Episode 211 - Is it Body Image Shame, Body Dysmorphic Disorder, or Anti-Fat Bias?

For those who struggle with body image shame, the question can arise: “Am I to the point of having body dysmorphic disorder (BDD)?” Others may wonder if how they are feeling is actually a deep internalization of anti-fat bias. But still, can’t seem to shake the belief that their body is inferior, even though intellectually they know it’s likely driven by bias. In this episode, I break down what BDD is and how it’s different from body shame, and I also talk about the influence of anti-fatness on both. Plus, surprise surprise, there seems to be some anti-fat fuckery happening in the way BDD is diagnosed and finally - ever heard of body dysmorphic disorder by proxy?! TW: brief mentions of EDs and su!c!de.

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🔗 Podcast transcript

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Links:

https://www.nationaleatingdisorders.org/body-dysmorphic-disorder-and-eds/

https://pubmed.ncbi.nlm.nih.gov/39226792/

https://www.readymind.com.au/wp-content/uploads/BDDQ-AS_Scoring.pdf

https://pmc.ncbi.nlm.nih.gov/articles/PMC7005216/

https://www.ncbi.nlm.nih.gov/books/NBK603747/

https://www.mentalhealth.org.uk/our-work/research/body-image-how-we-think-and-feel-about-our-bodies/body-image-report-introduction

https://www.eatingdisorderocdtherapy.com/blog/body-dysmorphia-versus-body-image-distress

https://www.researchgate.net/publication/381200761_Cultural_Differences_in_Body_Image_A_Systematic_Review

Lewis, H. A systematic review of the similarities and differences in etiology and psychopathology of BDD and eating disorders: Can both be classed as "body image disorders"? YouTube. https://youtu.be/tpvpewuYaR8

Grunewald, W., Sonnenblick, R., Kinkel-Ram, S. S., Stanley, T. B., Clancy, O. M., & Smith, A. R. (2024). Longitudinal relationships between anti-fat attitudes and muscle dysmorphia symptoms. Body Image, 51, Article 101786. https://doi.org/10.1016/j.bodyim.2024.101786

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787

Psychology Today Canada. Body dissatisfaction, body dysmorphia, and body shame cycles. Psychology Today. https://www.psychologytoday.com/ca

McEntee, M. L., Philip, S. R., & Phelan, S. M. (2023). Dismantling weight stigma in eating disorder treatment: Next steps for the field. Frontiers in Psychiatry, 14, Article 1157594. https://doi.org/10.3389/fpsyt.2023.1157594

International OCD Foundation. Do I have BDD? Body Dysmorphic Disorder Foundation & IOCDF. https://bdd.iocdf.org/about-bdd/do-i-have-bdd/

Krebs, G. Dr. Georgina Krebs on shame and body dysmorphic disorder (BDD) [Clinical interview transcript].

Maddux, J. E., & Winstead, B. A. (Eds.). (2024). Psychopathology: Foundations for a contemporary understanding (6th ed.). Routledge. https://doi.org/10.4324/9781003375982

Brown-Bowers, A., Ward, A., & Cormier, N. (2017). Treating the binge or the (fat) body? Representations of fatness in a gold standard psychological treatment manual for binge eating disorder. Health, 21(1), 21–37. https://doi.org/10.1177/1363459316674788

Philip, S. R., Standen, E. C., Schueler, J., Fields, S. A., & Phelan, S. M. (2025). Weight bias in mental health settings: A scoping review. Frontiers in Psychiatry, 16, Article 1596625. https://doi.org/10.3389/fpsyt.2025.1596625

Kittler, J. E., Menard, W., & Phillips, K. A. (2007). Weight concerns in individuals with body dysmorphic disorder. Eating Behaviors, 8(1), 115–120. https://doi.org/10.1016/j.eatbeh.2006.02.006

Philip, S. R., Standen, E. C., Schueler, J., Fields, S. A., & Phelan, S. M. (2025). Weight bias in mental health settings: A scoping review. Frontiers in Psychiatry, 16, Article 1596625. https://doi.org/10.3389/fpsyt.2025.1596625

Weingarden, H., Renshaw, K. D., Davidson, E., & Wilhelm, S. (2017). Relative relationships of general shame and body shame with body dysmorphic phenomenology and psychosocial outcomes. Journal of Obsessive-Compulsive and Related Disorders, 14, 1–6. https://doi.org/10.1016/j.jocrd.2017.04.003