Body Dysmorphia After Weight Loss: What to Know
Body dysmorphic disorder (BDD) is a mental health condition characterized by someone becoming intensely focused on perceived flaws in their appearance, which are often not visible to others.
The difference between BDD and occasional doubts or concerns about your body image is that body dysmorphia is a health condition and presents with intense and persistent symptoms. BD also has a greater impact on daily life.
BDD can affect anyone, regardless of gender, size, culture, or shape. For some people, body dysmorphia can develop or intensify after significant weight loss.
Is body dysmorphia common after significant weight loss?
Research on this topic is limited, but clinical reports suggest body dysmorphia after weight loss is not unusual.
Significant weight loss may sometimes create a disconnect between how you feel internally and how you now appear externally.
Losing weight may also lead to:
excess loose skin
muscle loss
heightened attention from others (e.g., comments about your physical appearance)
social pressure to maintain or increase weight loss
Any of these factors could make you feel more self-conscious or promote challenges with your body image, including BDD.
A 2023 paper suggested that some people experience 'ghost fat' after rapid weight loss caused by bariatric surgery. 'Ghost fat', or 'phantom fat,' is the feeling that you're larger or heavier than what you are. While ghost fat isn't the same as BDD, it's another experience that can affect body image and mental health.
A 2018 study, which surveyed 88 women after bariatric surgery, found that many experienced body image avoidance after surgery. However, avoidance improved over time. Body image avoidance is an attempt to avoid looking at yourself or displaying body features. For example, hiding mirrors, wearing extra-large clothing, and evading photographs.
Someone may experience body dysmorphia after significant weight loss, even without having bariatric surgery. Body dysmorphia can affect anyone.
What does it feel like to have body dysmorphia?
Body dysmorphia can affect both how you feel about yourself and your world, and how you behave.
Mental symptoms of body dysmorphia after weight loss
The mental symptoms of body dysmorphia may include:
constantly thinking about parts of your body you dislike
feeling ashamed, disgusted, or embarrassed by your appearance
believing you are larger than you are
difficulty accepting compliments about your appearance
intense fear of gaining weight again
Behavioral symptoms of body dysmorphia after weight loss
The behavioral symptoms, which can be evident to others, may include:
frequently checking mirrors or avoiding them altogether
persistent grooming, such as excessive makeup application or clothing changes
constantly comparing your body to others, both in person and online
avoiding social activities because of body image concerns
seeking frequent reassurance about your appearance from friends or family
These symptoms often interfere with daily life, affecting work, relationships, and overall mental health.
How to manage body dysmorphia after weight loss
Body dysmorphia may respond well to treatment. Options often include mental health therapy, medications, and other supportive strategies.
Therapy
Talking with a mental health professional can help you work through distorted body image thoughts. Therapies like cognitive behavioral therapy (CBT) can support you in challenging unhelpful thinking patterns and building a new relationship with your body.
If you believe you or someone you love has body dysmorphia, consider searching for a therapist who specializes in BDD and other dysmorphia manifestations.
»MORE ON THIS: How to find a therapist who's right for you
Medication
Medication may also help with the severe symptoms of BDD. Some doctors may recommend antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), to manage intrusive thoughts and mood changes.
SSRIs are the gold standard in treating BDD. The full therapeutic effects of these medications may take up to 12 weeks, but you may experience improvement shortly after you start treatment.
However, if SSRIs don't work for you, there are other options. Consider speaking with a healthcare professional if you don't feel that your current prescription is helping you manage your symptoms.
Self-care and lifestyle changes
Other supportive steps you might consider include:
practicing mindfulness to reconnect with your body in a nonjudgmental way
focusing on body functionality (what your body can do) rather than how it looks
limiting time spent on social media, if that tends to trigger you
surrounding yourself with people who celebrate body diversity
engaging in hobbies and activities that make you feel good
setting boundaries if friends or family often comment on weight or appearance
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