by Brian Cuban, Contributor
I first began to see my body reflection differently in my teens. I was the victim of fat shaming at home and weight bullying/teasing in school including a physical assault. When I looked in the mirror or saw my reflection in a store window, I had an overwhelming feeling that I had this grotesque stomach and love handles that seemed out of proportion to my body. It was not just the stomach however; I felt I could actually see ugliness and stupidity in myself. I saw the “fat pig” and “dumb bunny” that had been drilled into me by my mother just as she had it drilled into her by her mother. As is often the case with fat shaming at home, it runs downhill through generations. I saw the teased, fat little boy whose unacceptable weight and appearance had also been drilled into me by kids at school, my gym teacher and baseball coach. My reflection became my enemy but at the same time I was obsessed with it. Constantly looking at it. Unable to turn away from the train wreck. I had to take control of the mirror. At eighteen years old, I chose the only tool at my disposal. One that only I could control and could keep secret from everyone else. Food.
My freshman year in college, I began to starve myself. I thought that if I could get thin enough I would become accepted. I would no longer be ugly. I would no longer be alone all the time. I would go on dates. I would kiss a girl. I survived on less than 500 calories a day for much of my freshman year. I weighed myself obsessively, sometimes 3 times a day at the campus infirmary. I later began obsessively body checking every part of my stomach as if my eyes could calibrate fat loss. I dropped an unhealthy amount of weight by the end of my freshman year. There was no diagnosis of anorexia. I had no idea the word existed. This was nineteen-eighty. Karen Carpenter had not yet taken the word into the national spotlight, even if just for women. For a guy filled with shame there was only silence and loneliness. It was just a behavior that I felt if I kept engaging in, I would be accepted the next day. I would be “normal”. In my mind however, that never happened. There was no end game. There was only surviving day to day.
By the time 1981 came around I decided I needed to try something new. I could not mentally maintain the starvation diet. I discovered binging and purging. I became bulimic. In that brief moment of the purge, I felt normal. Then came the guilt. I stayed bulimic for twenty-seven years. There were times in that period where I was binging and purging daily where I probably fit the clinical diagnosis and there were times when it was more sporadic. Of course the mirror never changed.
As I got older, I discover alcohol and drugs, all in the name of the mirror. I began to abuse alcohol and cocaine. They gave me a brief moment of feeling accepted and being social. Brief moments that I would come to seek out over and over.
Then there were the steroids. Then the thousands of dollars in plastic surgery. Hair transplants. Liposuction. None of it changed the overwhelming feeling in my body and mind that I was somehow deformed and ugly. I was always that fat, shy little boy who didn’t fit in. The intense feeling had spread from my stomach to other parts of my body including the perception that I had gone completely bald. I was so overwhelmed by that feeling that I could not leave the house for a social event unless I was drunk or high.
I lived a lifetime of obsessive-compulsive physically and financially destructive behaviors with one goal in mind…fixing the shattered image. Fixing the fat, ugly little child I saw everywhere. The image that I projected everyone else saw. Behaviors that could be addressed and possibly diagnosed individually but searching for that one common thread to get to the core problem. To step forward into recovery. That diagnosis was Body Dysmorphic Disorder (BDD).
BDD is often associated with eating disorders but in reality “only” 30 percent of those with BDD have EDs. While it shares many common traits, there are also differences that require different diagnoses for effective treatment.
One example is that BDD also goes hand in hand with Obsessive Compulsive Disorder. I would engage in body checking rituals. Obsessively looking into the mirror at my stomach and chest, which I also viewed as “deformed”, or my imagined bald head later in life.
Another example is that certain types of antidepressants can lessen the Obsessive Compulsive symptoms of BDD. I take 20mgs of Lexapro a day. It helps a lot!
While drug addiction, steroid addiction and eating disorders all at various points could have sustained their own individual diagnosis, I did not make sustained progress in my recovery until the underlying Body Dysmorphic problem was diagnosed and dealt with.
It took so long to get there because not only did I go through much of it before there was not a lot of awareness on male eating disorders and Body Dysmorphic Disorder, but as a male I was awash in the intense shame associated with male stereotypes and the stigma of a negative body image. Men simply do not talk about such things. I would not even tell my trusted treatment providers. This is why it is so important to be honest with yourself and with your treatment provider. For me honestly about my behaviors and just as importantly, my shame was the first step in recovery. Treatment providers are not telepathic and may be assuming given the trusted relationship, you are being completely honest.
Body Dysmorphic Disorder is a real and destructive for both men and women. It can be difficult to diagnose because so many behaviors overlap with other disorders. It’s not just about eating disorders. It can be about addiction. It can be about plastic surgery. It can be about obsessive-compulsive behaviors. It can be about shame. For me, for recovery to begin, it also needed to be about honesty and the willingness to drop that wall self-loathing for just one second. Trust someone and step forward. It’s not easy but in recovery long run, it’s worth it. Give it a try.