“Dysmorphia” may not be part of your everyday vocabulary, but if I tell you that lots of people thought the late Michael Jackson suffered from it, you’ll probably know what I’m talking about. Body Dysmorphic Disorder (BDD, for short), is a complex psychological problem that results in obsessions with imagined defects in your personal appearance.
It drives people to exercise excessively, engage in extreme dieting, reshape their bodies through weight-lifting, get cosmetic procedures including plastic surgery, change their clothes often, engage in approval-seeking behaviors, and dress oddly in order to disguise imagined defects. It may also result in avoidance of mirrors, failure to seek medical help when necessary, refusal to participate in sports, sex, or other social activities, excessive beauty practices such as permanent make-up, dangerous chemical hair straightening, and the like. Many if not most of us have engaged in some of these behaviors at some point in our PCOS journeys.
In a group of people who have anxiety or depression, you’ll find BDD as an additional diagnosis in about 5 – 40%. This is quite a range, to be sure, but I think we’d find an even higher rate of BDD among women with PCOS. BDD is more common among women, actually, since we’ve already got a culture that is fixated on our likes as a central factor in our value. And, we’ve already got a much higher incidence of depressive and anxiety disorders, and our symptoms, while both internal and external, have particularly disturbing external manifestations. It can definitely reach an obsessive level of preoccupation when a woman is losing her hair, covered with excess hair in all the wrong places, erupting in acne, or dealing with stubborn, unbudgeable abdominal fat. The desire to be rid of THE PROBLEM can take an astonishing amount of time and energy.
I have clients who do all of the above, and more. If they’re not tackling the problem head-on (all discretionary funds go towards laser or electrolysis, they will not have sex unless and until they lose 50 pounds, they consider themselves complete failures at managing their bodies and tell themselves so regularly), they’re in avoidance mode. The avoidance usually affects social relationships, and further exacerbates depression – or being forced into a social situation will bring up anxiety.
It’s a complex condition that merits more than passing, gossipy attention from the media. It ruins lives. If you think you may suffer from BDD, please seek professional consultation to see how you can be helped. PCOS is complicated enough, without the extra layer of problems caused by BDD.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
If you've been enjoying the PCOS Challenge Radio Show, you'll love Sasha's latest venture! Dr. Van Dyke, Ellen Goldfarb, Gretchen Kubacky, and myself will be presenting more in-depth seminars on our areas of specialty.
Topics to be covered include:
Nutrition Essentials for PCOS--Monika M. Woolsey, MS, RD Tuesday, October 20
Eating Disorders and PCOS--Ellen Reiss Goldfarb, RD Tuesday, October 27
Living Happier and Healthier with PCOS--Gretchen Kubacky, PsyD Tuesday, November 3
Hair Removal Solutions for Women With PCOS--Susan Van Dyke, MD Tuesday, November 10
The Natural Solution to Overcoming PCOS--Julie Walsh, ND Tuesday, November 17
All webinars will be held from 8:00 — 9:00 Eastern Time.
Space is limited for the live sessions, but if you can't make any of the live sessions, they will all be recorded and made available on CD.
Please join us! We've all been working hard on this project and it's all been especially for YOU!
I enjoy a lot of physical activities. One that I particularly enjoy, likely because I have spent so much of my life in a hot climate, is swimming. Since junior high, one of my very favorite things to do, is get into the pool and swim a mile.
It has always bothered me that fitness experts give this form of exercise such a thumbs down. It's not weight bearing. It doesn't burn fat. Yadayadayada.
Tell me, does this look like the body of an out-of-shape woman to you?!?!?
Of course Dara Torres is genetically blessed, and of course, she lifts weights. But you can't argue that she spends a whole lot of time in the pool. It's not working against HER from what I see!
I wish fitness experts would stop talking about swimming as if it's a useless exercise.
The other night when I was swimming, there were a couple of people in the pool who were clearly getting back into fitness after significant time away. They would never have survived a half hour on the treadmill, or an afternoon hike, or a round of tennis. But they were in the pool and they were working hard. That is what was important.
Here are some reasons I love water fitness and why I encourage you to try it for yourself.
1. Swimming is gentle on your joints. If arthritis keeps you from a lot of activities, swimming might be an answer. You can move your body without pounding the parts of you that hurt.
