The Down And Dirty Of Body Dysmorphic Disorder(Shattered Image Book Excerpt #10)

CUBAN_BRIAN 003 4x6 72dpi fileBrian Cuban is a an author whose  best-selling book “Shattered Image: My Triumph Over Body Dysmorphic Disorder” chronicles his first-hand experiences living with, and recovering from childhood bullying, eating disorders and Body Dysmorphia Disorder (BDD) and drug addiction.  Brian speaks regularly to about his recovery and breaking the male eating disorder stigma.  You can purchase Shattered Image here   If you would like Brian to speak to your university, group or organization please email

I am just one guy out of many who struggles with BDD, a condition that often begins in adolescence and affects as many as 1–2% of the population, both male and female. For potentially millions of Americans, depression, addiction, eating disorders, and broken relationships are common byproducts of Body Dysmorphia. My goal with this book is to help other BDD sufferers identify and avoid destructive behaviors in their lives, replace them with positive, fulfilling behaviors, and to encourage other readers to reach out to friends or family members who may be suffering from BDD. I hope that by sharing my experiences, others will know that they are not alone.

Becoming obsessed with appearance and allowing that obsession to lead to harmful actions is not a disorder that happens overnight. I did not suddenly wake up one day and hate my image in the mirror. It was a life long process of negative experience triggering innate psychological tendencies. One of the keys to recovery is getting honest about those formative experiences. A path to BDD recovery probably will not be successful if it is grounded in denial and lies.

Disclaimer: If you suspect that you or anyone you know suffers from BDD, it is important to talk to a professional. This book does not constitute professional medical advice, and the path I took to recovery may not be possible or appropriate for everyone. I hope, however, that this book helps open up a new conversation about BDD. Body Dysmorphia is still not fully understood and not a psychological condition that many Americans are familiar with. If this book helps people understand that groups of symptoms such as anorexia, low self-esteem, depression, addiction, and self-destructive behavior can often be linked to a condition that is both diagnosable and treatable, then I have done my job.

So what is the down and dirty of BDD? Experts characterize BDD as a condition marked by sometimes disabling preoccupation with imagined or exaggerated defects of physical appearance. Many experts consider BDD a form of obsessive-compulsive disorder, or OCD. The disorder is fairly common, affecting as many as 2% of the population, and has been known to psychiatric experts for over a century. In 1891, an Italian physician named Enrico Morselli described a condition he called “dysmorphophobia”: “The dysmorphophobic patient is really miserable; in the middle of his daily routines, conversations, while reading, during meals, in fact everywhere and at any time, is overcome by the fear of deformity . . . which may reach a very painful intensity, even to the point of weeping and desperation.” Sounds familiar.

Is there an exact point in life that I can point to and say “this is when my thought process changed, this is when I developed BDD?” No, I cant. Maybe if I had a time machine I could go back to that ten or eleven year old bullied, shy, and self conscious child and say A-HA! I could nail it down. As it stands many decades later, memories blend together. Memories can be faulty. What I can say I am sure of is this: It was like building the foundation of a house. Negative experiences, including bullying, without a safe place to talk about them and treatment outlets were the bricks, and the obsessive thought process around them was the mortar keeping them in place. I was bullied as a child. I grew up in a family sometimes in conflict, with a pattern of verbal abuse on my mother’s side, passed through generations. I was a fat kid. I was the middle child and shy to begin with as a matter of biology and genetics. Psychologists, psychiatrists, and other treatment professionals will tell you that there is no one cause. They will also tell you (and you may know from personal experience) that the BDD-forming experiences from my adolescence are not necessarily unique. Life happens to us all. We all however, respond differently. Biological factors such as genetics, the psychological influences in your life, and environment all can play a role in the emergence of BDD.

What does it feel like? Here are some of the behaviors that have defined my struggle with BDD. To a casual observer some of these may seem narcissistic, “quirky,” or eccentric. I call these my BDD Tics. They have come and gone over the course of my life, and they may sound familiar to others at risk for BDD:

The shower inspection. I have been doing it as far back as I can remember—a detailed inspection of the areas of “concern” on my body when I shower. I know I am doing it, but it has become integrated into my daily routine. Like breathing, I just can’t stop. With the palm of my hand I press down on my stomach and try to flatten it. Of course it always bounces back, but I feel like I can actually measure if there has been any increase in my waist size. There is also the “trunk twist” to each side where I look for increased fat on each of my love handles. The palm of my right hand and fingers run down the left side of my rib cage starting from just under the armpit. I truly believe I can feel even a minute increase of fat in proportion to my rib and back. In my mind I can see the extra curvature if I have lost weight or the “filling in” if I have gained weight. My fingers press into my skin, acting like a tire pressure gage of BDD. Has the stick gone up or down? Will my outlook for the day change with it? Twist the trunk the other way and repeat with my left hand. One final look at the relationship of my love handles to my lower back. Press them in. I know they will spring back, but one can hope. Finish with the shower and on to the next ritual.

