It's Time to Really Talk About Body Dysmorphia

Trigger Warning: This post discusses body image and first-hand accounts of body dysmorphia. If these topics are triggering or disturbing for you, feel free to skip this post.

In the "before times," I swear I suffered from what I have dubbed "Reverse Body Dysmorphia." My denial surrounding how unhealthy I actually was caused me to think that I was "fine."

While I am all in for health at every size and body positivity, I wasn't fine, and it took me losing a decent amount of weight to realize it. It took the non-scale victories to see the difference in my quality of life.

That said, as I mentioned in my post that discusses What They Don't Tell You About Weight Loss, I now experience actual body dysmorphia.

Body dysmorphia looks different for everyone, with the understanding that there may be some similarities in people's experiences. First I will share what it looks like for me, and then I will share the experiences of friends dealing with body dysmorphia.

For Me

The very inspiration behind this post is the fact that I feel fat today. While the scale tells me I haven't gained any weight, I also haven't lost any weight in a month. I am in PMS mode, which inevitably causes bloating, and I ate at a Mexican restaurant last night.

I ate SALAD. At a Mexican restaurant. And I don't even think I managed to eat half of it.

While I also partook of guacamole and queso with chips, I think I ate ten chips total -- a far cry from the 27 or more that I would have consumed in the "before times." The guacamole, split between me, Anthony, and one of my besties, was not even finished -- my friend had to take it home with her. And I did have a cup of Mexican hot chocolate, but no other dessert. I counted calories as best as I could and found that I was still in a calorie deficit for the day. A serious improvement, considering I used to unknowingly eat 3,000+ calories a day. My salad had protein in it, too. Everything in moderation, right?

Today I am bloated. There could be any number reasons for feeling bloated, but I am trying not to be upset with myself about the queso. If I truly believe in the "everything in moderation" philosophy, I wouldn't be upset. I didn't eat enough queso to be upset. And yet, I could SWEAR that my face looks rounder today. I looked in my bathroom mirror and I looked like the 300-plus pound person I was eight months ago. I swear my pants are tight when they aren't. And I'm scared.

I couldn't have gained 55 pounds back overnight, right? Or even 14 or 10 pounds? I don't even want to think about the scale. What have I done? At the beginning of my time on Wegovy, I really believed in "everything in moderation." Now that I've seen more significant results, I don't want to do anything to screw up.

In the past, I would give up when I hit a plateau. Why bother? My therapist yells at me when I express fear that I will "rest on my laurels." Today I've barely eaten. I should probably fix that. But I'm not hungry.

For Others

I wanted to include accounts of body dysmorphia to demonstrate that the experience is truly different for everyone.

No one is immune to it -- not even the folks you see on TV. For my good friend Josh Mankiewicz from Dateline NBC, body dysmorphia continues even after his 70-pound weight loss, and achieving success in keeping the weight off. And, even after People Magazine asked him to talk about his success.

"You still see yourself as bigger -- even when you're not," he explained to me, over one of our many conversations about weight loss, lifestyle changes, and buying clothes that aren't your size anymore. (BTW, you can find Josh on Bluesky at @joshmankiewicz.bsky.social, though he's awfully humble about his weight loss.)

To get even more personal, my own father experiences body dysmorphia, more than 40 years after losing 110 pounds.

"I'm still fat in my mind," he shared with me, before telling me a story about a phone call he and my mom had with a psychic medium they once had sessions with frequently.

"Are you really fat?" the psychic asked my dad, who had lost the weight by this point. After explaining that he used to be, the psychic responded with, "You still see yourself that way." Regardless of your belief in psychics or aura readers, it was apparent that my dad's shame related to his formerly fat body was imbedded in him, years later. His body dysmorphia was apparent to someone who'd never met him in person.

Luckily, my husband has seemingly escaped body dysmorphia -- he's lost 41 pounds with Ozempic since July 30th. He is very proud of his weight loss (as he should be!) and is much more secure in his body than I am in mine, at this point.

However, I've heard him talk negatively about his body in old photos. Recently, in looking at our wedding photos, he referred to himself as "Jabba the Hutt" from Star Wars, which broke my heart a little. I am glad that he sees how far he's come, but I hope he doesn't continue to disparage himself for his past state of health. While Anthony may not experience body dysmorphia per se, he experiences feelings of guilt around his previous appearance.

From the female perspective, my mother still experiences body dysmorphia -- many years after she lost a significant amount of weight.

"I hear someone say that I'm thin, and I think, they can't be talking about me," she explained to me. From a completely objective perspective, my mother IS thin. But she still, instinctively, reaches for clothing sizes that are too big for her body.

In Sum

So, what can be concluded from these first-hand accounts from people I care about? We need to keep having conversations about body image at EVERY size. It is essential to stand up to the body shaming that plagues our society and infects our brains. Intentional weight loss is perfectly fine if it's your personal choice, if it is approached from a healthy perspective (read: you need to eat to live), and will allow you to feel better about yourself and your health. However, it is not anyone's right to criticize anyone else's body -- regardless of if you perceive that body as "too fat" OR "too thin." It is one thing to discuss concern for health with a trusted friend or family member; it is another thing entirely to body shame. We are so much more than our appearance.

Please know that if you're reading this post, and you experience body dysmorphia or any type of body shame, you are not alone. This experience is a metaphorical mountain, but it's possible to climb it. And if you need to talk, I am here for you.

To receive 24-hour help for Body Dysmorphic Disorder (BDD), contact the New Vista Helpline at (800) 928-8000.

Additionally, if you feel that you are, or someone you love is, exhibiting warning signs of an eating disorder, contact the National Eating Disorders Helpline at (800) 931-2237 or text "NEDA" to 741741. Eating disorders can include Anorexia, Bulimia, Binge Eating Disorder, and others.