My answer to the body image thing is to really face it by taking an objective, not an emotional look at what you looked like before with a very telling photo. I keep my photo on the fridge and the fat shorts that were too tight in the drawer, right on top. I have not had the huge loss you have had, but when I find myself in doubt, and I do, often, I go to these things and take a look, to ground myself, to again feel that my weight loss is real when I start to feel insecure. I think this sick thinking and self doubt is related to the imposter syndrome. I think it takes awhile to acept ones self when you look in the mirror and you are not what you expect to find- either before or after weight loss, face lift, new hairstyle, etc. You are not alone in this thinking, I think it is common, at least for me!