Body Dysmorphic Disorder

Tuesday night I attended a presentation of four psychologists titled "Body Image Issues for Gays and Lesbians." At the panel, sponsored by the civil rights organization Equality Forum, I learned quite a bit about Body Dysmorphic Disorder (BDD) - and its applications to those in and beyond the gay community.

Taken from Wikipedia: "BDD is a mental disorder in which the affected person is excessively concerned about and preoccupied by an imagined or minor defect in his or her physical features. The sufferer may complain of several specific features or a single feature, or a vague feature or general appearance, causing psychological distress that impairs important functioning or social aspects of life."

Panelists used the example of men in the gay community who have a preoccupation with big and lean muscles, one which drives them to spend countless hours in the gym.

Also from Wiki: "Most people wish that they could change or improve some aspect of their physical appearance; but people suffering from BDD, generally of normal or even highly attractive appearance, believe that they are so unspeakably hideous that they are unable to interact with others or function normally for fear of ridicule and humiliation about their appearance."

Panelist Elan Cohen described many of his male clients with BDD as having "ideal" body types (ripped abs, huge arms and chest, etc) who still believe themselves to be fat. Another therapist, Carly Schulman, mentioned that 90% of her BDD clients - mainly women who believed themselves to be fat - weren't actually overweight.

BDD should not be taken lightly as it seems to go hand-in-hand with depression, OCD, anxiety, and eating disorders. The panelists spoke of the frequent need to medicate clients with BDD.

So how do you recognize this condition? Some signs include:

• Compulsive mirror-checking or obsession with one's reflection


• Reassurance-seeking from loved ones


• Social withdrawal


• Frequent referencing of celebrities the person wishes to resemble


• Obsession with plastic surgery

Two unique signs came from Dr. Petros Levounis, who compared the disease to that of an addicted gambler, and offered the following:

• Someone who makes a promise or an agreement to do (or not do) a certain behavior - i.e. "Today is my day off from the gym." - and then still does it, may be suffering from BDD.


• Someone who lies to his/her family or friends about eating or exercise behaviors may be affected as well.

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As a trainer, what concerns me is that there seems to be a fine line between encouraging people to take interest in adopting healthy behaviors and feeling proud of their body's resulting physicality, and pushing them to the point where they are obsessed over these habits and their accompanying aesthetics...where things like BDD enter the picture. Unfortunately, our culture likes to emphasize feeling proud about the body more than adopting healthy behaviors. Just think to the widely-accepted "If you got it, flaunt it" mantra. The media feeds us images of men and women with "perfect" bodies in magazines, advertisements, movies, and on TV. And because we dwell on these nicely-packaged finished products, we spend less time exploring and becoming excited about the other part of the equation, which is adopting healthy behaviors.

This leaves me wondering, Is BDD specific to active people who workout in the gym? Or does it occur evenly across populations of those who seek exercise outside the gym (like outdoor runners, bike commuters, or those practicing yoga)? We try to keep the addicted gambler from the casino, the alcoholic out of the bar...should we be trying to keep the person with BDD out of the gym?

Two friends of mine - one a sociologist and the other a psychologist - weren't sure, and agree that I may have stumbled upon a dissertation topic. Yikes!

Any thoughts?

The Spot Reduction Myth

"What exercises can I do for a flatter stomach?"
"How can I get rid of my belly?"

This might be the most common type of question clients and acquaintances ask me. Usually, it's as if they are expecting a one-minute answer and an easy, simple solution. Sorry! There isn't one. No magical crunch variation will make abdominal fat disappear.

As with any body part, you can't "spot reduce," or eliminate fat at one region in particular - i.e. belly, back of the arms, inner thighs, etc. - by simply doing exercises to target that body part. Your body is composed of muscle tissue covered by a layer fat tissue. You cannot turn fat into muscle tissue. Period. It's impossible. You definitely can't put in a few sets of crunches every now and then and expect to turn a pot belly into a 6-pack. Exercises like sit-ups, crunches, and planks will strengthen and grow the abdominal muscles but they still will not appear toned if they are covered with a layer of fat tissue.

Reducing fat at a particular body part requires reducing fat on the body overall. This can be done most efficiently with a combination of:

1) Strength-training. Perform exercises for the entire body. Choose exercises that have a core stability component (typically for these your feet will be on the ground) over those that don't: squat over leg press, push-up over lying chest press, pull-up over lat pulldown. This way your abs are at work all the time. Include ab-specific exercises but don't obsess over them. Spend about 10 minutes three times per week doing abdominal exercises that fatigue your muscles in 45-60 seconds. PS - The people who say they do 1,000 crunches are foolish. First of all, I would LOVE to see anyone do 1,000 crunches with correct form. And second of all, you'd still have to figure out a way to reduce body fat for those PHENOMENAL abs to rip through...

2) Cardiovascular exercise. Make sure you are regularly doing some form of exercise that elevates your heart rate and keeps it elevated - i.e. walking, running, biking, boot camps, etc.

