Do you sometimes wonder if your relationship with food is “normal”? Maybe you’ve caught yourself thinking your eating habits aren’t disordered enough to matter, or that you don’t look like someone who would have an eating disorder. If these thoughts sound familiar, you’re not alone and understanding common eating disorder myths can help you discover the truth about your experience.

Eating disorder myths remain some of the most dangerous misconceptions in mental health. Despite decades of research, these harmful eating disorder myths continue to shape how we think about these serious illnesses, creating barriers that prevent millions of people from seeking the help they need and deserve.

As a therapist specializing in eating disorders and OCD, I see firsthand how misinformation impacts clients. The reality is that eating disorders are complex, deeply individual experiences that cannot be reduced to stereotypes. It’s time to challenge these misconceptions and replace them with truths that support healing, autonomy, and justice.

The Hidden Impact of Eating Disorder Myths

Before we dive into specific eating disorder myths, it’s important to understand why these misconceptions are so dangerous. Eating disorder myths don’t just spread misinformation, they:

• Delay diagnosis and treatment by making people question whether they’re “sick enough”
• Perpetuate shame and stigma around seeking help
• Lead to inadequate or harmful care from uninformed healthcare providers
• Prevent early intervention when treatment is most effective
• Reinforce harmful stereotypes that exclude marginalized communities

If you haven’t felt valid in your struggle with food and body image, these myths may be the reason why. Let’s debunk them once and for all.

Myth #1: Eating Disorders Have One Clear Cause

The Truth: Eating disorders are complex, multifactorial illnesses with no single cause.

There’s no simple explanation for why eating disorders develop. Genetics, biology, environment, attachment trauma, cultural pressures, and systems of oppression all interact in unique ways for each individual.

Simplifying eating disorders to “a diet gone too far” or “control issues” erases the very real intersection of personal history and systemic forces that contribute to their development. In my practice, I typically work with people who experience a “perfect storm” of triggers, perhaps a genetic predisposition combined with major life stressors or trauma.

For example, research shows that growing up with food insecurity can lead to a full-blown eating disorder even without a family history, while others may have genetic vulnerability that only manifests under specific environmental conditions.

Myth #2: Everyone With an Eating Disorder Is Underweight

The Truth: Only 4% of people with eating disorders are underweight.

This is perhaps the most dangerous myth of all. The stereotype of the emaciated person not only misrepresents reality, it actively harms those in larger bodies or at “average” weights, who may be dismissed by healthcare providers and even themselves.

This misconception delays or prevents access to treatment, leading to more severe medical and psychological complications. Some research shows that “atypical anorexia” can be just as deadly, if not more deadly, than typical anorexia.

The reality: Eating disorders affect people in every body size, and body size alone tells us nothing about the severity of the illness or the person’s need for support.

Need Help Understanding Body Image Issues? If you’re struggling with how you see your body or wondering if your concerns are valid, explore our comprehensive guide on body image therapy and what it can do for you. Remember: every body deserves compassion and care.

Myth #3: Hospitalization Is Required for All Eating Disorder Treatment

The Truth: Healing looks different for every person, and many paths lead to recovery.

While some people benefit from inpatient or residential treatment, many find healing through outpatient therapy, support groups, or community-based care. One-size-fits-all approaches ignore the diversity of recovery paths and can be inaccessible for those who cannot afford or take time away for higher levels of care.

For those who don’t have access to traditional healthcare, the notion that you must go through formal treatment levels might prevent you from seeking any help at all, which is far worse than seeking alternative support.

If you can’t afford paid help, there are options:

• Free support groups at ANAD
• Free recovery peer mentors at MEDA
• Treatment scholarships through Project HEAL

That said, if you can access healthcare, it’s highly recommended to work with a medical doctor, registered dietitian, and specialized therapist.

Myth #4: Eating Disorders Are Personal Character Flaws

The Truth: Systems of oppression significantly influence eating disorder development.

