When you think of body dysmorphia, actress Megan Fox may not be the first person who comes to mind. After all, she’s featured on the 2023 Sports Illustrated Swimsuit Issue cover. And when you are in this annual issue, it’s not as if you are wearing parkas or slankies. To be in the issue, you kind of have to show off your body. But Fox did indicate, “I have body dysmorphia,” in the recent video interview for Sports Illustrated seen here:
As you can see, Fox went on to elaborate, “I don’t ever see myself the way other people see me. There’s never a point in my life where I loved my body, never ever.”
Fox is certainly not alone. Body dysmorphic disorder (BDD) affects an estimated 2.4% of all adults in the U.S., according to the Cleveland Clinic. It’s prevalence may be a bit higher among females (2.5%) than males (2.2%). The prevalence of BDD seems to range from 1.7% to 2.9% in other countries.
BDD is when you don’t have a very fair view of your own physical appearance. Now, this doesn’t mean that you think abnormally highly of your own body and want to show other people your body when they really don’t want to see it. For example, it’s not when you insist on wearing very low-riding pants when everyone else is saying don’t go low. That would be more like body audacity disorder, which would be BAD, if such a term existed.
BDD is the exact opposite. It’s when you have very negative feelings about your own appearance and end up spending a lot of time focusing on what you perceive to be flaws in your body characteristics. You may even obsess over these perceived flaws and exert a ton of effort to try to change them. This can manifest in different ways such as spending excessive amounts of time thinking such “flaws,” comparing yourself with others, taking selfies, grooming, repeatedly checking your appearance, or changing your appearance. You may go down the cosmetic procedure route and start treating your face and body like some kind of JPEG to repeatedly photoshop. Alternatively, you may try to avoid being seen or seeing yourself. You may believe that others are staring at you and judging you when in fact the only one really doing that is your cat.
BDD most often begins when your are in your early teen years, which correspond to the start of middle school or junior high school, otherwise known by many as the years that suck. It can start earlier. Fox related, “When I was little, that was an obsession I had of like, ‘But I should look this way.’ And why I had an awareness of my body that young, I’m not sure.” The majority of BDD cases emerge before adulthood. But just because you’ve reached the 18 years of age mark without suffering BDD, doesn’t mean that BDD can’t creep up in the future. There are adults who end up developing BDD as well.
Now, BDD is not the same as simply not being perfectly happy with your body. These days with so many people in entertainment, in advertising, and on social media telling you how you should look, it’s tough not to wonder whether your body parts are up to snuff. This can be especially the case if you are a racial minority who doesn’t have the exact same appearance as those supposedly in the mainstream. Heck, if I had a nickel for each time I was told that my eyes look funny while growing up, I would have a lot of nickels.
What determines whether you have BDD is how much your self-perception differs from reality and how much concerns about your physical appearance end up negatively affecting your life. Something becomes a disorder when it impairs your ability to do other things. For example, simply liking hot dogs would not be a disorder. Having it consume your daily thoughts and being willing to risk your job, your marriage, and your family just to drive the Oscar Mayer Wienermobile, now called the Frankmobile, would be a disorder.
It’s not completely clear what leads some people to get down with BDD and others to manage to avoid it, despite the constant bombardment with images of what we are supposed to look like . There is evidence that having a a first-degree relative with BDD makes you more likely to develop it yourself. Studies have suggested that those with BDD may have differences in brain activity in certain areas of their brains.
Childhood abuse, neglect, or bullying can play a major role too. Fox has spoken in the past of how she was bullied during her school days to the point that she had to eat lunch in the bathroom to avoid being pelted with ketchup packets. In a 2009 article for Rolling Stone, Erik Hedegaard described how Fox developed physically early with her menstrual periods starting at age 10 and began masturbating soon thereafter and quoted Fox as sayin, “I’ve always felt different and alien, and that only confirmed my suspicions of being strange.” The article relayed how Fox was called “slut” and “whore,” even though she didn’t lose her virginity until age 17.
Now, it does help when you recognize that you do have body dysmorphia. Those without such insight may not even seek treatment. While BDD typically isn’t curable, treatment can help mitigate its effects. Treatment can consist of psychotherapy that can help adapt your thought processes and coping strategies. In some cases, medications like antidepressants can be helpful. However, it’s never a good idea to jump to medications as soon as possible, unless there is an urgent, high-potential-for harm problem.
Although having BDD does not necessarily meant that you have an eating disorder, it can lead to eating disorders. It can also lead to anxiety, depression, substance use, and way too many cosmetic procedures. More severe cases of BDD can segue to self-harm and even suicidal thoughts. So once you recognize BDD, it’s a good idea to get a proper psychological evaluation.
It’s important to remember that appearance is one of the most subjective things out there. Just look at paintings from previous centuries and you’ll see how much the concept of ideal appearance has changed over the years. Heck, the subjectivity of looks can be summed up in one six-letter word: mullet.