Kardashians, J-Lo and Condoleezza — Baby Got Back

I usually avoid the gossip pages — and granted, the Kardashians are celebrities who are famous mostly for having no discernable reason to be famous.  But one of the deepest, darkest secrets revealed in their new book is that one of the sisters (no, I am not going to make the slightest effort to notice which) was seriously concerned about the size of her, uh, derriere, until she became friendly with Jennifer Lopez.

Ms. Lopez – nickname “J.Lo” — is a celebrity judge on “American Idol” and actually has some talent and has made numerous movies and hit recordings.  She is also reportedly afflicted with an abundant bottom, about which she and the Kardashian person commiserated.

Not that I care if her gluteus maximus is convex or concave, but the story reminded me of a patient who came to me and lamented, “I have a bubble butt.”

Normally, this is not a psychiatric problem.  However, obsessions with body size, shape and image or depression caused by those factors is often treated by mainstream doctors with prescription drugs like antidepressants and anxiolitics.

She claimed that this particular anatomical anomaly had ruined her life.

When there are so many problems in our country with a bad economy and unemployment, and so many problems in the world with wars and such, it might be difficult to sympathize with someone whose main problem is the way she looks from the rear.

However, I’ve been through some extensive changes in my own body recently, and it takes the brain a while to process that the trim person in the mirror is the obese person who purchased the mirror only a few years ago.

Whether shrinking or growing, the body is our vehicle for navigating the world and the life we live in.  I could understand the disturbed mood of this young lady.

For men, it might make a little sense.  Evolution — the survival of the species — certainly explains a lot of things.  Well-developed gluteal muscles in a man means that he can run fast and far to either bring home the evening meal or avoid becoming the evening meal for some predator.

But female gluteal muscles? Clearly not the same evolutionary mechanism, but clearly something that seems to be attractive to men. As evidence, just consider the wild success of “Baby’s Got Back” – a number-one hip-hop recording in 1992 by Sir Mix-a-Lot.  I think he’s British royalty, but I may be mistaken.  I don’t follow the hip hop field. My obsessive patient was a 23 year old anorectic, with a feeling her bottom was too big that seemed to have come from an offhand remark by a male passerby – a total stranger to her — who wanted her to know that her backside was too fat.  If I had the time, I’d like to find that person and study why he felt he needed to make that observation.

If there was anything wrong with her anatomically, I could not tell – even though she insisted on twisting her body and showing me her alleged excessive baggage.

There is little or no explanation in the medical, psychological or sociological literature of why this portion of the body should be a focus of interest.  There are apparently certain men who are interested in this feature, and libraries of pictures to satisfy their interest. I cannot help but notice that anyone interested in this part of the human anatomy would be spared dealing with the human face, that delightful repository of emotion– maybe even human speech– if one is not acquainted with the owner of the gluteal muscles in question. Maybe it is an intermediate stage, a part of the anatomy which when viewed, invites a chase, which could actually end up in … verbal interchange. All this is purely speculation on my part. What we have is a lot of people who are celebrity watching because they have empty lives. My patient who thought her bottom was “ballooned” was suicidal — for many reasons including that one — so she ended up in the hospital. She was all kinds of obsessive, had what is officially termed “body dysmorphic disorder” and depression.  No, cataloguing her problems won’t help, but the real problem was that she thought the alleged over-development of the fatty tissue covering her gluteal muscles was the worst of her problems. Somehow, celebrity news coverage may be perpetuating — if not causing — this strange kind of thought. Such obsessions about a part of the anatomy that a woman cannot even see unless she has a second mirror hung behind her to see what she looks like from the back.

I once read that Condoleezza Rice had a second mirror behind her.  For something or other like this?  Who knows? Different ages have different kinds of pathology.  This has been charted, actually for delusions and psychosis, from religious demons to Unidentified Flying Objects. Female body image distortions have always been with us, I think. This may just be a contemporary form. Still, it is difficult to see all the subtle problems of being female coalesced into a symbol that you can’t see terribly well, but you do get to sit on.