Diet culture, anti-fat bias, racism, ableism, transphobia, and other systemic injustices all contribute to the onset and maintenance of eating disorders. These aren’t simply individual “choices”—no one chooses an eating disorder.

They’re often shaped by living in a society that upholds harmful ideals about bodies, worth, and belonging. For example, for a BIPOC person, body restriction might serve as a protective strategy against white supremacy culture, though it remains harmful nonetheless. Research shows how racial discrimination directly impacts eating behaviors.

Healing from racial trauma and other forms of oppression must be central to eating disorder recovery.

Wondering If Your Struggles Are Valid? Many people struggle to identify the difference between a “Diet” and an eating disorder. Learn more about the thin line that differentiates them.

Myth #5: There’s Only One “Right” Way to Recover

The Truth: Recovery is not a rigid checklist, you can define your own healing path.

What matters isn’t meeting someone else’s standard of what “recovered” should look like. Instead, recovery is about reclaiming your agency, safety, and connection to your body in ways that work for you.

Of course, being medically and psychologically stable is important for everyone’s recovery, but the steps you take to get there can be unique to your life circumstances and needs. This might include exploring harm reduction approaches that meet you where you are in your journey.

Myth #6: Eating Disorders Only Affect Young, White Women

The Truth: BIPOC and transgender individuals have some of the highest rates of eating disorders.

White-centered portrayals of eating disorders erase the experiences of Black, Indigenous, Asian, Latinx, mixed-race, and transgender communities, many of whom experience eating disorders at equal or higher rates than their white cisgender peers.

These groups also face greater barriers to diagnosis and care due to systemic racism, transphobia, and medical bias. Research shows that eating disorders are far more prevalent than many assume, affecting 10 million men and 20 million women at some point in their lives.

When we overlook marginalized communities, we perpetuate systemic oppression and harm. Instead, we must work to dismantle these barriers and create inclusive spaces for all bodies in eating disorder recovery.

Myth #7: People With Eating Disorders Are “Control Freaks”

The Truth: While some may seek agency due to trauma, eating disorders aren’t inherently about control.

Many clients describe using food and body behaviors to cope with overwhelming powerlessness or pain. Framing eating disorders solely as “control issues” oversimplifies and stigmatizes a deeply complex experience.

Someone needing a sense of control has likely faced circumstances where they had none, leaving them feeling powerless. Seeking autonomy is a basic human need and drive, very different from being “born a control freak.”

Feeling Overwhelmed by Food and Control Issues? If you’re using food to cope with difficult emotions or trauma, you’re not alone. Discover how trauma and eating disorders are connected and find healthier ways to regain your sense of power.

Myth #8: Recovery Is Purely a Matter of Willpower

The Truth: Access to recovery requires resources, not just willpower.

Yes, recovery involves intention and choice. But it also depends on access to supportive care, financial stability, safe housing, and affirming relationships. Telling someone to “just choose recovery” ignores the structural realities that make healing possible.

For example, the average cost per day at a residential eating disorder program is upwards of $2,000, clearly beyond many people’s reach.

Myth #9: Harm Reduction Enables Eating Disorders

The Truth: Harm reduction is lifesaving and honors autonomy.

Meeting people where they are, rather than demanding immediate, complete cessation of harmful behaviors, can keep them alive and engaged in care. Harm reduction is rooted in respect for autonomy and recognition that healing is rarely linear.

Harm reduction for eating disorders might include gradually reducing behaviors or agreeing to minimum nutritional intake that sustains life while building coping skills. It’s about keeping people safe and alive while they work toward recovery at their own pace.

Ready to Explore Your Treatment Options? Recovery doesn’t have to be all-or-nothing. Learn about different approaches to eating disorder treatment and find the path that feels right for you, whether that’s traditional therapy, harm reduction, or something in between.

Frequently Asked Questions About Eating Disorder Myths

Q: How do I know if my eating behaviors are disordered enough to seek help?

