Contributor: Courtney Howard, B.A., Executive Assistant at Eating Disorder Hope and Addiction Hope
Eating disorders often co-occur with other mental health conditions, including body dysmorphic disorder (BDD). BDD is a preoccupation with real or perceived physical flaws to the point of extreme emotional distress. Most commonly seen with anorexia nervosa, BDD is a serious condition that can not only impact an individual’s mental health, but also his or her relationships, work life, and ability to function on a day-to-day basis.
Mental health advocate and former model Nikki DuBose recently spoke out on the prevalence of BDD in the modeling industry and how this relates to disordered eating. As she notes, the critical nature of this industry can be especially harmful for those already struggling with mental health issues.
Eating Disorders in Canada
According to a 2002 survey , as many as 1.5 percent of Canadian women between the ages of 15 and 24 fit the diagnostic criteria for an eating disorder. Another survey  on adolescents that same year revealed that 28 percent of Canadian females in ninth grade engage in “weight loss behaviors.” This can range from mild dieting to extreme disordered food behaviors.
This high prevalence of eating disorders in adolescents is not unique to Canada, but it is important to know these numbers to better serve the eating disorder population throughout the world. Now Canadian schools can work to address these realities.
As recently as 2013, multiple cases of adolescent eating disorders that surfaced throughout Canada were believed to be triggered by “healthy living” programs promoted throughout the nation’s grade schools. While these programs are well-intentioned, they often miss the mark by indirectly promoting negative food talk and food-shaming.
How Does This Relate to BDD?
Though BDD does not always present in individuals with eating disorders, it is relatively common among those with anorexia nervosa. Distorted body image, or body dysmorphia, is often an integral part of this and other eating disorders.
Behaviors that can be seen as red flags for body dysmorphia, and potentially BDD, include body-checking, negative body talk, and an obsession with real or perceived physical flaws. Body-checking is common with eating disorders and is typically performed by the individual before and after meals out of concern that his or her body has changed due to recent food intake. A couple common behaviors include lifting up the shirt to see the stomach or measuring the circumference of arms and legs using fingers.
When it comes to BDD, body-checking can become more specific to body parts that do not have to do as much with weight. For example, according to the Body Dysmorphic Disorder Foundation, the most common body parts individuals with BDD become fixated on are skin, nose, and hair. This body dysmorphia can become so debilitating that the individual isolates and, in extreme cases, refuses to even leave the house.
BDD and Eating Disorders
The co-occurrence of BDD and eating disorders is undisputed, but it is often unclear which disorder comes first. Does body dysmorphia lead to disordered eating, or do disordered food behaviors implemented as a maladaptive coping mechanism lead to the development of a distorted body image?
BDD is closely linked to obsessive-compulsive disorder (OCD), as reflected in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This is because the obsessive thoughts associated with BDD often lead to compulsive behaviors, such as the aforementioned body-checking or more extreme actions to correct “flaws.” Though eating disorders have their own category in the DSM-5, this same pattern can be applied to their obsessive-compulsive nature.
When an individual presents with both BDD and an eating disorder, it is important that these conditions be treated concurrently. Correcting disordered eating patterns without addressing underlying body dysmorphia will likely prove ineffective long-term, just as the opposite is true.
Both conditions are extremely complex and can begin as a means of coping with outside triggers. Addressing all of these issues in treatment will give the individual a better chance at full recovery and a life free from obsessive thoughts about food or body image.
There are many treatment centers and resources in Canada available to those struggling with eating disorders, including the National Eating Disorder Information Centre (NEDIC), based out of Toronto. Reach out for the help you need and deserve today.
Community Discussion – Share your thoughts here!
Do you know of any other Canadian resources for eating disorder recovery? We want to know about any resources to help those struggling with disordered eating and/or body dysmorphia throughout Canada.
About the Author: Courtney Howard is the Executive Assistant for Eating Disorder Hope and Addiction Hope. She graduated summa cum laude with a B.A. from San Diego State University, holds a paralegal certificate in Family Law, and is a Certified Domestic Violence Advocate. After obtaining her certification as a life coach, Courtney launched Lionheart Eating Disorder Recovery Coaching in 2015 and continues to be a passionate advocate for awareness and recovery.
References:: 2002. “Mental Health and Well-being.” Canadian Community Health Survey (CCHS), Cycle 1.2.
: Boyce, W. F. (2004). “Young people in Canada: Their health and well-being.” Ottawa, Ontario: Health Canada.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on May 19, 2016
Published on EatingDisorderHope.com