2. Swimming is a great body image equalizer. Once you're in the pool, no one can really see what you look like. I think that's what keeps a lot of people out of the gym, fear that those in great shape are looking at them and judging them, rather than appreciating the tremendous effort it took to get there.
3. Swimming uses upper and lower body parts. I know I should probably lift more weights. But weights, to me, are incredibly boring. I am getting ready to take tennis lessons, but that's going to use one side of my body more than the other. I could equalize that with.you guessed it…weights…but I'd rather balance it with swimming, which works my upper body in an equalized way that is enjoyable to me.
4. Swimming is meditative. I cannot tell you how many times, after being stuck on a project or writing assignment, I've gone to the pool, started moving, and the perfect idea just popped into my head. It seems to foster brain blood flow in a way that enhances cognitive function.
5. Swimming is relaxing. I ALWAYS sleep well when I swim. In fact, I often have to force myself to stay awake past 8:30 on days that I swim, so that I don't wake up at 4 am ready to go! You all know that poor sleep encourages insulin resistance. If you're sleeping well because you're swimming, the benefit you get may not directly be from how many calories you burn in the pool, but from the improved insulin function that encourages weight loss long after you've been in the water.
6. Swimming doesn't remind you of your body size with every move you make. I agonize for Biggest Loser contestants sweating away on the treadmill. Every step they take, every breath they take, they're reminded of how out of shape they are and how far they have to go. Swimming is the great body size evaporator. You can exert yourself within reason without feeling like you have to punish yourself. The water is one environment where you can, at least temporarily, not have a constant reminder of your size. You're weightless, you can glide, you can float, you can propel yourself. It's a completely size acceptant and encouraging environment.
7. What I've never seen studied, and I've looked for it a lot, is an analysis of what happens to body fat in swimming. It may not drop, but I have a hunch it migrates, toward the skin, where it is needed to help insulate against the water temperature. But if you think about that, it may help you to look a little younger, to have a small layer of fat just underneath the skin to support its structure. I actually kind of like that my body is a little more rounded and not so gaunt and"ripped" when I swim. I think I look more feminine. It's the internal fat, the fat around the middle, that causes problems you don't want. If you're noticing that your waist inches are decreasing, your body fat may be a little higher as a swimmer, but it doesn't necessarily mean it's BAD fat. (I kind of think the reason a lot of my athlete/fitness expert/weight lifting friends don't enjoy swimming is because their body fat is so low they don't have flotation on their side and they have to work too hard to enjoy it. So they justify why you shouldn't pursue it to fit their own physiological bias!)
So there you have it. I've hopefully removed some of the excuses and barriers that keep you out of the pool. If it gets you moving, if it helps you to sleep, if it improves your insulin function…why are you listening to the people who contradict your truth? What matters is what works for YOU. Not what some lean, cut person who has sunk to the bottom of the deep end is trying to tell you.: )
I’ve been having an interesting conversation on Twitter with a woman who advocates for size acceptance.
I shared with her that I believe in size acceptance, but that my experience in over 30 years of being a dietitian has been that it hasn’t seemed to help progress the movement to confront it directly. In fact, many popular women’s magazines I’ve seen, tend to politely give lip service to the idea by putting an article in about the topic. At which point, I see it posted by the author on Facebook, all of that person’s friends “like” the post, they get a moment of fame for the piece, and traffic is driven to the magazine’s website. Where everywhere you look there are advertisements and other articles with messages running completely counter to the well-intended message in the “healthy” article.
The magazines don’t care what’s in the article. They want hits, because hits determine advertising rates. If baiting and switching the size acceptance crew to keep them coming back… keeps them coming back, and they read the counterproductive ads, then it’s highly possible that continuing to agree to participate in this vicious cycle only keeps those who feel victimized by the whole media/body image disconnect… further entrapped.
I’m a realist. We live in a country that is based on the right to freedom of speech. The very freedom I have to write this blog post is the same one the magazine publishers have. They really don’t care about my self-esteem, or your self-esteem, at all. They care about keeping their stockholders happy. Getting people to visit your website, regardless of how you make it happen, to keep advertisers happy, to keep ad rates up, to create the bottom line that keeps those stockholders happy… is all that matters to any media entity.
So while I applaud the efforts of my friends who work in size acceptance, I have come to believe that the approach they’ve been taking is quite possibly having the opposite effect.