A: If your relationship with food or your body is causing distress, interfering with your daily life, or feels out of control, you deserve support, regardless of your weight, symptoms, or how you compare to others. There’s no “sick enough” threshold for getting help.

Q: Can eating disorders develop at any age?

A: Yes, eating disorders can develop at any stage of life. While they often begin in adolescence or young adulthood, they can also emerge in midlife or later, especially during major life transitions or stressful periods.

Q: Are eating disorders genetic?

A: Genetics play a role in eating disorder risk, but they’re not destiny. Having a family history increases vulnerability, but environmental factors usually serve as the “trigger” for symptoms to develop.

Q: Can you fully recover from an eating disorder?

A: Yes, full recovery is possible for many people. However, recovery looks different for everyone and may take time. Some people achieve complete freedom from symptoms, while others learn to manage their condition effectively with support.

Q: Do men get eating disorders?

A: Absolutely. While eating disorders are more commonly diagnosed in women, men account for about 25% of people with anorexia and bulimia, and about 40% of those with binge eating disorder. Men may be underdiagnosed due to stigma and different symptom presentations.

Q: Is it possible to have an eating disorder without extreme weight loss?

A: Yes. Most people with eating disorders don’t experience dramatic weight changes. Eating disorders can occur at any weight, and psychological symptoms often precede or occur without significant physical changes.

Ready to Take the Next Step?

If you or someone you love is struggling with an eating disorder, know this: Your experience is valid. Your body is not the problem. And recovery is possible.

Every person deserves compassionate, informed care that honors their unique journey. Whether you’re just beginning to question your relationship with food or you’ve been struggling for years, support is available.

Find Your Local Support Explore the GoodTherapy therapist directory to connect with qualified eating disorder specialists in your area who understand the complex nature of these conditions.

Additional Resources for Support:

• Body image therapy and support
• Understanding eating disorder treatment options
• The role of trauma in eating disorders

Remember: Healing is not a destination but a journey, and you don’t have to walk it alone. There is hope, and there is help.

References:

Becker, C. B., Middlemass, K., Taylor, B., Johnson, C., & Gomez, F. (2017). Food insecurity and eating disorder pathology. International Journal of Eating Disorders, 50(9), 1031–1040. https://doi.org/10.1002/eat.22735

Beck, A. R., & Saucedo, J. C. (2019). Food insecurity and eating disorders in college students. Journal of American College Health, 67(7), 662–667. https://doi.org/10.1080/07448481.2018.1499652

Brown, K. L., Graham, A. K., Perera, R. A., & LaRose, J. G. (2022). Eating to cope: Advancing our understanding of the effects of exposure to racial discrimination on maladaptive eating behaviors. International Journal of Eating Disorders, 55(12), 1744–1752. https://doi.org/10.1002/eat.23820

Hassan, S. (2022). Saving Our Own Lives: A liberatory practice of harm reduction (Foreword by A. M. Brown; Introduction by Tourmaline). Haymarket Books.

Let’s be honest: Reality television has become America’s not-so-secret obsession. Whether it’s your guilty pleasure after a long day, the background noise while you’re scrolling your phone, or something you swear you’d never watch (but somehow know all the contestants’ names), there’s no denying we’re consuming more reality TV than ever before.

From the drama-filled villas of Love Island to the backstabbing brilliance of The Traitors, from the soaring vocals on The Voice to the rose ceremonies on The Bachelor — these shows have us hooked, and they’re undeniably entertaining. Still, researchers and mental health professionals are increasingly worried about the impact this “harmless” entertainment might be doing to our mental health, especially as it relates to body image.

If you’ve ever felt a knot in your stomach after watching impossibly perfect people find love on a tropical island or noticed your mood dip after a reality TV binge, you’re not alone. These shows are messing with our minds in ways we’re only beginning to understand, and the impact on how we see ourselves, especially our bodies, is becoming impossible to ignore.

