Do You Have Body Dysmorphia?

By Brian Cuban
I am just one guy out of many men and women who struggles with Body Dysmorphic Disorder( BDD), a condition that often begins in adolescence and affects as many as 1–2% of the population. For potentially millions of Americans, depression, addiction, steroid abuse, eating disorders, and broken relationships are common byproducts.

So what is the down and dirty of BDD? Experts characterize BDD as a condition marked by sometimes disabling preoccupation with imagined or exaggerated defects of physical appearance. Many experts consider BDD a form of obsessive-compulsive disorder, or OCD. The disorder is fairly common, affecting as many as 2% of the population, and has been known to psychiatric experts for over a century.

Is there an exact point in life that I can point to and say “this is when my thought process changed, this is when I developed BDD?” No, I can’t. I was bullied as a child. I grew up in a family sometimes in conflict, with a pattern of verbal abuse on my mother’s side, passed through generations. I was a fat kid. I was the middle child and shy to begin with as a matter of biology and genetics. Psychologists, psychiatrists, and other treatment professionals will tell you that there is no one cause.

What does it feel like? Here are some of the behaviors that have defined my struggle with BDD. To a casual observer some of these may seem narcissistic, “quirky,” or eccentric. They may sound familiar to others at risk for BDD:

The shower inspection. I have been doing it as far back as I can remember—a detailed inspection of the areas of “concern” on my body when I shower. I know I am doing it, but it has become integrated into my daily routine. Like breathing, I just can’t stop. With the palm of my hand I press down on my stomach and try to flatten it. Of course it always bounces back, but I feel like I can actually measure if there has been any increase in my waist size.

Verifying body defects through touch. I do it all the time. I rarely notice it. Primarily my chest area. This is a remnant of a past steroid addiction. I could be walking down the street, in a mall, sitting at dinner. For a split second I will touch my chest. It may even cause concern among those around me if it occurs more than once in a short period—I have had that happen. The person will ask if I am okay. They may think I am having chest pain, on the verge of a heart attack.

The pants carousel. Women are stereotyped as trying on numerous outfits before they go out. It’s part of their mystique and what we love about them. And we all want to look good in what we wear. No big deal. But is it common for a guy to try on numerous outfits before he goes out at night? What about before he leaves the house in the morning? What about trying on every pair of pants in the closet to make sure they all still fit as a daily routine while getting ready for work?

A love-hate relationship with mirrors. Don’t we all have that? Nothing out of the ordinary. The difference is that growing up, I traditionally did not see my reflection. I saw over-exaggerated love handles. A receding hairline seemed completely bald. The reflection in the mirror showed scarring that did not exist in real life. My chest seemed deformed and unattractive. I was even able to “see” stupidity. I saw a monster.

The hanging shirt. I hate to tuck in my shirts. Fortunately it has become kind of a style statement so it does not seem too weird. For me, however, the un-tucked shirt is not an attempt to be stylish. The very act of tucking the shirt and creating less space between my stomach and my clothes is stressful for me.

Fear of crowds/Social Anxiety. This could be going to a party, nightclub, bar, or anywhere else that I expect people to be sizing each other up. Any situation where in my mind the entire scene is about judging and comparing my looks and “defects” to other people, forging romantic relationships, or being scrutinized based on looks has always been a terrible problem for me. And the way I’ve coped with social anxiety has sometimes been worse than the anxiety itself. In the past, I’d always be drunk or high before the event.

Plans to artificially fix the “defects.” Any other BDD sufferers out there who have contemplated lap band surgery even though they are not medical candidates for it? When the Bariatric Weight Loss commercial comes on the tube, I quickly think, “Will Lap Band be okay for me or do I need a gastric bypass?” What? I weight 220 lbs at 6 foot 2 inches! Of course I don’t need that. My mind for a split second says something different.

Inner critic; outer-critic. I would see flaws not just in myself, but in everyone I met as well. When I was at my worst, this was a terrible problem for me and hurtful to others. When you obsess over defects in yourself, zooming in 10X on even the most minute flaws, you tend to do the same when you look at others. When I was younger, this sometimes turned me at times into what I despise—a bully.

One Word: Plastics. Multiple visits to the plastic surgeon are common for BDD sufferers. I am no exception. As of the writing of this book, I have had four hair transplants, one liposuction, and lasik at a total cost of about twenty thousand dollars. Not too extreme by BDD standards, but the only reason I did not have more procedures is because I could not rack up any more debt to get them.

Self-medication. Using drugs to try to change how you feel about yourself, how you see yourself, how you perceive others seeing you. I excelled in this. Alcoholic. Cocaine Addict. Abuse of weight loss drugs laxatives and anabolic Steroids. All of them gave me a brief self-image high the moment I took them, but in the end they all led toward vicious cycles of destructive behavior.

Disordered Eating Behaviors. Eating disorders are something that many BDD sufferers are intimately familiar with. I am not an exception here, either. About thirty percent of those with BDD will also develop and eating disorder.

Depression. Depression has always gone hand in hand with my BDD, and when it’s at its worst, depression has robbed me of the will to live. To make my life better and put an end to self-destructive habits.

Suicidal thoughts. I am very lucky to be above ground to write this book. I had a Spanish made .45 automatic. I almost wasn’t. Some are not.

Am I cured? The climb out was a long, slow, hard process. It started with putting one small step forward. There were setbacks. There were times when it seemed easier to go backwards than forwards. There were times when simply giving up was within hand. I now have the strength to face my path in life independant of what I see in the mirror? What do I see? I see something I did not see for so many years. I see Brian. Heavy, thin, bald, pimples, love handles and all. It’s ok. I am enough.

Today, I am addiction free except for my daily Starbucks Vente Blonde coffee. (In the world of addiction, the Vente seems a good trade-off from my old routine of coffee with a cocaine chaser to get going in the morning. or jabbing a steroid needle in my butt) I can face the world of people and social interaction—with some stress, yes, but not life-disabling stress, without the need to artificially change the image in the mirror. I love and have loved. I have been rejected. I have let go. I have forgiven. I am alive. I am okay. You can be as well. Take that step forward. It all starts with dropping that wall of shame and allowing yourself to be helped.

Resources: The Broken Mirror by Dr. Katharine Phillips.