Eating Disorders: Do These Genes Make Me Look Fat?

We are a society obsessed with looks. It's much more than just worrying about a bad hair day, it's millions of dollars spent on skin treatments, botox, plastic surgery, diet pills, models too fat, models too skinny, beauty pageants, make-up, hair implants, workout videos, gym memberships, liposuction, personal trainers. As a society, we seem to have OCD (Obsessive Compulsive Disorder) about our looks.

So it is no surprise that eating disorders are so prevalent. We probably all know someone, or know of someone, who struggles with one or more of these disorders every day. Some important facts to note: There is a proven genetic component to eating disorders, people may be pre-disposed to struggle with it, and eating disorders often start in the teen years, but don't be fooled into thinking that it's only teens who have it. Adults can and do have eating disorders as well, but generally are better at hiding the signs.

February 25-March 3 is National Eating Disorders Awareness Week.

People with eating disorders spend 80% to 90% of their day, every day, fretting and obsessing about their appearance, according to Theresa Fassihi, PhD. Dr. Fassihi is a psychologist with the Menninger Clinic's Eating Disorders Program. And 40% of those with eating disorders also suffer from a distorted image of their bodies, clinically called body dysmorphic disorder (BDD). Any treatment, therefore, for eating disorders should also include efforts to re-focus body image on the real rather than distorted image. This is the objective of the Menninger Clinic program.

(Houston's Menninger Clinic is a nonprofit psychiatric center, ranked among America's Best Hospitals by U.S. News & World Report for 16 consecutive years. They provide psychiatric treatment, research, and education.)

Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is a mental illness, diagnosed when a person is obsessed with either perceived or minor flaws in their appearance. BDD causes its sufferers to engage in extreme or harmful behaviors (e.g. bulimia), to spend extravagant amounts of money on treatments and surgeries, and to compulsively seek out mirrors to see themselves, not out of vanity, but out of disgust. Sadly, those with BDD usually think of themselves as hideous, with sufficient reason to either hide themselves or do whatever is necessary to change their appearance (think of some of the stars, like Michael Jackson, who have had so many surgeries, striving for perfection).

BDD can lead a person to withdraw from friends and from society, fearing humiliation and ridicule. Low self-esteem is common because the person places the highest value on appearance, and their own appearance is, to them, disgusting. In severe cases, a BDD sufferer may become completely homebound. Sadly, the disorder is also linked to a significantly higher rate of suicide among all mental disorders, 10 to 25% higher than in the general U.S. population.

Body dysmorphic disorder is a serious and sometimes devastating disturbance. For more information on this disorder, such as signs and symptoms and DSM IV criteria, click here.

The Menninger Clinic Eating Disorders Program

When the Menninger Clinic identified BDD as a necessary focus for treatment of eating disorders, they implemented a 12-week program to help patients improve their body images. They based the program on the work of psychiatrist and researcher Christopher Fairburn. Twice a week, patients met for experiential therapy and cognitive-behavioral therapy.

All exercises in both therapy groups focused on helping patients see the difference between their real body image and their perceived body images. In the experiential group, patients drew their own perceived body size onto paper, then another patient traced their actual body outline for comparison. Patients usually overestimated the size of their bodies, and it proved helpful to see the difference in a tangible way.

In the cognitive-behavioral therapy sessions, patients were asked to give voice to their negative self-talk and opinions, and then challenged to recognize the distortions and concentrate instead on the disputing evidence. Making positive changes to self-talk can lead to positive changes in self-esteem and improvement in symptoms.

Another exercise in the cognitive sessions had patients estimate how much string they thought it would take to wrap around a particularly worrisome body part, such as their waist or a thigh. Because patients with eating disorders often have such distorted body images, these patients usually estimated a length of string three times longer than what was actually needed. Once the circumference was measured, they could see the concrete evidence of their distortion.

This type of program by the Menninger Clinic promises hope for treatment of any type of eating disorder, as well as body dysmorphic disorder itself. If you would like more details on this program for eating disorders, please read the article here.