Hollywood actor Megan Fox — known for movies like Transformers and Jennifer’s Body — recently revealed her personal battle with body dysmorphia, shedding light on a condition that affects countless individuals worldwide.
Body dysmorphia, characterised by a relentless obsession with perceived flaws in one’s appearance, can have a profound impact on self-esteem and mental well-being.
South First spoke to mental health experts who say it is important to understand and address this silent battle, and educate the public — especially adolescents and their parents — about this condition and when it is likely to affect someone.
Megan Fox speaks up
In a candid interview, Megan Fox shared her experience of living with body dysmorphia, offering a glimpse into the internal struggle she has faced throughout her career.
Despite her stunning beauty and success, she revealed feeling an intense pressure to conform to societal beauty standards, leading to excessive self-criticism and an obsession with perceived imperfections.
She said that she’s one among 5-10 million people in the US affected by body dysmorphia. In the interview, she said, “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’s revelation highlights that body dysmorphia can affect anyone, regardless of external appearances or achievements, emphasising the urgent need for awareness and mental health support.
Understanding body dysmorphia
Renowned psychiatrist Dr Mahesh Gowda, founder of Spandana Group of Hospitals, says that while this issue is not much spoken about, it is quite common.
“Body dysmorphia is a mental health condition. It is a spectrum disorder under Obsessive Compulsive Disorder. In this, individuals obsessively focus on perceived flaws in their appearance, often magnifying them beyond reality,” he explained.
“These perceived flaws can be related to any aspect of one’s physical appearance, such as the entire body, skin, weight, hair, or facial features. The distorted perception leads to persistent distress, self-consciousness, and avoidance behaviours, profoundly impacting daily life,” Dr Gowda added.
People with body dysmorphic disorder, also called BDD, often don’t directly seek help from a psychiatrist. Instead, they most often visit a dermatologist or a plastic surgeon, who then refers them to a psychologist, explains Dr Satish Kumar CR, Consultant, Clinical Psychology, at Manipal Hospital, Bengaluru.
Symptoms & impact of body dysmorphia
Dr Satish Kumar says that BDD is defined by characteristics where a person has difficulties in identifying or accepting one or more parts of their body. They often perceive that these parts are distorted, while there are no organic or physical-aesthetic changes that can be seen.
“At Manipal, we frequently get patients from the psychiatry, dermatology, and plastic surgery departments. In most cases, these patients feel that their nose is not proper or their eyes don’t look very good. They go to dermatologists for Botox or fillers. In the West, dermatologists require a psychological assessment to decline BDD before offering Botox or filler to a patient,” he explained.
But in India, there are no such eligibility criteria in terms of assessment. It is mostly when a doctor identifies and sends it to a psychologist. In multi-speciality hospitals, however, doctors are able to understand it and send those patients to the Psychology Department to get a proper treatment.
As far as symptoms as concerned, Dr Mahesh Gowda says that they could be obsessively talking about certain parts of their body in a negative manner. In many cases, this could manifest into eating disorders like anorexia nervosa or bulimia.
In the case of anorexia, the person — even though of appropriate BMI — may have a strong fear of gaining weight and may go on an extensive diet or even refuse to eat completely, leading to several complications. In the case of bulimia, the person tends to binge eat and then purge to lose weight and avoid weight gain.
Doctors explain that body dysmorphia can have far-reaching consequences on an individual’s mental well-being and quality of life. The relentless self-criticism and preoccupation with appearance can lead to low self-esteem, anxiety, depression, and social isolation.
Individuals may resort to extreme measures in an attempt to “fix” their perceived flaws, such as excessive grooming, cosmetic procedures, or even withdrawal from social interactions.
“Some of them can even have suicidal tendencies or suffer from severe depression,” added Dr Gowda.
What are the triggers of body dysmorphia?
Doctors said that this condition usually results from a combination of genetic, biological, psychological, and environmental factors.
According to Dr Gowda, among the most common triggers are societal and cultural influences that can impact body-image perceptions. This includes constant exposure to media, such as Instagram, Facebook, Snapchat, television, movies, and so on.
Also, certain traumatic experiences during childhood or adolescence, including bullying, teasing, or critical comments related to one’s appearance, may contribute to the development of body dysmorphia later in adulthood.
Interestingly, the percentage of women who experience this is higher than men.
Personal factors like individuals’ with low self-esteem, perfectionism tendencies, or a history of anxiety or mood disorders, may make some more vulnerable to developing BDD.
“Any kind of verbal abuse, body shaming by either spouse, boyfriend, parents or any significant personality, can have long-lasting effects and contribute to the development of BDD,” added Dr Gowda.
However, he added that it is not that these factors alone necessarily lead to BDD in every individual; one has to consider the fact that it is multifactorial.
Treatment options for body dysmorphia
Dr Satish Kumar explained that these concerns are rooted in the individual’s perception rather than the presence of actual deformities, highlighting the potential benefits of cognitive-behavioural therapy as the mainstream treatment modality.
Various therapeutic techniques, including cognitive distortions, are employed to identify and address these issues. But before that, a comprehensive assessment is conducted where the individual’s case history, personality, past traumas, negative events, past or family psychiatric history, and substance abuse history are collected.
The assessment helps formulate an appropriate management plan, which typically involves cognitive-behavioural therapy, relaxation techniques, stress inoculation therapy, and addressing any unresolved past issues.
Dr Gowda added that a lot of principles of supportive counselling techniques and cognitive-behavioural therapy (CBT) are effective in treating body dysmorphia. It helps individuals identify and challenge distorted thoughts, develop healthier coping strategies, and improve body-image perception.
People with BDD constantly get into emotional crises and in such cases, dialectical behavioural therapy also helps. Medications such as SSRIs are also good options to address co-occurring symptoms of anxiety or depression, he added.
Megan Fox’s courage in sharing her experience helps raise awareness about body dysmorphia and contributes to reducing the stigma surrounding mental health challenges.
It is essential to foster a compassionate and supportive environment that encourages open conversations about body-image issues and emphasises the importance of mental well-being, said doctors.