Why can't I like my body?
November 16, 2011 8:17 AM   Subscribe

Body dysmorphic disorder with no insurance, self diagnose before investing in a shrink?

I'm a late 20's male. I run 30 miles a week, surf 6 times a week for 2 hours (weekends are marathon 6 hour sessions) and do free-weights randomly throughout the week. I am 5'11" and ~174 pounds.

I am basically anorexic throughout the week, zero food during the day, healthy home prepared dinner. I eat whatever I want on the weekends (pizza, subs, chinese, cookies, beer, lots of beer) and feel guilty about it Sunday night.

My mom says I am 'skinny', but moms do that. I feel fit, strong and in shape, but can't help passing a mirror without checking myself out. Manboobs, a slight belly. Need more tone in my arms. My abs aren't showing enough. My 32 waist shorts feel tight this evening.

I judge every photo of me based on how my weight looks and how the skin on my face is bunched up. Is that shirt too tight? Can I see a belly?

By every definition of the US average, I am in incredibly great shape, but how would i stack up in, say, France?. My clothes looks good, shoulders are strong, I wear a medium, my jeans sag off my waist (although I feel the button pushing against my tummy).

So, help? is this normal? I used to be a little chubby but nothing severe, and I'm paranoid I'll get back to that weight. I enjoy the confidence of venturing in to the world knowing I look toned, but when I'm alone, I'm pinching my (lack of) tummy fat and sighing, feeling guilty about eating 1600 calories today and knowing people are looking at me thinking "he looks in shape, but he could be in better shape"
posted by anonymous to Health & Fitness (14 answers total) 4 users marked this as a favorite
Well, with the exception of not eating during the day, you're following (roughly) a Cyclical Ketogenic diet. The load-up on the weekends gives you the glycogen to burn during the rest of the week, but you're not just burning fat on this diet, you're burning muscle. You're not eating enough to build any muscle, not matter how often or how heavy you lift.

What's your BF%? Skinny fat isn't attractive in men or women. As for liking your body--I think that you might think about counseling and/or finding something more fun and gentle to do with your body--yoga, dancing, etc. It's not the meat, it's the motion.
posted by Ideefixe at 8:28 AM on November 16, 2011

I can't diagnose you with anything, but sounds like this is distressing you significantly and hampering your ability to live a normal life, so I think that it is probably time to see a therapist about it.
posted by the young rope-rider at 8:35 AM on November 16, 2011 [4 favorites]

is this normal?
Eating nothing all day and pigging out on the weekends? No.

knowing people are looking at me thinking "he looks in shape, but he could be in better shape"

They really aren't.

Drink less beer, eat less junk on the weekends and eat proper food during the week - at least 3 meals a day. If you want to be in shape, one of the worst things you can do is skip breakfast. Weight yourself once a week and moderate your calorie intake/exercise levels accordingly to prevent ballooning.

From your stats you're at the upper end of healthy BMI-wise but that could mean anything from skinny-fat to pretty buff.

We cant tell from your post whether you have BDD even if we were psychiatrists (I believe a key feature of BDD is that the 'flaw' is imaginary or so trivial hardly anyone would notice). You certainly seem obsessed with your appearance and maybe therapy could help with that but with all the working out you do if you do still have moobs and a bit beer gut, pre-occupation with those things isn't entirely unreasonable. How often are you preoccupied with thoughts about your appearance? Is it only when you pass a mirror or see a photograph or do these thoughts interfere with your daily life?
posted by missmagenta at 8:39 AM on November 16, 2011

Skinny fat isn't attractive in men or women.

Telling someone who might be anorexic that a certain body type "isn't attractive" is very mean. The young rope-rider has the only possible answer: we can't diagnose you online. Seek professional advice.
posted by John Cohen at 8:39 AM on November 16, 2011 [20 favorites]

If you are constantly thinking about your weight - whether you are skinny or fat - you may benefit from therapy. Body dysmorphic disorder might not be the issue; it might be depression/anxiety/obsessive thoughts. No matter what your weight, it's not a reasonable way to live if you're constantly anxious about your appearance, constantly worrying about how you look in photos (which is miserable, I've been there), freaking out about how others are judging you. (Which they aren't, generally.)

There are two things in play here: a reasonable desire to be healthy and feel attractive; and tying up something (self-worth? anxiety? obsession? self-punishment?) in how you look.

First off, think about what a miserable mental world you're living in - one where it's totally okay to judge complete strangers on something as random as whether they are "toned enough" or not. Think of the older folks, folks with illness or disabilities, folks whose body types simply never will be "toned enough" no matter what - I bet you don't believe that those folks should feel terrible about themselves and totally inadequate and guilty. So why not extend the same compassion to yourself?