Verifying body defects through touch. I do it all the time. I rarely notice it. Primarily my chest area. This is a remnant of a past steroid addiction. I could be walking down the street, in a mall, sitting at dinner. For a split second I will touch my chest. It may even cause concern among those around me if it occurs more than once in a short period—I have had that happen. The person will ask if I am okay. They may think I am having chest pain, on the verge of a heart attack. I simply say I am fine.

The pants carousel. Women are stereotyped as trying on numerous outfits before they go out. It’s part of their mystique and what we love about them. And we all want to look good in what we wear. No big deal. But is it common for a guy to try on numerous outfits before he goes out at night? What about before he leaves the house in the morning? What about trying on every pair of pants in the closet to make sure they all still fitas a daily routine while getting ready for work? It does not happen every morning. It primarily happens when I have eaten a big meal the night before and went to bed feeling full.

A love-hate relationship with mirrors. Don’t we all have that? Nothing out of the ordinary. The difference is that growing up, I traditionally did not see my reflection. I saw over-exaggerated love handles. A receding hairline seemed completely bald. The reflection in the mirror showed scarring that did not exist in real life. My chest seemed deformed and unattractive. I was even able to “see” stupidity. I saw a monster.

The hanging shirt. I hate to tuck in my shirts. Fortunately it has become kind of a style statement so it does not seem too weird. For me, however, the untucked shirt is not an attempt to be stylish. The very act of tucking the shirt and creating less space between my stomach and my clothes is stressful for me, and it’s been that way ever since I was a kid that got picked on for being big. For years I would avoid social events simply on the basis of whether I had to wear a suit or other clothes that required a tucked in shirt. I would have rather been perceived a slob than have to face scrutiny of my waistline.

Fear of crowds/Social Anxiety.  This could be going to a party, nightclub, bar, or anywhere else that I expect people to be sizing each other up. Any situation where in my mind the entire scene is about judging and comparing my looks and “defects” to other people, forging romantic relationships, or being scrutinized based on looks has always been a terrible problem for me. And the way I’ve coped with social anxiety has sometimes been worse than the anxiety itself.  In the past, I’d always be drunk or high before the event. It was not unusual for me to drink half a pint of Jose Cuervo Tequila with an eight-ball cocaine chaser before I went to a party or nightclub. Coke wears off?  Confidence goes down. A cocaine baggie in one of my pockets was a mandatory accessory. And I’d never wear my glasses or contacts. The vanity? No. The blindness!  If I couldn’t see anyone, then I wouldn’t stress as much about whether they were scrutinizing me. I still feel the pressure these days, but I’ve learned to better cope with it (though I’ll still leave the glasses at home from time to time…).

Plans to artificially fix the “defects.” Any other BDD sufferers out there who have contemplated lap band surgery even though they are not a medical candidate? When the Bariatric Weight Loss commercial comes on the tube, I quickly think, “Will Lap Band be okay for me or do I need a gastric bypass?” What? I weight 220 lbs at 6 foot 2 inches! Of course I don’t need that. My mind for a split second says something different. A commercial for a popular Dallas Lap band doctor comes on. “Are you tired of dieting and worrying about weight loss?” Of course I am. Even If I don’t need to lose weight? It has nothing to do with reality, I inevitably think, hmmm… should I do that? I am a healthy weight. No ethical doctor would perform the surgery on me. The desire is a tic of the BDD mind. I may entertain the same thought when I eat too much. So easy to run to the bathroom and take care of it by putting my finger down my throat. The desire is fleeting but it is there.

Inner critic; outer-critic. I see flaws not just in myself, but in everyone I meet as well. When I was at my worst this was a terrible problem for me and hurtful to others. When you obsess over defects in yourself, zooming in 10X on even the most minute flaws, you tend to do the same when you look at others. Not because I zoom in on their perceived defect like I do with myself when I look in the mirror. Because I am reflexively comparing them to myself. Is my love handle or stomach worse or better?  When I was younger, this sometimes turned me at times into what I despise—a bully.

