It’s 3 AM as I stumble my way from my bed into my bathroom. I don’t turn on the light; I don’t need to. I know where I am going.
In the darkness, my feet find the rounded edges of the scale and I step onto its cool surface. A blue screen lights up the room, flashing familiar numbers at me.
I let out a sigh of relief. (Had I been holding my breath?)
The numbers haven’t changed since last night. That helps.
It means I don’t need to worry about pulling out the measuring tape.
Not until the morning, anyway.
Maybe now I can finally sleep...
A little over two years ago, I led a very different life. For a variety of reasons, many of which were beyond my control, I had forgotten how to move my body and how properly fuel it. I spent over a decade living a sedentary, deconditioned life, and my body was suffering the consequences. I lived in a perpetual state of exhaustion. My brain was tired, my body was tired, and my spirit was tired.
I knew I needed to do something soon, or the fatigue would wind up consuming me. So, over the course of next year, I made a series of small but intentional changes to my activity levels, my nutrition, my sleep habits and- in essence- my entire life.
I embarked on a transformative journey of self-care.
The change was dramatic, positively impacting virtually every aspect of my life. And, while I would argue that it is isn’t the most meaningful or important change, by far the most noticeable one was the roughly 100 lbs weight loss.
I didn’t expect the weight loss, nor was it the focus of my efforts. Mostly, I just wanted to be stronger and to feel more alive. That said, it’s hard to not focus on the weight loss when it is literally the only thing people seem to notice and talk to you about.
“This isn’t about size”, I would try to keep reminding myself. “This is about creating a happier, healthier you.”
And as far as goals go, I’ve been mostly successful on that front. You’d be hard-pressed to find a doctor who wouldn’t define me as ‘healthier’ now and, overall, I suppose I am happier. I wake up with more energy, get a better quality of sleep, and have discovered exciting new hobbies and interests. I have a new career in health and fitness that inspires me. I feel deeply passionate about my life in a way that I never have before.
But let’s get real here: happiness is a spectrum, and weight loss? Well, it’s a little more complicated than you might think.
For the past year, I have been struggling in my body. My brain, still not able to fully process the physical transformation that I have undergone, wavers between the borderline-delusional belief that I am still as heavy as I used to be, and the paralyzing panic that all the weight I lost will suddenly reappear. Every morning, I bind my excess soft, saggy stomach, fighting back tears at the thought that others must find it repulsive. Every night I stare in the mirror, analyzing every loose fold on my body, wondering who they belong to.
I feel lost in this body. I am a stranger in this skin.
While I am sure that some people feel happier when they lose significant amounts of weight, for many of us it’s a pretty bittersweet phenomenon. And for those who- like me- experience Body Dysmorphic Disorder (BDD), it can be a dangerous one.
If weight-related BDD is new to you, you aren’t alone. We live in a thin-obsessed culture that is so hyperfocused on body size that the idea of potential downsides to weight loss seems unimaginable. But if you are a health and fitness professional, it’s time to get intimately familiar with this condition; at the risk of sounding dramatic, the lives of your clients may depend on it.
BDD is defined as a serious body image disorder characterized by persistent and intrusive preoccupations and dissatisfaction with imagined or perceived flaws in one’s physical appearance. A serious condition on its own, it is often further complicated by co-occurring diagnoses depression, substance abuse, self-harm and suicide ideation. Suicide completion rates for those living with BDD are up to 36 times those of the general population.
While relatively rare, BDD nonetheless affects approximately 1 in 35 people, and this occurrence rate may be even higher in populations that have experienced significant changes to their appearances. When experienced by those who have lived massive weight loss, BDD is often referred to as the Phantom Fat Phenomenon, and often presents as a difficulty in processing and accepting one’s new body size as ‘real’, as well as excessive anxiety related to weight-gain.
Of particular interest to the health and fitness professional is that BDD will often manifest differently in men and women. Women with size-related BDD are more prone to social avoidance, and extreme behaviours such as taking on dangerous excessive exercise habits or disordered eating patterns focused on reducing their body mass. Men, on the other hand, tend to gravitate in the opposite direction by exhibiting a very specific subtype of BDD referred to as Muscle Dysmorphic Disorder (MDD), a pervasive and debilitating preoccupation with increasing muscle mass. It is not uncommon to find men with MDD gravitating towards steroids use, or spending excessive amounts of time and energy weight training.
And while incidences of BDD are themselves relatively rare, research indicates that- contrary to our current beliefs- weight loss is not generally associated with significant improvements in psychological well-being, and may even double the risk of depression in otherwise healthy obese individuals. In fact, most people who go through significant weight changes will experience some element of dysmorphia, of varying severity. The implications of these emerging studies can not be overstated, especially in an industry where we unabashedly link weight loss with “happiness” and continuously tell our clients how much better they will feel if they lose weight.
As health and fitness professionals, we have a responsibility to ensure that our training methods are safe for all our clients. This includes the mindful use of behaviour modifying tools and language intended to motivate and support lifestyle change. However, we must also exercise caution in ensuring that we are vigilant in how words can impact our clients, for better and for worse. As evidence indicates, our continued tying of ‘weight loss’ to ‘improved happiness’ may in fact be more harmful than helpful, triggering strong reactions of self-loathing and anxiety in many people.
We must instead begin to shift our focus towards the aspects of health that we know are much more directly correlated to improved happiness and quality of life, namely how our clients will feel as opposed to they will look. We must consider that true health is the delicate balance of the mental, emotional and physical wellness.
We must learn to see people, not just bodies.
After all, health- and happiness- comes in all shapes and sizes.
To learn more about BDD and other health related mental illnesses, visit The Body Dysmorphic Disorder Foundation at www.bddfoundation.org or contact the Alberta Chapter of the Canadian Mental Health Association at http://alberta.cmha.ca/.
Zita Dube-Lockhart is a fitness and exercise professional based in Edmonton, Alberta. A mother of two amazing kids, her practice is centered on promoting the values of body positivity, social inclusion, diversity and accessibility. She is the creator of the Atmosports Trampoline Fitness Programs, including SkyFIT, AirObics and Fitnastics, exclusively offered at Jump 360.