This is absolutely not about how you look - it's just not. We all really need to separate out how we look, our health, how we eat/exercise and whether we are worthwhile/at home with ourselves. Those are all different things.

And guys can totally starve themselves, you're right. I knew this guy - such a pretty kid - who was vulnerable to that. I didn't see him for a couple of months and then I didn't recognize him, he was so thin and ravaged-looking from exercise addiction and self-starvation. It was shocking and very sad. There was no way in the world I would have wanted him to feel that kind of pressure to conform to beauty norms.

Now, it may be that you're still in a post-chubby adjustment phase and this anxiety will dissipate, but a couple of sessions with a therapist will help you distinguish something like that from obsession/anxiety that needs further treatment.

(A side-note : I went through some extreme dieting in my teens, got about as skinny as my body type will allow, and gained most of it back seven years later. (but I learned that I like to exercise a lot, which I still do and am pretty fit) I was miserable and anxious for most of those seven years. I'm fatter now, yes, but I am happier and more attractive and no longer beanplate every body thing. Now, you may well stay skinny for life, especially if your family tends to be thin (which mine totally does not) but please keep telling yourself that skinniness is not the definition of happiness or attractiveness, nor is it absolutely necessary to mental peace.
posted by Frowner at 8:41 AM on November 16, 2011 [1 favorite]

(And just to continue - I think it's great that you're able to name this as a troubling thing. Just from the answers I'm seeing here, it's so clear that guys simply are not supposed to name/talk about body image stuff. Trust me, it's one thing to want to be all cut and toned and so on and another to have no peace if you're not. The solution isn't to "man up" and decide based on your body fat percentage "hey, I should totally be miserable about this!" or "no, I shouldn't worry". In fact, that kind of thinking is exactly what you shouldn't do. Work on the unhappiness and let the fitness take care of itself, especially since you seem to enjoy exercise for its own sake (or I assume that no one surfs all the time unless they like it, at least).
posted by Frowner at 8:47 AM on November 16, 2011

and knowing people are looking at me thinking "he looks in shape, but he could be in better shape"

No one is actually doing this. This is in your head.

I agree with the young rope-rider, these thoughts are constant and intrusive, and that means it's time to see a mental health professional.
posted by crankylex at 8:50 AM on November 16, 2011 [2 favorites]

Yes, you probably need a therapist, but I thought I would recommend you see one AND see a nutritionist, and it would be ideal if they came as a team specializing in eating and body image problems.

I say this because your calorie intake as reported sounds drastically low. I put your height, weight, and activity level as reported into an online calculator and it suggested you need over 3000-3500 calories a day just to maintain the weight you're at with your current physical activity. It sounds like you're not getting nearly that much and it's probably not helping you stay fit and healthy in the long term, if you measure more than waistline. What's your blood pressure, insulin sensitivity, etc.? Are you deficient in a major nutrient? Those are the best indicators of whether or not your diet is working. If you don't eat you will never look "toned" but more importantly you will be unhealthy in other ways.

Hopefully a combination of medical and psychiatric professional help will get you thinking about your health in a different way. If you can't afford all that now, see the nutritionist first for a consultation and eating plan, see if you can start eating like they tell you for a while, and if you're still feeling unhappy then it's therapist time. Ask the nutritionist for a referral.
posted by slow graffiti at 8:58 AM on November 16, 2011 [1 favorite]

eat proper food during the week - at least 3 meals a day. If you want to be in shape, one of the worst things you can do is skip breakfast.

There's a fair bit of evidence to contradict that advice. Well, at least a fair bit to suggest that intermittent fasting or every-other-day fasting has positive health effects and definitely enough to suggest that it's at worst a wash. So I wouldn't want the OP to feel like he has to radically change his eating habits.

I dunno if it's "normal", but it's certainly something a lot of people live with. If you're obsessing about it enough to Ask Mefi, you might want to consider therapy, though.
posted by pjaust at 10:50 AM on November 16, 2011

As someone with BDD the way you're thinking sounds really familiar. As the young rope-rider says, it's impossible for us to diagnose over the internet, but I can tell you that your question just made me suck in my stomach and sit up straighter, and that I've had all of the thoughts you describe despite being objectively quite thin and normatively attractive.

Do you have a friend (who isn't your mom) that you can check in with about this? One thing I have found helpful in the past is to just ask someone else to double check my assessments of my weight, specifically to point out people on the street whose body shape appears similar to mine, as this gets closer to some kind of objective measurement than having someone say I'm skinny. I never point out the same people my friend does, but it's helpful for me to see exactly how wrong I am, and that definitely varies from time to time. If not, looking at a height/weight chart with photos of real people might be helpful.

