If you follow any of the big diet and/or fitness communities, you will see something like this at least once a week: people who have a completely dysfunctional relationship with their bodies or with dieting.

For example, let’s take this post. Here’s a lady with a BMI of 22.9, a body fat percentage of 25%. Most sources call both those numbers “average“. She’s not happy with that. She wants to get down to a BMI of 19.4, and she specifically wants to have her collarbone sticking out and her lower ribs visible. But here’s where it becomes clear that she has a real problem:

Tried throwing up after every meal, but my husband started noticing and questioned me about it. Tried not eating, but it just slows my metabolism down so nothing comes off at all. I hit the gym 6 days a week and running 5-6 miles a day (about 1 hour). Now I just started taking a diet pill.

Let me put this so there is no misunderstanding: THROWING UP AFTER MEALS IS NOT A DIET PLAN. Thank goodness somebody noticed she has a problem! Hopefully he will realize that just because she’s stopped throwing up doesn’t mean she’s stopped being ill.

The DSM-IV has criteria for a mental disorder called body dysmorphic disorder, or BDD for short. It is “a preoccupation with an imagined defect in appearance; if a slight physical anomaly is present, the person’s concern is markedly excessive. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, and it cannot be better accounted for by another mental disorder….”

As with all mental disorders, the key question to ask is whether it impacts other areas of the person’s life. In her case, it clearly does. Her diet efforts have her partner concerned. She admits spending almost every day working out at the gym and running for an hour. She’s spending money on a personal trainer and diet pills that, according to the raw data, she doesn’t need to say nothing of forcing herself to vomit. And all this is to attain a weight and appearance that is unrealistic and probably unhealthy for her.

At Age Against the Machine, we advocate maintaining a healthy weight and healthy habits. That includes realistic ideas about what you and your body can do.