The “problem” is, of course, that he hasn’t achieved the rail-thin physique he had as a teenager. His mother, instead of congratulating him for getting his health back and being able to crank out thirty to forty miles at a clip on his bike (he rides to work at least once a week, even during the winter), is not-so-subtly tweaking him for having settled at between 235 and 245 pounds, which is the weight he achieved two years ago. (Oh, and this is on a 6′ frame — really, I think most of his remaining “fat” is actually loose skin that just hasn’t shrunk enough to fit his current size.)

Does your friend have insurance? If so, then that’s an option for searching within her system to find a therapist who treats BDD. My therapist is within the HealthPartners system (and perhaps others) and her approach is Cognitive Behavior therapy which I found extremely helpful for my PTSD, anxiety, and body issues.

I wish that worked for me… I have pictures of when I was 18 and now at the exact same size and I see myself as huge in the now pictures.

And I third EFT. I think it’s the act of forgiving yourself… unfortunately for me it’s only been temporary fixes however I’ve managed to get through horrible moments using it. Beware though: Some people get physically ill after doing EFT and you may feel dehydrated and exhausted.

I don’t live in the Twin Cities sorry… but if anyone in the Cleveland, Ohio area needs a good therapist mine specializes in Body Image and Eating Disorders, she’s fairly fantastic and amazing.

I suggest trying to find an eating disorder group in the area and tapping them for ideas on therapists…

FWIW, “true” BDD (i.e. the DSMV diagnosis) is in large part neurologically based. If your friend is really stuck, it could be that her internal distortions are physically based, and therefore not able to benefit (right now) from straight-up psycho-social approaches. Cognitive Behavioral Therapy has shown promise with BDD, and there are some clinical trials going on right now (alas, not that I can find in the Twin Cities area, but
http://clinicaltrials.gov/show/NCT00211809 in case this is useful to someone else). SSRIs have also been shown to be helpful for some.

I hope that your friend will seriously consider CBT if her joy in life and ability to function are coming to be affected. BDD (like, well actually, MOST diseases, regardless of the organ affected) is chronic, and is likely to worsen the longer it goes un- or under- treated.

Best wishes,

I do this too, oddly.

It might sound strange, but you wanna know what helped? Taking pictures of myself. Repeatedly. Like, almost every day. My initial reasoning behind it was for me to learn what looks good on me and what doesn’t (fatshion). I’d take the picture and wait a day or two to really study it. It helped me to be objective about what I really looked like. The more I took pictures, the more my mental view of myself changed. At one time, I honestly thought I looked like those stereotypical “headless fatty” photos you see everywhere. But the more I looked at these pictures, the more I saw myself as I REALLY am. And yeah, I’m fat – there’s no denying that. But what I REALLY am and what I THOUGHT I looked like are so different it’s not even funny.

I would strongly recommend getting some sort of professional help for BDD, so I think you’ve got the right idea. But I would also say think about my approach as something to do ‘as well as’ and not ‘instead of’. I realize that just because it worked for me doesn’t mean it’ll work for anybody, but it’s something to think about at least. :-)

Can I look at myself in the mirror? No, not yet, EFT is helping me work on that.