That is why, several years ago, I dropped out of the eating disorder conference circuit. I stopped participating in the dialogue. I kept hearing the same old dialogue, over and over and over, but it always stopped with “dialogue”. No action plans were coming out of that dialogue, no progress was made in the success rates for treating ANY eating disorder… it just wasn’t making a difference. I wanted to make a genuine difference.
What the women advocating for size acceptance want, those creating the dialogue want… is validation. And they seem to desperately want it from an industry, that quite realistically, doesn’t care about validation. Quite the opposite. They want women to feel BADLY about themselves. Because if they were quite satisfied with their looks, they would not respond to any of the advertisements that keep THEIR stockholders happy, which wouldn’t line the pockets of the companies producing the products who also have stockholders to answer to.
One side of the issue wants dialogue and validation, the other wants money. That is never going to change.
So when I dropped out of the dialogue and went on to create this inCYST network, what I envisioned was that we would create a warm, safe, nourishing community where we could learn to be healthy. We wouldn’t stomp and scream and hold our breath and not do anything for ourselves until the world was perfect, we’d create a perfect world for ourselves. That is why, for the most part, on this blog, even though the majority of the audience we work with has body image issues, history of an eating disorder, and/or weight issues, we don’t really talk about it very much. Talking about it only focuses you on the feeling that you’re being victimized. We’d rather empower you out of that tree.
I care very much about how each and every one of you feels about yourself. But I am not interested in dialogue that focuses you on what someone else is or is not doing. I don’t want to talk about the thing you’re trying to evolve away from. I want to know what you’ve done today. To manage your stress. To eat more folate. To delegate. To move your body.
Let’s imagine for a moment that when we wake up tomorrow, overnight I was given a superpower that allowed me to reinvent the entire media industry. Internet, Facebook, television, Twitter, newspapers, magazines… everything And let’s imagine that I used that super power to reinvent all of those things so that the only messages that could be communicated, anywhere, were positive, nurturing, and reinforcing.
Would you be able to live in that world? Would you be able to have a conversation with someone if you couldn’t talk about body image? If you weren’t spending significant amounts of time reading destructive magazines, following unproductive Twitter personalities, having dialogue about what’s wrong with the world? Would you be able to fill your day with self-nurturing activities? Would you eat better? Would you be happier?
Or would you be totally at a loss for what to do with yourself?
I don’t have that super power, but I aspire to create that kind of world. Last week I sent a thank you note to someone who made a purchase out of our new eMarket. She thanked us for having a place for her to shop where she felt heard and validated. And she also gave me a long list of suggestions for things we could do to expand on that world. I was happy to be able to ask her to “hold that thought” because most of those ideas were already on the drawing board.
I actually don’t want to have that kind of superpower. Because that wouldn’t be very empowering to YOU. I want YOU to take action. To stop looking at those magazines in the grocery store. To stop walking past the healthy salad bar and walking into the fried chicken joint. I want inCYST to be an underground of sorts, of women who have decided they don’t have to be victims anymore.
And who understand that one of the most powerful ways to speak, is with their wallets. If you’re not buying the magazines, not clicking on the websites, you are having a much greater effect on those media corporations than you are with dialogue.
I hope you choose to patronize the companies offering products in our eMarket, because if we can help these companies with great ideas as well as integrity to succeed, they are validated financially and can have the opportunity to become advertisers with power who actually have some influence over the media.
And the bottom line is, I want us to use our community to learn how to live in a world whether or not the media influences do exist. They only have a negative influence on you if you allow them to, and clicking on links and buying magazines opens the door to that path. Not going there is going to mean being more introspective, and talking about things like what you think how you feel, what you aspire to… what your talents are, what action you’re going to take… but for me, that is the dialogue that inspires me.
That world can exist right here, you know. Which is why I don’t participate in the dialogue about media. There are only so many hours in the day and any minute I spend on a fruit less effort is a moment that I’ve wasted because I didn’t use it focusing on YOU and who you are and how we can make inCYST world a place thtat celebrates who you are.
I know it sounds a little weird to some of you who are used to identifying yourself or introducing yourself as afat person or a former fat person or an infertile person,… or other limiting labels. I want to challenge you to, every day, if even for 15 minutes to start with, see how it feels to stop using labels to define yourself. Labels that keep you in a position of disempowerment. Labels that keep you stuck right where all those media companies want you. You might be surprised at how limiting your current labels actually turn out to be.
