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Actress Megan Fox, cover star of the Sports Illustrated Swimsuit 2023 issue who has long been considered a sex symbol, says she is among 5 to 10 million people in the United States affected by dysmorphia bodily.
“I never see myself as others see me. There was never a time in my life where I loved my body, ever,” Fox said in a video interview with Sports Illustrated. “When I was little, it was an obsession I had. like, ‘But I should look like this.’ And why I had body awareness at such a young age, I’m not sure.
A discrepancy between how someone sees themselves and how others see them is a hallmark symptom of body dysmorphia. Also known as body dysmorphic disorder, it is “characterized by excessive preoccupation with an imagined defect in physical appearance or markedly excessive preoccupation with a slight physical abnormality,” according to the American Psychological Association.
How people actually look – or how attractive they look – often has nothing to do with it.
“If that person had, for example, a very noticeable scar or some other physically visible deformity, that’s not what we’re talking about,” said Ramani Durvasula, a clinical psychologist and author based at California.
“The individual becomes preoccupied, almost even obsessed, with a small physical feature. the others,” she added. “It’s never good enough. … And it’s going to kind of take over their lives.
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People with body dysmorphia tend to spend a lot of time looking in the mirror to analyze perceived flaws.
According to the Anxiety & Depression Association of America, approximately 2% of the world’s population suffers from body dysmorphia, and the disorder affects men and women almost equally. Symptoms usually begin to appear in adolescence when bodies begin to change drastically.
There is a sub-form of body dysmorphia: muscle dysmorphia, which primarily affects men, is marked by the perception that the body is not lean or muscular enough – often regardless of a person’s musculature.
Here’s what life with body dysmorphia is like and how people can find help.
What body dysmorphia is not
Body dysmorphia is often confused with an eating disorder, but it’s not because of certain distinctions, according to Durvasula and Ann Kearney-Cooke, a Cincinnati-based psychologist who specializes in eating disorders and body image.
People with eating disorders are concerned about a distortion in how they perceive their shape or weight, Durvasula said. “The person engages in (disordered eating) behaviors as well as what we call compensatory behaviors, which can be things like not eating for certain periods of time, hyperexercising, using diuretics or laxatives, that kind of things.”
Body dysmorphia, however, usually centers on an imagined or real feature, experts said.
What Causes Body Dysmorphia
There is no single cause for body dysmorphia, but certain factors contribute to it.
“Body dysmorphia belongs to the same family of disorders as obsessive-compulsive disorder,” Durvasula said. “The only genetic evidence we see is that if a person has a first-degree relative (parent or sibling) with OCD, they might be more likely to develop body dysmorphia.”
According to a 2010 study, researchers suggested that the brains of some people with body dysmorphia may have “abnormalities in processing visual data when it comes to examining their own face.”
Body dysmorphia sometimes occurs at the same time as anxiety. If someone is preoccupied with certain things because of anxiety, a body feature might be another issue to focus on, Durvasula added.
“Social media certainly didn’t help that. There’s a lot more social comparison with what other people look like. A lot of people are spreading fake images,” Durvasula said. “As a teenager, that form of assessment — physical appearance, fitting in and all that — is going to be much more pronounced.”
Having family members who assess, validate or like themselves or others based on their appearance can also play a role, she added.
“It makes the person overly sensitive to (perceptual) flaws in their appearance,” Kearney-Cooke added. “And what often happens is somewhere deep down inside them, whether it’s because of a difficult childhood or whatever, they’re like, ‘I’m not enough. I’m not attractive. And then they project it onto their bodies.
A perfectionist mindset intensifies this view, she added.
Living with body dysmorphia
The effects of body dysmorphia can extend to all aspects of life – social, professional and financial – especially if the disorder worsens over time without treatment.
“Because they are so obsessed with this kind of sense that there is this physical problem, they will spend a lot of time and money to get cosmetic medical treatment or cosmetic dental treatment, dermatological treatment, even medical treatment. surgical,” Durvasula said.
People with body dysmorphia also have “verifying” behaviors, which can be like spending a lot of time looking in the mirror and taking countless selfies and evaluating them, Durvasula added.
According to the National Association of Anorexia Nervosa and Associated Disorders, compulsively looking at yourself in the mirror can allay fears about how people think they look or help them see if a perceived flaw is still there. where it got worse. They think the feature is abnormal or ugly. Body dysmorphia was originally described as “imagined ugliness syndrome,” Kearney-Cooke said.
A person with the disorder may also seek reassurance from others by asking if they see the defect, if a feature looks correct, or if something is wrong or different about the feature.
People with body dysmorphia could isolate themselves out of shame or because they spend too much time worrying about their appearance, experts have said. They can also exhaust their social support by constantly seeking reassurance, Durvasula added.
Spending so much time analyzing their appearance can often result in being late for work or missing schoolwork, she said. Some people put themselves at financial risk by buying cosmetic products or procedures — by incurring debt for themselves or their families, and sometimes doing so in secret for fear of what might happen if people found out.
Kearney-Cooke had a patient who was so obsessed with a perceived defect on her nose that she always looked in the mirror, even while driving, the psychologist said. Crashing a car into a tree while doing so was a red flag for the patient, she noted, leading to treatment and eventually improvement.
Getting treatment for body dysmorphia
Body dysmorphia cannot be cured, and it’s a “difficult clinical condition” to manage because “it’s a schema that’s very resistant to change,” Durvasula said. But some effective treatments are available.
A favorite by many experts is cognitive behavioral therapy. A person’s distortions or thoughts are thought to cause this behavior, so therapists work on the person’s distortions and go from there, Durvasula said. Since body dysmorphia is in the same category as obsessive-compulsive disorder, OCD treatments such as “exposure and response prevention” might also be helpful in managing body dysmorphia. In a safe environment, this therapy exposes people to situations that provoke their obsessions or triggers and forces them to choose not to respond with compulsive behaviors.
When undergoing such treatment, a person with body dysmorphia doesn’t look in the mirror much or take selfies, Durvasula said. “They have to actually tolerate the discomfort of not engaging in the controlling behavior. But this must be complemented by cognitive-behavioral work.
A history of trauma would also require trauma-informed therapy, which would involve a mental health professional recognizing how the person’s trauma could be a root cause of the body dysmorphia.
“Some of the therapies can also be very educational — about what kind of images we see in the world and how unrealistic they are,” Durvasula said.
Researchers have looked at brain chemicals, such as serotonin, which are also a cause of body dysmorphia, Kearney-Cooke said – so antidepressants known as selective serotonin reuptake inhibitors serotonin or 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 expertise in OCD or eating disorders, Durvasula said.