body image

My friend is a 33-year-old female who has struggled with weight all of her life.  She has been anywhere between 150lbs-250lbs.  She says she couldn't see herself as thin at 150, and doesn't see how fat she is at 250 (but she feels terrible and wants to lose the weight.)  Pictures and videos disgust her--but she just can't believe this is how she looks.  Any suggestions?  Thanks!

[HFHS MD - RG]

A condition called Body Dysmorphic Disorder is what your friend may be suffering from.
This is an imagined belief that there is a defect in appearance of all or a part of the body.
Usually the patient complaints of a defect which is out of proportion to any minor objective physical abnormality.  no known patholgivcal abnormalities exist and actually minor body deficits may exist but the concern is grossly excessive.

Because of her imagineed porr body image, it seems like her reaction goes to extreme explaining the wide disparage in weight.

A trial of SSRI antidepressants like Prozac, Zoloft, Paxil may benefit her. Psychotherapy is useful as it uncovers conflicts realting to symptoms, and feelings of inadequacy.

[Doggies4]

I think she may feel as I do.  I have fought with my weight since I was 19. I am now in my forties. I weighed in the 130's and now I am up to the 260's.  When I lost all of my weight one time, I didn't see myself as thin, and now that I am 260 I don't see HOW large I am.  I feel just normal, of course, I know I am not!  I know I am fat, but I don't see HOW fat unless I see myself in pictures.  Then it disgusts me.  I feel so ashamed and embarrassed that this is how people see me.

I definitely know I have a problem.  I have no advice, but I have that problem, too.

[Betty]

Let me tell you that I have the same feelings that you have!  I have been overweight since I was about 6 years old.  It would get real bad one year and then the next I would loose weight. When I was in middle school and high school I was about 180 pounds and that was HUGE compared to the other girls AND boys.  I lost weight with every diet on the market including street drugs and starvation.  Of course the weight always came back but then I decided to loose weight again when I was about 30.  I lost a little over 100 pounds and looked and felt great!  People treated me nice after i lost weight because they were wanting to talk to me and find out how I did it and tell me how pretty I am.
Well, I stopped working out all the time everyday and it all piled back on!  I hate this!  When I weighed 150 I felt so terrible that people were looking at me that I didn't even want to get out of my car and get gas at one point.  I just kept driving around to find a station that was empty.  I didn't like people treating me nice just becasue I looked good and when i gain the weight back I'm invisable again.  I've seen how people treat me fat verses normal size for years now and it stinks!  I'm starting to loose weight again and I hope that this time I can handle it and keep it off! After 35 years of up and down I've had it!
Betty

[marie]

I too have been overweight most of my life and know how difficult it is to cope with both the self-loathing and the disdain of others (including physicians). It's also difficult for me to visualize how heavy I am now (am 5'5" and weight 215 lb)until I inadvertently see myself in a mirror or photo. However, with all due respect to the psychiatrist who answered the question about Michele's friend, is this really body dysmorphic disorder?  If body dysmorphic disorder is defined as excessive concern about an imagined or slight body defect, surely being approx. 100 pounds overweight is neither imagined nor slight.  I also don't have any answers because countless times I have dieted, lost a significant amount of weight, felt good about myself, and then regained all the lost weight and more.  In my case, the SSRIs (Zoloft, etc.) actually seem to have contributed to weight gain, rather than weight loss, since I develop an "I don't care" attitude on these medications (even though some part of me cares very much).  However, I cannot stop taking these medications because they do ameliorate the severe clinical depression that I also have. Sorry this is such a nonhelpful reply.  Does anyone have positive suggestions?

[Julia Griggs Havey]

This particular forum discussion was forwarded to me. I am shocked by the therapist answer. This woman is 250 pounds. She is morbidly obese and must get her weight under control. Tranquilizing her is NOT the answer! Teaching her what to eat and  how to best exercise and get her body healthy will go further in rebuilding her self esteem and making her happy again than pills ever will! To drug her would be to merely but a bandaid on the damn that is about to burst!
I lost over 130 pounds and know first hand the terrible effects that obesity can have on our mind, our lives and our future. I encourage the friend that sent this in to have the young lady in question contact me. I will personally do what I can to help her!
www.JuliaHavey.com