How Wrecking My Gut Forced Me to Face My Body Dysmorphia

As Seen on: Shape

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In the spring of 2017, all of a sudden, and for no good reason, I started to look about three months pregnant. There was no baby. For weeks I would wake up and, first thing, check on my non-baby. And every morning it was still there.

I tried my familiar debloating routine-cutting out wheat, dairy, sugar, and alcohol-but things only got worse. One night I caught myself surreptitiously unbuttoning my jeans under the table after a dinner out, and I was overcome with the queasy sensation that I was watching something go wrong with my body. Feeling alone, weakened, and scared, I made a doctor's appointment.

By the time the appointment arrived, none of my clothes were fitting, and I was ready to jump out of my skin. The bloating and cramping were extremely uncomfortable. But even more painful was the image I'd created in my mind. In my mind, my body was the size of a house. The 40 minutes I spent going through my symptoms with the doctor felt like an eternity. I knew the symptoms already. But I had no idea what was wrong or what to do about it. I needed a solution, a pill, a something, now. My doctor ordered a litany of blood, breath, hormone and stool tests. They would take at least a month.

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That month, I hid behind billowy shirts and elastic waistbands. And I punished myself with more food restrictions, eating few things beyond eggs, mixed greens, chicken breasts, and avocados. I dragged myself from procedure to procedure, test to test. About two weeks in, I came home from work to find that the woman who cleans my apartment had accidentally thrown away the kit for my stool tests. It would take weeks to get another. I collapsed on the floor in a pile of tears.

When all the test results finally came back, my doctor called me in. I had an "off the charts" case of SIBO, or small intestine bacterial overgrowth, which is exactly what it sounds like. My mom cried tears of joy when she found out it was curable, but I was too angry to see the silver lining.

"How did this even happen?" I scowled as my doctor prepared to go over my treatment plan. She explained that it was a complicated infection. The initial imbalance could have been brought on by a bout of stomach flu or food poisoning, but ultimately a concentrated period of severe stress was the main culprit. She asked if I had been stressed. I let out a sarcastic laugh.

My doctor told me that to get better, I would have to down two dozen supplements every day, inject myself with B12 every week, and cut grain, gluten, dairy, soy, booze, sugar, and caffeine out of my diet altogether. After she went over the plan, we went into the exam room to demonstrate the B12 shots. I pulled my pants down and sat on the exam table, the flesh of my thighs spreading across the cold, sticky leather. I slumped over, my body taking on the shape of a sick child. As she prepared the needle, my eyes filled with tears and my heart began to race.

I wasn't scared of the shots or worried about the dietary changes I'd have to make. I was crying because there was a deeper problem that I was too embarrassed to talk about, even with my doctor. The truth is, I would have gone without gluten, dairy, and sugar for the rest of my life if it meant I could maintain a chokehold grip on my figure. And I was terrified that those days were over.

Confronting My Long History with Body Dysmorphia

For as long as I can remember, I associated being thin with being loved. I remember telling a therapist once, "I like waking up feeling hollow." I wanted to be empty so I could make myself small and get out of the way. In high school, I experimented with throwing up, but I was no good at it. My senior year of college, I shrunk down to 124 pounds at 5'9". Rumors went around my sorority that I had an eating disorder. My roommate and sorority sister, who watched me regularly scarf down fried eggs and buttery toast for breakfast and nachos and cocktails for happy hour, worked to dispel the whispers, but I relished them. The rumors made me feel more desirable than I ever had.

That number, 124, rattled around in my brain for years. The consistent flow of comments like "Where do you put it?" or "I want to be as skinny as you" only affirmed what I was thinking. That spring semester of senior year, a classmate even told me I looked "fetchingly svelte but not too gaunt." Every time someone commented on my figure, it was like a shot of dopamine.

At the same time, I also loved food. I wrote a successful food blog for many years. I never counted calories. I didn't overexercise. Some doctors expressed concern, but I didn't take it seriously. I operated under a constant state of food restriction, but I didn't think I was anorexic. In my mind, I was healthy enough, and managing fine.

For over 10 years, I had a routine for assessing how good I'd been. With my left hand, I would reach behind my back for my right ribs. I'd bend slightly at the waist and grab for the flesh just below my bra strap. My entire self-worth was based on what I felt at that moment. The shallower the flesh against my ribs, the better. On good days, the pronounced feeling of my bones against my fingertips, no flesh bulging out of my bra, sent waves of excitement through my body.

In a world of things I couldn't control, my body was the one thing I could. Being thin made me more attractive to men. Being thin made me more powerful among women. The ability to wear tight clothing calmed me. Seeing how small I looked in photos made me feel strong. The ability to keep my body trim, together, and tidy made me feel safe.

But then I got sick, and the foundation of my self-worth-a worth based primarily on the flatness of my stomach-collapsed.

SIBO made everything feel unsafe and out of control. I didn't want to go out to eat with friends for fear of not being able to stick to my strict diet. In my bloated state, I felt deeply unattractive, so I stopped dating. Instead, I worked and I slept. Every weekend I left the city and went to my childhood home upstate. There I could control exactly what I ate, and I didn't have to let anyone see me until I was as thin as I wanted to be again. Every day I'd stand in front of the mirror and examine my stomach to see if that bloat had gone down.

Life felt gray. For the first time, I saw clearly how my desire to be thin was making me unhappy. Outside I was perfectly thin and successful and attractive. But inside I was uncomfortable and unhappy, holding onto control over my weight so tightly that I was suffocating. I was sick of making myself small to win approval and affection. I was desperate to come out of hiding. I wanted to let someone-to finally let everyone-see me as I was.

Accepting Life and My Body As It Is

In the late fall, as predicted by my doctor, I started to feel noticeably better. Over Thanksgiving, I was able to enjoy stuffing and pumpkin pie without my stomach inflating like a balloon. I'd made it through the months of supplements. I had enough energy to go to yoga. I went out to eat with friends again. Pizza and pasta were still off the table, but a salty steak, buttery roasted root vegetables, and dark chocolate went down without a hitch.

Around the same time, I started to reassess my dating life. I was worthy of love, and for the first time in a long time, I knew it. I was ready to enjoy my life exactly as it was, and I wanted to share that.

Eight months later I found myself on a first date with a guy I'd met in yoga. One of the things I liked most about him was how enthusiastic he was about food. Over hot fudge sundaes, we discussed the book I was reading, Women, Food and God, by Geneen Roth. In it, she writes: "The relentless attempts to be thin take you further and further away from what could actually end your suffering: getting back in touch with who you really are. Your true nature. Your essence."

Through SIBO, I've been able to do that. I still have my days. The days I can't bear to look at myself in the mirror. When I reach for the flesh on my back. When I check the appearance of my stomach in every reflective surface. The difference is that I don't linger too long on those fears now.

Most days, I don't worry that much about how my butt looks when I get out of bed. I don't avoid sex after big meals. I even let my boyfriend (yep, that same guy) touch my stomach when we curl up together. I've learned to enjoy my body while also still grappling, like most of us do, with a complicated relationship with it and food.

Clara Artschwager