier self. “My brain says, ‘Yep, still fat.’”
“It's been really hard to change my self-image,” says Hicks, 37, of Chesapeake, Va. “I still feel like I'm this enormous person who takes up tons of space.”
When I was in residential treatment the last time (in 2006), I groused about how fat I felt, how skinny all the other girls were, etc, etc. Standard AN kvetching and bitching. Still, the dietitian I was talking to made a good point: I had gained weight. Okay, not much, but I had, and I knew it and that's in part what I was there to do. My body was heavier than it had been. And considering I had been underweight for at least a solid year by the time I started treatment again (though my lowest weight was back in 2001), some of my physical feelings of fatness were not strictly ED-driven, but also might happen to anyone gaining weight. Or, in the context of the article, people losing weight as well.
I was oddly reminded of this conversation about a year ago, when I was riding the commuter train from DC to Baltimore, as I headed home from my summer internship. There was a 16-year-old boy (I'm guessing) and his family, and he was almost literally all limbs. He carried himself a bit awkwardly and--here's the really interesting bit--he kept banging his head against the overhead rack. He made a joke about his growth spurt, and it hit me: his perception of his body (known formally as proprioception) hadn't yet caught up with his new height! Cammy did a wonderful post about something similar right after this happened, which kind of cemented the incident in my head.
It makes sense that there would be a link between body image and proprioception, and researchers have found previously that the body image distortions in people with anorexia was linked to abnormal amygdala functioning and the fear response. So it makes sense that significant fluctuations in weight would be linked to both body image and proprioception, especially in people with a history of dieting like many of the women featured in the article.
“People who were formerly overweight often still carry that internal image, perception, with them,” says Elayne Daniels, a psychologist in Canton, Mass., who specializes in body-image issues. “They literally feel as if they’re in a large body still.”
Daniels and other experts suspect this may happen because the brain hasn’t “caught up” with the new, leaner body, particularly for people who were obese for many years and then experienced rapid weight loss.
“Body image is a lot harder to change than the actual physical body is,” Daniels says.
Amen to that, sister.
Psychologist Joshua Hrabosky found that women who were currently "overweight" or formerly "overweight" had a "dysfunctional appearance investment" and were more preccupied with weight that women who were never "overweight."
The findings suggest that “people who undergo major weight loss may experience improvements in satisfaction in appearance, though still not necessarily as much as someone who was never overweight,” Hrabosky explains. “But they are also still more invested or preoccupied with appearance than someone who was never overweight.”
It does make me wonder what dieting and food intake might have to do with weight perception and body image, as even healthy men in the Minnesota Starvation Study complained of "feeling fat" during the rehabilitation phase.
But the article raises some really good points about the psychology, too. When you've thought of yourself as fat for most of your life, it's really hard to change that thinking no matter how much weight you've lost or how much you understand the futility of dieting. I'm curious to see how this research will affect thinking on the body image distortions in eating disorders. We shall see.