Sports Illustrated Swimsuit 2023 cover star Megan Fox, long considered a sex symbol, has said she is one of the five to ten million people in the United States who suffer from body dysmorphia.
“I don’t see myself the way other people see me. There’s never been a time in my life when I’ve loved my body,” Fox said. In an interview with Sports Illustrated. “When I was a kid, it was an obsession, like, “But I want to be like this.” And I don’t know why I became aware of my body at such a young age.”
A major symptom of body dysmorphia is a discrepancy between how a person sees himself and how others see him. Also known as body bipolar disorder, it is “characterized by an exaggerated preoccupation with an imagined defect in physical appearance or a markedly exaggerated concern with a minor physical anomaly.” American Psychological Association.
People’s actual appearance – or their attractiveness – often has little to do with this.
“For example, if the person has a very visible scar or other physically noticeable defect, we don’t talk about it,” said Ramani Durvasula, a clinical psychologist and author based in California, USA.
“A person becomes interested, almost obsessed, with a small physical feature. It may be a small scar, a small bump on the nose, a slightly misplaced tooth, the shape of something, but something that is not noticed by others”, pointed out. “It’s never enough. It basically takes over their lives.”
People with body dysmorphia spend a lot of time in the mirror analyzing their perceived flaws. Microgen Images/Science Photo Library RF/Getty Images
According to the Anxiety and Depression Association of America, About 2% of the world’s population suffer from body dysmorphia and this disorder affects males and females almost equally. Symptoms usually begin to appear in adolescence, when the body begins to change dramatically.
There is a subform of body dysmorphia: muscle dysmorphia, which mainly affects men and is characterized by a preoccupation with the idea that one’s body is not lean or muscular enough – often no matter how muscular the person is.
Learn what it’s like to live with body dysmorphia and how people can get help.
What is not body dysmorphia
Body dysmorphia is often confused with an eating disorder, but because of some differences, psychologists Durvasula and Ann Kearney-Cook say it’s not.
People with eating disorders worry about a distortion in how they feel about their shape or weight, Durvasula said. “A person engages in (disordered eating) behaviors, as well as what we call compensatory behaviors, which can be things like not eating at times, excessive physical exercise, using diuretics or laxatives.”
However, according to experts, body dysmorphia usually focuses on an imagined or real trait.
Causes of Body Dysmorphia
There is no single cause of body dysmorphia, but certain factors can contribute.
“Body dysmorphia is in the same family as obsessive-compulsive disorder,” Durvasula explained. “The only genetic evidence we see is that if a person has a first-degree relative (parent or sibling) with OCD, they are more likely to develop body dysmorphia.”
A step 2010 studyResearchers suggest that some people with body dysmorphia may have “abnormalities in the processing of visual information when examining their own face” in their brains.
Body dysmorphia sometimes occurs at the same time as anxiety. Durvasula said that if someone is preoccupied with certain things because of anxiety, the aspect of the body may be another situation to pay attention to.
“Social media certainly doesn’t help. There is a lot of social comparison with other people’s looks. Many people share fake pictures,” noted Durvasula. “During adolescence, this kind of evaluation — physical appearance, acceptance and all — becomes more pronounced.”
Having family members who judge, validate or like themselves and others based on appearance can also play a role, he said.
“It makes a person more sensitive to the perception of flaws in their appearance,” Kearney-Cook clarified. “What usually happens is that somewhere deep down, whether it’s a difficult childhood or something else, they feel, ‘I’m not good enough,’ ‘I’m not attractive.’ And they express that in their bodies.”
A perfectionist mindset intensifies this view, he added.
Living with body dysmorphia
The consequences of body dysmorphia affect all aspects of life – social, professional and economic – especially if the disorder worsens over time without treatment.
“Because they are so obsessed that they have physical problems, they invest a lot of time and money in cosmetic medical treatments, cosmetic dental treatments, skin treatments and surgical treatments,” noted Durvasula.
People with body dysmorphia have “controlling” behaviors, including spending a lot of time in the mirror and taking countless selfies and evaluating them, the psychologist also pointed out.
According to the National Association of Anorexia Nervosa and Associated Disorders, compulsive looking in the mirror can ease people’s fears about how they look or help them realize whether a perceived defect is still present or has worsened. [National Association of Anorexia Nervosa and Associated Disorders]. People believe that this trait is abnormal or ugly. Body dysmorphia was originally described as “image distortion syndrome,” Kearney-Cook said.
People with this disorder may seek comfort from others, asking them if they see something wrong, if everything seems fine with a trait, or if there is something wrong or different about that trait.
According to experts, people with body dysmorphia may isolate themselves out of shame or worry too much about their appearance. They can also wear down those who support them by constantly seeking reassurances.
Spending too much time analyzing their appearance may cause them to be late for work or not doing their homework. Some people put themselves at financial risk by purchasing cosmetic products or procedures, going into debt, and sometimes secretly, fearing what will happen if people find out.
Gurney-Cook was so interested in a patient with a defect in his nose that he was looking in the mirror even while driving. A car crash into a tree was a warning to the patient, who started treatment after the accident and recovered.
Treatment of body dysmorphia
Durvasula explained that body dysmorphia has no cure and is a “difficult medical condition” to treat because “it’s so resistant to change.” But there are some effective treatments.
One of the options of many specialists is cognitive-behavioral therapy. A person’s distortions or thoughts are believed to be driving the behavior, Durvasula said, so therapists work with the person’s distortions and go from there. Because body dysmorphia is in the same category as obsessive-compulsive disorder, treatments for OCD such as “exposure and response prevention” therapy can be helpful in managing body dysmorphia.
In a safe environment, this therapy exposes people to situations that trigger their obsessions or urges and requires them to choose not to respond with compulsive behaviors.
Durvasula said that during treatment, a person with body dysmorphia cannot look into the mirror too much or take selfies. “The person must tolerate the discomfort of not adopting the controlling behavior. But this must be supplemented with cognitive-behavioral work.”
A history of trauma also requires trauma-informed therapy, which requires a mental health professional to recognize the fact that a person’s trauma may be the root cause of body dysmorphia.
“Part of therapy can also be very educational about the images we see in the world and how unrealistic they are,” Durvasula said.
According to Kearney-Cook, researchers see brain chemicals like serotonin as the cause of body dysmorphia, so antidepressants called selective serotonin reuptake inhibitors (SSRIs) can also be helpful in treatment.
If you can’t find a mental health professional who specializes in body dysmorphia, try working with someone who has experience with OCD or eating disorders, suggests Durvasula.
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