3) Balanced caloric consumption. If you are taking in more calories than you are expending, your body stores those extra calories as fat. Most people I talk to know exactly what they are eating that is causing weight gain or delaying weight loss. They are simply not making any changes. You don't need to count points or go on a cleansing cocktail fast to moderately adjust your areas of indulgence. You might reduce your portions, avoid processed foods, eat more fruits and vegetables, stop buying takeout, stop going back for seconds, cut down on soda and sweetened beverages, limit fried foods, or - horror of horrors - reduce alcohol consumption (No!).

Get the idea?

It's a commitment.

If it were easy, more people would be running around with rock hard abs.

April Book Review: My Depression

About four months ago, I started seeing a therapist for depression. I put it off longer than I probably should have because I thought myself to be far more emotionally superior to those who had experienced trauma or sexual abuse or personality disorders. Those were the people who needed help. I just needed to get over it. 

To look at my life on paper, things were going great. Making decent money? Check. Great partner? Check. Exciting friends? Check. Supportive family? Check. 

But when acquaintances casually asked me, "Hey, Linds, how's it going?" I felt disgusted with myself when I fired back automatically with, "I'm great. How are you?" or "Hangin' in." The truth is that I felt unstimulated, dragging myself through most days, unable to account for the funk that I was in, and hating myself for not being able to break through it. As it got worse, I cried myself to sleep on many evenings, not knowing how to accept comfort from others. I felt lonely and isolated. After nearly breaking down at work one day, terrified to teach a class for fear that I wouldn't be able to hold it together, I finally realized that maybe it wasn't such a stretch after all for me to talk to someone about the way I was feeling. 

I didn't intend for this post to be about me, only to relay how relevant a book like My Depression has been to me, someone who seems so "buttoned-up" (a phrase someone actually used to describe me recently!) on the outside yet often feels a lack of control inside.  

Elizabeth Swados, a well-accomplished musician and writer, shares the intimate story of her own depression using a children's book format in My Depression. With simple illustrations and humorous captions, Swados takes us on a 20-minute journey down into her "black hole" and out again. We learn what triggers a depression, how it feels to spiral downward, what it feels like to be in it, and the slow process of climbing out. While many people suffering from depression may relate directly to the feelings expressed in the book, others may gain insight into the lives of affected friends and family members. I learned about the book through my friend, Dan, a psychologist who uses the book to help clients, and their loved ones, connect to and understand the condition. I recommend it to anyone who is interested in taking a closer look at this disease in a refreshingly non-clinical way. 

March Book Review: Strength Training Anatomy

February Book Review: In Defense of Food

January Book Review: Mindless Eating

Take a Walk. Eat Gelato.

The forecast for Thursday afternoon is 70 degrees and sunny. Catch spring fever: park your car on the edge of the city, walk to Capogiro, and eat the best tasting gelato EVER.

Capogiro, with two locations in Philly (13th and Sansom; 20th and Sansom), is a family-owned gelato producer devoted to using seasonal ingredients and milk from local, grass-fed and hormone-free cows.

I know, you're thinking, But isn't that fattening? Why is a trainer telling me to eat ice cream? Gelato, the Italian version of ice cream, actually has half the fat and half the calories of ice cream. It is a denser dessert, containing less air, so more of its flavor reaches the palate. When I go, I order a small (portion control - holla!). It will look kiddie-sized, but I promise, it is more than enough.

Plus, I am advocating that you walk. If you park in Fairmount near the Art Museum or on one of the Schuylkill River bridges in West Philly (where you'll find parking more easily than in the heart of the city), it will take you a 15-20 minute walk to arrive at Capogiro. By the time you walk back to the car, you'll have expended the calories you just enjoyed consuming.

And if that's not enough convincing, Capogiro will let you sample the flavors until you find the one or two you like best.

Join the Yogurt Brigade!

We are about to collect LOTS of yogurt cups.

And save the environment.

And donate to a local non-profit.

No, forreal though. 

I just signed up to collect Stonyfield yogurt cups as part of the Yogurt Brigade, a pilot program run through a hip new eco-friendly company called Terracycle. As explained on the website, Terracycle aims to recycle the yogurt cups into planting pots: 

"Every year millions of yogurt containers end up in garbage and landfills. Stonyfield Farm, the organic food leader and environmental pioneer, is partnering with Terracycle in a pilot program aimed at collecting used yogurt containers and reusing them as planting pots. TerraCycle will then sell planting pots to large retailers who currently use black plastic planting pots, millions of which are discarded by consumers every year."

Even cooler than turning trash into usable stuff? Terracycle will donate 2 cents for every 6 oz yogurt cup and 5 cents for every 32-ouncer to Back On My Feet (my non-profit of choice). For more info on BOMF, click here to check out my blog post or visit their website at: www.backonmyfeet.org. 

What you can do: Save your Stonyfield yogurt cups!! Stack them in your basement or in a closet or right by the trash can so you don't forget to throw them away. If you know me and see me, you can hand them off at any point. Over the next couple weeks, I will be working on putting together drop off points and will make rounds periodically through the city to collect! 

Email me at lindsey.schweiger@gmail.com if you will be saving your yogurt cups so I can keep you posted on collections. Spread the word by guiding your friends, family, and co-workers to this post!