Do You Have a Body Image Disorder?

The Savvy Psychologist, Dr. Ellen Hendriksen, joins Get-Fit Guy to explain Body Dysmorphic Disorder (BDD) and how it can wreak havoc on your life. The good news is that Dr. Hendriksen has 6 tips on how to overcome your body image issues and feel great about yourself.

Ben Greenfield
8-minute read
Episode #176

When I was 12-years-old, my dad brought home a set of 10-pound dumbbells from the local sporting goods store. I had no clue how to use them, but I remember grabbing them from his room one day, taking them into my bedroom, lying face-down on the edge of the bed, and attempting a teenage boy’s version of biceps curls until I couldn’t lift those weights anymore..

I had absolutely no clue what I was doing. But one thing I did know for certain: the next day my arms were very, very sore. And – perhaps a little bigger? Just like many boys, I flexed my muscles in the mirror, and it certainly did seem like my arms grew a bit. Not only did that mean these dumbbells might make me stronger or faster, but they might make me look better too – and at that time in my life, that meant two things: girls looking at me and guys being jealous of me.

Through high school I continued to lift weights and actually got what I (and others) would describe as a nice “bod.” And yes, I kept on flexing in the mirror to check out my muscles every now and again to make sure nothing seemed out of place. Abs toned? Check. Arms not looking too small? Check. Calves getting out of toothpick mode? Check.

In college, while studying exercise science (no surprises there, right?) I learned about body fat testing, and added that tracking parameter into the mix – every week hopping on a scale to make sure I never saw any double digits (which somewhere in the back of my mind meant I could be risking not looking good in my swim trunks or increasingly tight t-shirts). I also began to fret endlessly over food – not in an anorexic, caloric-restriction kind of way – but more in a fat-phobic, extreme calorie counter, have complete control over every bit of food that goes in my mouth kind of way.

And finally, 8 years from that very first encounter as a skinny adolescent boy with a tiny set of dumbbells, and many, many hours of flexing in front of the mirror later, I stepped onto stage at my first bodybuilding show – at 210 pounds and 3% body fat. I had finally arrived at what I thought at the time was “the ultimate body.” And boy, was I proud of myself.

In fact, back then if you had taken one shred of muscle fiber off my body, or told me I couldn’t lift weights or exercise anymore, I would have immediately experienced a slight lowering of confidence, a hint of depression, and lots of plain ol’ grumpiness.

Of course, as a bodybuilder, I was constantly surrounded by hundreds of men and women just like me. Men and women who cared – cared a lot – about their bodies and how they looked. So was this bad? Is this unhealthy? In today’s episode, I have as my guest the newest Quick and Dirty Tips host, the Savvy Psychologist Dr. Ellen Hendriksen to fill us in on body image issues and give us some tips to feel great about our bodies no matter what.

Ellen, take it away…!


Thanks, Ben, I’m delighted to be on your show! 

Somewhere out there are bodybuilders (or models, or Hollywood stars) who keep a healthy perspective about their bodies. But when body perfection pervades the culture, it’s really hard—and potentially even isolating—to stand apart.

Of course, preoccupation with body image isn’t limited to bodybuilders.  Many people believe that if only their bodies were different, perfect, or more like a Victoria's Secret model's or Hugh Jackman’s, they’d be happy.  What you courageously reveal, Ben, is that even when you’ve achieved “the ultimate body,” the pride and public recognition still didn’t banish that hint of depression, that grumpiness, or that chip in your confidence.  You backed away from the unhealthy side of the bodybuilding world and are happier—and, notably, healthier— for it. 

Body Dysmorphic Disorder Explained

At its most extreme, obsession with appearance has a label: body dysmorphic disorder, or BDD.  Celebrities from Bruce Jenner to Hayden Panettiere, and of course, Michael Jackson, have been rumored to suffer from it. 

BDD is an obsession with a perceived flaw—a supposed defect that appears minor or even non-existent to most observers.  It could be an obsession that one’s Adam’s apple is too big, feeling tortured over some minor acne scars, or an absolute certainly that one’s perfectly-normal-looking-to-others nose will draw ridicule and humiliation if anyone sees it.  The distress about the flaw is so strong that some sufferers only go out at night, cover the perceived flaw with clothing or oddly combed hairstyles, check a mirror hundreds of times a day, or undergo multiple surgeries (many of which are elective and paid out of pocket – again, Michael Jackson is the perfect example).  Sadly, surgery or dermatologic treatment doesn’t cure the problem. That’s why individuals with BDD often run from doctor to doctor, or throw their money away on sham miracle cures.


There is a specific subtype of BDD called muscle dysmorphia, nicknamed “bigorexia,” whose sufferers, usually men, have an irrational, obsessive belief that they are too skinny or not muscular enough.  This isn’t just a preoccupation with size, it’s a near-delusion, and it most often affects men whom most people would consider muscular. 

The Broken Mirror by Dr. Katharine Phillips is the BDD treatment bible, and many people with BDD—who make up 1-2% of the U.S. population—report feeling more understood and hopeful after reading it.  Another book called The Adonis Complex by the same author addresses muscle dysmorphia and men and boys’ quest for physical perfection to the detriment of everything else.

BDD is often treated with a class of antidepressants called SSRIs and cognitive-behavioral therapy, a structured type of therapy that challenges the beliefs underlying BDD, like “I can’t go out because my abs aren’t chiseled enough,” plus the behaviors that go along with those beliefs.

Ben, you also mentioned fretting endlessly over food in your previous life.  While you’re certainly within healthy limits now, it sounds like back then you, as well as many others in the bodybuilding world, may have come close to a proposed new eating disorder: orthorexia.


All content here is for informational purposes only. This content does not replace the professional judgment of your own health provider. Please consult a licensed health professional for all individual questions and issues.

About the Author

Ben Greenfield

Ben Greenfield received bachelor’s and master’s degrees from University of Idaho in sports science and exercise physiology; personal training and strength and conditioning certifications from the National Strength and Conditioning Association (NSCA); a sports nutrition certification from the International Society of Sports Nutrition (ISSN), an advanced bicycle fitting certification from Serotta. He has over 11 years’ experience in coaching professional, collegiate, and recreational athletes from all sports, and as helped hundreds of clients achieve weight loss and fitness success.