As far as the way you're eating, that sounds like it must be contributing to the problem. Can you find a way to make your diet a bit more regular and less-guilt inducing? I don't even mean that it's likely contributing to the (maybe imaginary) weight problem, but that it's clearly anxiety inducing and uncomfortable both during the week and on the weekends. I'd argue that body image and what you do about it can be totally separate issues, but it may take you a while to disentangle them (if you ever can), but it's worth trying. If anything, I'm living proof that it's entirely possible to have ridiculously inaccurate body image and still eat in a healthy, non-upsetting way and maintain an objectively reasonable body weight. It's not the best way of living, but it at least limits the effects of the BDD to my mind, rather than taking them out on my body as well.

It's also worth saying that even if this anxiety isn't related to BDD, and even if you're perceiving your body accurately, it's clearly making you unhappy, and that's something worth addressing. If you don't like your body, the answer may be to try to find ways to like it, rather than finding ways to change it.
posted by dizziest at 11:13 AM on November 16, 2011 [1 favorite]

I am a lady but you sound exactly like the mean voice in my head. Other people have addressed the issue of whether or not you're eating enough to maintain muscle. Perhaps you should see a therapist; it sounds like CBT might help you with the incessant picking at yourself and worry about the way your clothes fit.

I'd like to know if you're, well, lonely or unfulfilled in other ways. When I'm really present with my friends or engaged in a happy relationship, the voice goes away. When I'm working on a project I really care about, the voice goes away. I feel loved and proud of myself at those times, so the way I look matters so much less. When I don't have enough going on in my life, I start running more, eating less and worrying about my waistline. Do you find this to be true in your life? Is there something you can do about it?
posted by millions of peaches at 11:41 AM on November 16, 2011

It sounds like you're having repetitive thoughts of guilt and shame about weight. Fortunately, these kinds of intrusive thoughts are basically what therapy is made for, so I think you could benefit immensely here. You don't have to prove you have a particular type of mental illness in order to get a therapist who will take you seriously and work on these issues with you.

Also, you might find the Seth Rogen/pinups thread (NSFW) illuminating for challenging the accuracy of your internal judgments: not everyone equates skinny with sexy, and some people even invert this judgment. In my experience, the knowledge that it's impossible to be universally attractive can be liberating. That doesn't mean you can't exercise control over your weight if you choose to, but breaking some of the painful and inaccurate associations can help make it a less emotionally fraught issue.

There's also the question about whether your actual eating habits are disordered. It's true that there are people in the fitness community who do things like eat once a day or alternate fasting/feeding cycles. But my understanding is that these are advanced techniques -- they can be anti-productive if overdone, and it sounds like your mental state might be getting in the way of doing them properly. For example, thePrecision Nutrition website has some cautionary tales about overuse of IF:
I had a similar experience to JB when I combined more frequent IF with heavy training for several months – another thing not to do.

In particular, people commented on how awful my face looked. (Thanks, guys.) I was lean (about 15%), but still a normal weight (110 lb at 5’0”). Family members worried that I had a terminal disease. One person even told me I looked like a prison camp inmate. Not exactly the look most us are striving for.

When it comes to fasting, do just enough to meet your goals. And maybe even a little bit less than you think you “need.” Don’t overshoot your body’s capacity to recover, unless you want to look (and feel) like the proverbial Death sucking on a cracker.

... If you’re considering IF as part of a fat loss program, use it wisely. If strong food cravings and binge behaviours appear repeatedly (especially if you are using IF to compensate for binges, or as a means to control and restrict your food intake), treat them as a signal from your body. Pay attention.
Good luck and be well.
posted by en forme de poire at 11:46 AM on November 16, 2011

Just from the answers I'm seeing here, it's so clear that guys simply are not supposed to name/talk about body image stuff.
posted by ead at 3:36 PM on November 16, 2011

Normal? Probably not. Common? *Oh* yes. I don't really exercise, though I should, but I have also fallen into the Weird Eating Trap again lately. Technically, it's something we should get out of. It's also not something I know how to get out of.

Here's one thing: if you are like me, your idea of eating a lot on the weekends is probably not much like most people's idea of eating a lot. It might be useful to remember that. And if you really are binging, it would no doubt feel better to regularize your eating a little bit. Allow smaller treats on more days. It helps the craving for Bad Foods (TM) stay a little bit more manageable.

Also, if you're like me, the height/weight sites may not help. I was just on the one linked last week criticizing myself for not being taller and thinner. If you are a person who makes *sense*, mind, it might help a lot. For me, this has been lifelong. Hopefully it won't be for you.

But probably keep up the exercise. That sounds like a really good habit to be in regardless of body image.
posted by Because at 12:46 AM on November 17, 2011

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