Understanding body dysmorphia, a condition that impacts even celebrities

In a recent podcast interview, actor Megan Fox opened up about struggling with body dysmorphia since she was five-years-old. In India, actor Ileana D’Cruz, has been vocal about her struggles with Body Dysmorphia Disorder (BDD) and how it almost led to her committing suicide. Sonam Kapoor and Parineeti Chopra have also been vocal about their body-image issues. Lili Reinhart from the popular TV series Riverdale,  Oscar-award winning singer Billie Eilish, why even Michael Jackson have battled with  debilitating health condition. 

What is BDD and why is it so rampant amongst the youth? Lounge spoke to experts to find out more about this condition, its causes and plausible treatments.

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What is BDD?
Do you look at yourself in the mirror a lot, fixated on a flaw that others might not even notice? Have you undergone many cosmetic surgeries to look a certain way? Do you find yourself over-critical about your body weight and shape? You might be suffering from a mental health condition called Body Dysmorphic Disorder or BDD.

In this condition, a person usually obsesses over a minor or imagined defect in their appearance. This can lead to significant distress, social withdrawal, and compulsive behaviours like excessive mirror checking, grooming rituals, or seeking cosmetic procedures. According to Jashan Vij, a certified health and fat loss coach, “Recent statistics estimate around 2-2.5% of people may experience this condition.” Citing Kendall Jenner and Jameela Jamil’s battles with BDD, Vij says, “While some have faced issues like obsessive self-criticism and excessive grooming, some face the typical issues of wanting to look like some celebrity. In the bargain, they set unrealistic benchmarks for themselves.”

Symptoms and Causes
You might have BDD if you find yourself obsessing over one or more perceived flaws in your appearance or develop compulsive behaviours such as excessive use of mirrors or not looking at it at all, hiding your flaws with excessive makeup or wearing certain types of clothing to disguise the shape.  “I’ve never felt comfortable in really tiny clothes. I was always worried about my appearance. That was the peak of my body dysmorphia. I couldn’t look in the mirror at all,” Eilish was quoted as having said in an interview. 

Other behaviours include seeking constant reassurance about your appearance, obsessive worrying about the body, or negative thoughts about certain areas of the body that you think are too big or too small. Some people might also constantly compare themselves to models or celebrities and seek cosmetic surgeries or medical treatments to change their looks. Modern Family actor Reid Ewing suffered from BDD for years and underwent many cosmetic surgeries but was never happy with the results. Even the legendary Michael Jackson had several cosmetic surgeries to look a certain way. 

Dr Gitanjali Natarajan, Clinical Psychology – Director at Niyama Healthcare in Chennai, explains that the main reason for such behaviour is due to a complex interplay of biological, psychological and socio-cultural factors rather than a single causative factor. For instance, there could be imbalances in certain brain chemicals, like serotonin and dopamine, that might contribute to obsessive thoughts and compulsive behaviours associated with BDD.  Also, genetic factors, such as having a close family member with BDD or other mental health conditions like OCD or depressive disorder, increase the risk of developing it.

Certain psychological factors like negative childhood experiences, including bullying, teasing, or abuse related to appearance, could lead to BDD in adult life. Natarajan points out that societal emphasis on unrealistic beauty ideals and media portrayal of “perfect” physiques are among the main causes of body dissatisfaction and self-comparison, triggering BDD in vulnerable individuals. 

Plausible Treatments
A combination of psychological therapies and medication has been shown to be most effective in managing BDD. Natarajan lists out the four most effective treatments for this condition: 

1. Acceptance and Commitment Therapy (ACT): This therapy helps individuals manage distressing thoughts and feelings about their appearance, and commit to living a meaningful life aligned with their values, without getting overwhelmed by their perceived flaws. 
2. Cognitive Behavioural Therapy (CBT): It helps individuals identify and challenge distorted thoughts and beliefs about their appearance, leading to more realistic self-perception and reduced anxiety. It also teaches coping mechanisms to manage obsessive thoughts and compulsive behaviours related to appearance, like mirror checking or reassurance seeking. 
3. Exposure and Response Prevention (ERP): This specific type of CBT gradually exposes individuals to situations that trigger their BDD symptoms while building their skills to resist compulsive behaviours. This helps to break the cycle of anxiety and avoidance in BDD.
4. Body Image Therapy: This therapy works on challenging unrealistic beauty standards, developing a more positive and accepting body image and better self-compassion. 

Natarajan recommends a few more steps in addition to the treatments:

1. Develop self-acceptance and compassion: Refraining from self-criticism and constantly comparing oneself to others is necessary to have a healthy self-image. 
2. Manage emotions and thoughts with mindfulness: Practice mindfulness techniques like meditation and present awareness to manage difficult emotions and self-judgmental thoughts. 
3. Limit social media: Reduce time spent on platforms that trigger negative comparisons or exacerbate body image concerns. 
4. Focus on your values: Define what’s important to you in life beyond appearance. Pursue value-based goals to find meaning and purpose. 
5. Practice self-care: Engage in activities you enjoy that promote relaxation and well-being. Prioritize healthy sleep, balanced diet and exercise.
6. Contact support groups: Connect with others who understand your struggles. Sharing experiences and learning from others can be incredibly helpful in not feeling alone in the struggle with BDD.

Remember, BDD is a common mental condition and with the right guidance, you can rewrite your body narrative. 

Shweta Dravid is a self -confessed explorer who writes on travel, health, wellness, mindfulness and life truths.

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