Sorting Out Body Image Concerns: Kristina Schermer

In 2014, Kristina Schermer had been in treatment for an eating disorder and was feeling good about the progress she had made.

Then 26, she decided to have BRCA testing because her mother has a BRCA2 gene mutation, which raises a person’s risk of breast cancer and several other cancers. Kristina’s mother has never had cancer but has two sisters who were diagnosed with breast cancer, one of whom has the gene mutation.

Genetic testing showed Kristina also has a BRCA2 mutation. She was upset by the news, but felt reassured when doctors told her they would watch closely for breast cancer with an annual MRI. “I just thought I would take care of my health and do the MRI,” says Kristina, who lives in Denver and works for a private equity firm.

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But her first MRI suggested she may have breast cancer. After further tests, her doctors confirmed she had stage I disease. She had a double mastectomy, followed by a process to freeze her eggs and preserve her fertility. Then she had chemotherapy and breast reconstruction. After she finished these first treatments, Kristina began taking tamoxifen, a hormonal therapy, to lower the risk of cancer returning. The medicine caused her to have hot flashes, night sweats, weight gain, anxiety and depression.

Body Image Concerns

Kristina was now living with two conditions – breast cancer and an eating disorder – that stirred her worries about body image.

At first, she lost weight during breast cancer treatment. Then she started gaining weight on tamoxifen. “As somebody who has recovered from an eating disorder, watching your [weight] go up and down is really hard,” she says.

She worried that taking tamoxifen would trigger the eating disorder “because I would gain weight and stop trusting my body to balance itself out. And I would resort to my [eating disorder] to try and control the weight gain.”

Kristina saw she had two choices: stop taking tamoxifen and risk having the breast cancer return, or to take tamoxifen, gain weight and trigger the eating disorder again.

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Working with her oncologist, she stopped taking tamoxifen for about 5 months. Her menopausal symptoms lessened. She also saw a counselor who specialized in eating disorders. They talked about her weight gain fears and she started taking medicine that helped with anxiety and depression. As she began to feel better, Kristina agreed with her oncologist to try tamoxifen again. Now 28, she has been back on tamoxifen for about 10 months.

Speaking up and getting help when she needed it was important. “The biggest step was giving myself permission to admit that it was OK I didn’t feel great,” she says.

When she talked with the plastic surgeon for her breast reconstruction, she was clear about wanting only to look like she did before cancer: she did not want to change the look of her breasts with surgery. “Having had an eating disorder, walking into a place where you could customize your body was my living nightmare,” she says.

Kristina feels she’s on solid ground again now and is moving forward with a better understanding of how to care for herself. “Unfortunately, just like my breast cancer, I will carry my eating disorder and my struggles with body image for the rest of my life,” she says. “I just have to recognize it, so I don’t set myself up to fail.”

To Date or Not

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Kristina didn’t think about starting to date again until after her reconstruction was complete in the spring of 2015. During treatment, she didn’t think someone would want to date her because of the way she looked. But as she ended treatment and reconstructive surgery she started to feel like it wasn’t a deal breaker.

That summer worries about weight gain kicked in, along with anxiety and depression. She once again set aside any interest in dating. “I just really wanted to get to a healthy place,” she says.

Now, Kristina finally feels she’s comfortable dating again. She met one man while watching sports in a bar (“I’m a sports nerd,” she says) and they dated for a few months. She met someone else on a dating app. She would explain early on why she had short hair. Most of the men she has met so far have been sympathetic and asked thoughtful questions.

Describing herself as “pretty open and outgoing,” Kristina says she’d like to meet someone and start a serious relationship, but she’s waiting for the right person.

“If you want to get to know my heart and who I am, [breast cancer] is a piece of it,” she says. “[If I exclude] that, I feel like I’m not being true to myself.”

Hear more of Kristina's story during our Twitter Chat on Breast Reconstruction Awareness (BRA) Day, October 19 at noon ET.

This article was supported by the Grant or Cooperative Agreement Number 1 U58 DP005403, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.