Take Love Island USA, for instance. This longtime fan favorite has been called out for years over its harmful body image messaging, yet the most recent season (which premiered June 3rd, 2025) serves up more of the same. It might be your go-to guilty pleasure, but it’s worth asking: What’s the real cost of the “Love Island Effect” on our mental health?

Below is a deeper dive into the show’s impact on our mental health — from the show’s impossible beauty standards to the direct psychological toll it takes on us — plus some practical ways to enjoy your reality TV fix without letting it mess with your self-worth.

Negative Body Image and Mental Health: Understanding the Connection

When it comes to what shapes your mental health, body image plays a bigger role than you may realize. The way you see yourself in the mirror isn’t just about vanity: it’s deeply connected to your overall well-being and self-worth. When those thoughts are persistently negative, your mind can suffer.

Poor body image can trigger or worsen a number of conditions or symptoms: 

• Anxiety and depression 
• Body dysmorphia 
• Eating disorders like anorexia and bulimia 
• Feelings of shame and guilt 
• Self-esteem 
• An unhealthy obsession with body type

Learning how body image affects mental health isn’t just important: it’s essential if you want to take care of yourself, feel better in your own skin, and help others do the same. There are four components to body image you should know: what you see when you look at yourself (perceptual), how that makes you feel (affective), what you think about it (cognitive), and what you do as a result (behavioral).

Here’s the kicker: Reality TV and social media can mess with any or all of these layers, creating a perfect storm for mental health struggles.

The good news? If you’re battling negative body image, you don’t have to go it alone. Therapy professionals are specially trained to help you spot reality TV’s toxic influence and flip the script on how you see yourself. They can even coach you through tough conversations about body image with friends and family, helping curate a more positive message to the people you care about.

Read More: Wondering How to Talk to Your Child About Their Body? Start Here 

The Popularity of Reality TV

Despite all the hand-wringing about reality TV’s impact on our mental health, we’re watching more of it than ever. In fact, reality shows now make up a staggering 57% of all available TV programming. The message is crystal clear — reality TV isn’t just a guilty pleasure anymore: It’s become part of our daily media diet.

How Reality TV Impacts Body Image

You’ve probably encountered at least one of the Love Island franchises, whether it’s the UK, Australia, France, Germany, or USA version. Yet, what stays consistent across every beach and villa is the show’s basic formula of putting conventionally attractive twenty-somethings in swimwear and watching them compete for love — and the troubling impact it has on how we see ourselves.

The numbers are pretty sobering. New research from the Mental Health Foundation reveals that nearly 25% of 18-to-24-year-olds say reality TV makes them worry about their body image. The newest debut of Love Island USA, season 7, exacerbates this widespread concern. The cast is another lineup of people who fit that narrow definition of “beach body ready” and have likely had cosmetic work done.  Love Island is certainly not alone in promoting unhealthy body standards, but researchers are particularly worried about the show’s so-called “Love Island Effect”: when viewers don’t just watch the show but also start questioning their own appearance and considering cosmetic procedures.

Despite the show’s lack of body diversity and some franchise changes, like offering mental health support for contestants after the show, Love Island USA celebrates the same, negative idea about body image: that true physical beauty does not include plus-sized bodies and only celebrates those with toned physiques and cosmetic enhancements.

Understanding how your TV habits affect your mental health is just the beginning. Actually building a positive body image, though, is the real work. Learn some concrete steps you can take to reset your perspective and find the support you need to feel good in your own skin.

How to Develop a Positive Body Image

As you grab the remote this week to turn on your favorite reality TV show, stop yourself and remember this key fact: the people you see on TV both represent skewed body ideals and likely struggle with body image issues themselves. 