One Word: Plastics. Multiple visits to the plastic surgeon are common for BDD sufferers. I am no exception. As of the writing of this book, I have had four hair transplants, one liposuction, and lasik at a total cost of about twenty thousand dollars. Not too extreme by BDD standards, but perhaps the only reason I did not have more procedures is because I could not rack up any more debt to get them. I got my first hair transplant in about 1998. My father lost his hair early. Both my granddads lost theirs early. My older brother has a full head of hair. He got the only good hair gene for a generation. I didn’t stand a chance. Cosmetic surgery has taken a bite out of my pocketbook and never leaves me feeling satisfied. It’s a behavior that borders on self-destructive.


Most of the tics in that I’ve described so far have not been life threatening. These are behaviors that can be harmful, sure. Annoying, definitely. And when they occur frequently, they can be a sign that I need to take better control of my thought processes and work toward more positive everyday behavior. In the past, however, BDD has taken me to even darker places, to behaviors that can be very harmful or even fatal. For anyone that’s experiencing any of the following actions or feelings, I recommend seeking help immediately.

Self-medication. Using drugs to try to change how you feel about yourself, how you see yourself, how you perceive others seeing you. I excelled in this. Alcoholic. Cocaine Addict. Abuse of weight loss drugs. Steroids. All of them gave me a brief self-image high the moment I took them, but in the end they all led toward vicious cycles of destructive behavior.

The extreme diet. Eating disorders are something that many BDD sufferers are intimately familiar with. I am not an exception here, either. I have endured years-long bouts with both anorexia and bulimia. . Eating disorders are fundamentally destructive to both mind and body.

Depression. Depression has always gone hand in hand with my BDD, and when it’s at its worst, depression  has robbed me of the will to live. To  make my life better and put an end to self-destructive habits.  Crying for no discernable reason almost every day. Sleeping up to fifteen hours a day.  Not taking care of myself, which makes the BDD thoughts even worse.  What did I do to compensate with this?  Binge and purge to control my weight and thoughts.  Drink more alcohol. Take more drugs!

Suicidal thoughts. I am very lucky to be above ground to write this book. I had a Spanish made .45  automatic. I almost wasn’t.


For me, those four core symptoms represent the drop into the abyss of BDD. The climb out was a long, slow, hard process. There were setbacks. There were times when it seemed easier to go backwards than forwards. There were times when simply giving up was within hand’s reach. I forged ahead, baby step by baby step. Am I cured? I am not sure there is a “cure.” There are always BDD thoughts. There are always BDD tics. I am not happy all the time. No one is. Like everyone else, I have problems that cause stress and often depress me. I still become confused about my path in life from time to time. Only now I have the strength to face my path.

This book is about how I developed BDD and how it has affected my life. This book is also about how I have overcome BDD to lead a happy life with confidence in my body and hope for the future. Through therapy, medication, and focused effort in how my mind processes negativity, I have faced the bullies of my childhood. I can now engage in social situations. I now understand that thoughts are not always reality. My body—fat or thin—no longer repulses me when I view it in the mirror.

Later in this book I will describe the steps I took in my life to crawl out of the pit. Some of the steps I have taken have been conventional, such as psychiatric therapy and medication. Some have been trial and error and have worked for me. Some have not. All eight of the steps that have helped me recover have one thing in common: changing obsessive and destructive thought processes through repetition of positive behaviors. Today, I am addiction free except for my daily Starbucks Vente Blonde coffee. (In the world of addiction, the Vente seems a good trade-off from my old routine of coffee with a cocaine chaser to get going in the morning.) I can face the world of people and social interaction—with some stress, yes, but not life-disabling stress, without the need to artificially change the image in the mirror. I love and have loved. I have been rejected. I have let go. I have forgiven. I am alive. I am okay. You can be as well.

Brian Cuban is a an author whose  best-selling book “Shattered Image: My Triumph Over Body Dysmorphic Disorder” chronicles his first-hand experiences living with, and recovering from childhood bullying, eating disorders and Body Dysmorphia Disorder (BDD) and drug addiction.  Brian speaks regularly about his recovery and breaking the male eating disorder stigma.  You can purchase Shattered Image on

Want to book Brian Cuban for your event?  Please contact:

Paul D. Kreiter, M.Ed.
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2 Responses

  1. Really looking forward to reading this book. Judging by the excert on here you are describing my life!

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