I want to create a new world and a new econmy with you, supported by health professionals and companies who see your beauty and your talent and who really would like to do business with you. Of course, they have stockholders too. But when they can go back to those stockholders and report that they succeeded with a product that was hard to get on the market because they took a risk on a product they were told didn’t have broad enough appeal… they teach those stockholders to seek out other small companies with big visions.
It’s a trickle up effect. I can offer you options, but it starts with you. And your decision to not focus on what the “bad” guys are doing, but to find those good guys who can help you feel good about yourself.
It’s still dialogue, it’s just dialogue with action plans attached. And from what I can see with who’s buying in our store and the energy it’s creating, it confirms to me that my better action here is to not talk about body image and self-esteem. But rather to encourage those very things with actions.
If you are a solution-focused person ready to take action, inCYST is designed for you. If you're into dialogue it may not be a great fit. If the dialoguing eventually moves you to a place where you're ready to take action…come join our fan page, come to a fundraiser, come to a class at our new office in Santa Monica, work with one of our network members to create change in your life, or simply read our posts and try a suggestion from time to time.
We like to think if you hang around us long enough, you'll start to feel like hanging out on the same old site with the same old ads and articles, Tweeting the same thoughts to the same people, is going to feel a lot less rewarding than what we have going on here. Our network stretches from New Hampshire to Florida to San Francisco to Seattle. Wherever we are, we're pretty great and we have a lot of fun. We look forward to seeing you somewhere, sometime soon. No magazines allowed.: )
I missed the live version of this interview but stayed up until midnight listening to it. I was going to just catch the first few minutes but Ellen and Sasha did such a wonderful job of talking about body image, eating disorders, and PCOS, I was hooked!
It's such a great, thorough, and compassionate look at a part of PCOS that is not easy to discuss. A lot of physicians who treat PCOS are more skilled at managing your lab values than your emotions…and it can be frustrating to feel that such an important part of your disorder is not being acknowledged.
I do not intend to criticize physicians with my comment. They are often under pressure to see their patients in a tightly scheduled day, and if they're good at managing your insulin level, they need to be respected for what they're best at.
One of the things PCOS Challenge AND inCYST are trying to do, is provide support that sometimes simply is not available in a medical office visit. A major goal at inCYST, as well, is to network with physicians and help them understand the importance of recognizing this very important aspect of PCOS, and knowing where to refer their patients if they can't or don't want to be the caregiver offering emotional support.
If you've been feeling like that support is what you need, then a good start might be to listen to this broadcast. I guarantee, at the very least, you will learn that you're not alone. www.pcoschallenge.com
Thanks, Sasha and Ellen, for taking the time to talk so compassionately about such a challenging topic!
You've seen Ellen here, on her own blog, and in classes she teaches in West Los Angeles. Here is your opportunity to hear her talk on an issue important to followers of PCOS information.
'Eating Disorders, Body Image, and PCOS' on Sasha Ottey's PCOS Challenge!
Time: June 24, 2009 from 6pm to 7pm EDT Location:"PCOS Challenge Radio Show"
Event Description: On Wednesday, June 24, 2009 at 6pm EDT, Sasha Ottey speaks to Ellen Reiss-Goldfarb, a Registered Dietitian with a Private Practice in West Los Angeles, California. She was co-founder of"Through the Looking Glass", a support program for people with eating disorders and body images issues. She has worked as a clinical nutrition consultant and nutritional educator for over ten years. Her vision is to assist people in achieving their personal goals through nutrition education, as well as supporting their efforts in attaining balance in all areas of their lives. Besides Specialized work with Eating Disorders, Ellen has recently also expanded her practice to specialize in Women's hormonal issues which include PCOS and problems with Fertility. Ellen has been involved in nutrition and dietetics due to a personal passion to support and educate people on how to develop a healthy diet and lifestyle.
Tune in on Wednesday, June 24, 2009 at 6pm EDT to listen to Ellen impart her knowledge about eating disorders, body image, and the role they play in PCOS.
If you have any questions you would like to ask Ellen during the show, you can leave a comment here.
Or, if you would like to call in during the show to ask her a question, call (646) 929-0394.
If you would just like to listen, you are welcome to do so at http://www.blogtalkradio.com/pcoschallenge
