Health & Fitness

What is a narcissitic personality disorder?

Mehmet Oz, M.D., and Michael Roizen, M.D.
Mehmet Oz, M.D., and Michael Roizen, M.D.

Q: I keep hearing about people being narcissistic, as if it were something terrible. But it just means that someone thinks they’re really good-looking or special. That’s not so bad, is it?

Candice B., Phoenix

A: Vanity might be an irritating personality trait, but it’s not the same as having what psychiatrists call narcissistic personality disorder. In ancient mythology, Narcissus fell in love with his own reflection and died staring at himself. The personality disorder is named after him, but the condition is more psychologically complicated and more serious than simply falling in love with your own image.

The Diagnostic and Statistical Manual of Mental Disorders is the go-to reference book for diagnosing mental illnesses. In its latest version, the fifth edition, there’s a somewhat lengthy description of all the traits that characterize narcissistic personality disorder. Here are five important take-away points. A person with NPD:

1. Sees themselves as exceptional and seeks the approval of others.

2. Has no ability to empathize, recognize or identify with others.

3. Has superficial relationships that exist only to serve self-esteem.

4. Exhibits pathological personality traits of antagonism; feelings of grandiosity, entitlement, and self-centeredness.

5. Seeks admiration through excessive attempts to attract and be the focus of attention.

The previous version of the DSM also mentioned that someone with NPD can be preoccupied with fantasies of unlimited success and power, will take advantage of others to achieve their desired goals, and often exaggerates his or her achievements and talents.

People with these traits can be helped with intensive talk therapy. Fortunately, learned behaviors can be untangled and unlearned -- with effort, but still unlearned. And short-term cognitive behavioral therapies can help establish new patterns of behavior. But don’t worry if you or someone you know is a frequent mirror-gazer, it doesn’t mean you’ve got NPD. It could just be a sign of good grooming and not a diagnosable personality disorder.

Q: I’ve reached an age (35) where my thighs have started to develop cellulite. I want to get rid of it. What’s the most effective treatment: creams, exercise or liposuction?

Janice F., New York

A: First of all, cellulite -- dimpled, lumpy-looking fat deposits on thighs, butt and even arms -- afflicts around 90 percent of women and 10 percent of men. It appears at around your age, Janice, when hormones, genetics, inflammation and lifestyle all conspire to alter fat cells. And it happens to thin women as well as the not-so-thin.

Why the Thigh? Fat that’s located in women’s thighs tends to keep expanding because the thigh has alpha receptors that stimulate fat cells to produce fat and beta receptors that break down fat, but gals have nine alpha receptors for every one beta receptor! (Guys are one to one.) Expanding fat pushes through connective tissue between skin and muscle and becomes trapped, giving the skin’s surface that dimpled-skin appearance.

What’s the Answer? Unfortunately, there are no magic bullets. Creams mostly target fat using substances like caffeine that block alpha receptors to prevent fat deposits. But that’s not enough to get rid of cellulite. Machines that roll or heat cellulite do increase circulation and break down connective tissue, but it can take years!

What about melters, fillers and zappers? Treatments like acoustic wave therapy can improve appearance, but are temporary fixes.

Your best, long-term solution is the one-two punch of good nutrition and exercise. You’ll reduce inflammation, increase circulation and help your body burn fat.

1. De-bloat fat cells by eliminating the Five Food Felons: all trans and most saturated fats, all added sugars and sugar syrups, and any grain that isn’t 100 percent whole.

2. Eat 5 to 9 servings of fruits and vegetables daily.

3. Get 10,000 steps a day or the equivalent. Do strength-building exercise two to three times a week.

Bonus tip: Don’t wear elastic underwear, waist cinchers or tight pants. Cellulite appears where those circulation-destroying garments live!

Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at