While GoodTherapy’s expert therapists are ready to help you tackle any body image challenges head-on, you can start protecting your mental health right now with these three game-changing strategies:

1. Set Boundaries: Think of boundaries as your personal protection measures — whether physical, mental, or emotional. They’re your first line of defense in protecting your peace of mind.
2. Fight Back With Cognitive Dissonance: Recognize and combat toxic beauty standards. See something unrealistic? Call it out. Challenge it verbally or take action against it.
3. Remember the Ultimate Goal: Self-love isn’t one-size-fits-all. What works for your best friend might not work for you, and that’s okay. The freedom that comes with genuine self-acceptance? That’s universal.

These are the big-picture strategies, but let’s get practical. Here are some small but mighty actions that can transform how you see yourself:

• Start your day with positive affirmations (yes, they actually work) 
• Chase health, not a number on the scale 
• Spread compliments freely to others and yourself 
• Make a list of what you love about yourself (and read it often) 
• Catch yourself comparing and shut it down 
• Notice when your inner critic gets loud and stop it in its tracks 
• Remember you’re more than just a body: you’re a whole person

Fighting back against TV’s toxic body standards doesn’t mean you have to give up Bachelor in Paradise or stop rooting for your favorite Survivor contestant. It just means watching with your eyes wide open and recognizing your triggers so you can practice foundational skills in cognitive behavioral therapy (CBT). When you notice yourself making comparisons while watching Love Island, that awareness itself is the first step toward change.

Read More: Want to Learn About the Importance of CBT? Start Learning Now

How You Can Watch Love Island and Protect Your Mental Health 

You don’t have to navigate this mental health journey solo. GoodTherapy’s trained professionals understand how reality TV affects mental health. They’re equipped with tools and strategies to help you build a healthier relationship with your body image.

With the right support, you don’t have to break up with Love Island USA this summer. You can absolutely keep up with all the villa drama while also working on rebuilding your confidence and protecting your mental health. It’s not about choosing between entertainment and self-care: it’s about finding that sweet spot where you can enjoy both.

Ready to take that first step? Find the right therapist for you, today!

Sources:

Multidisciplinary Digital Publishing Institute: Body Perceptions and Psychological Well-Being

Reality TV Statistics by Shows, Franchise, Demographics and Popularity

Which American Genres Have the Highest Global Demand?

Popularity of Reality TV as Online Video Content Genre in the U.S. 2019-2023 as of June 2024, by Quarter

Mental Health Foundation Raises Fears About Impact of Reality TV on Young Viewers

The Issue of Diverse Body Representation on Reality TV Goes Way Beyond Love Island

Reality TV Fuels Body Anxiety in Young People, Survey Says

Very few people are one hundred percent happy with their physical appearance. Most of us have something about ourselves that we would like to change in some small way.

But for most of us, our perceived flaws do not interfere with our happiness or daily functioning. For those who have body dysmorphia, or body dysmorphic disorder (BDD), however, a small flaw—either real or imagined—can substantially reduce their quality of life. They may obsess and worry about the flaw for hours every day (Anxiety and Depression Association of America, n.d.). BDD is a serious mental health issue that can lead to suicidality and significant social and occupational dysfunction. Both men and women can experience BDD (Phillips & Castle, 2001).

People with BDD are often extremely preoccupied with their physical appearance and can become deeply upset over minor flaws that wouldn’t even be noticed by others. The person’s perception of the flaw, however unrealistic, often causes intense emotional distress and can trigger avoidance of social situations.

The preoccupation and obsession with flaws that comes with body dysmorphia can take away the ability to experience joy and healthy relationships. Some people with BDD undertake multiple cosmetic procedures to correct the flaw. Unfortunately, relief is likely to be short-lived at best. The root issue is not the flaw, which may be minor or even imagined. After the cosmetic procedures, the individual with BDD may simply focus on a different or “new” flaw.

The preoccupation and obsession with flaws that comes with body dysmorphia can take away the ability to experience joy and healthy relationships.

Emotional Neglect and Body Dysmorphia

Emotional neglect can be understood as a pattern in a parent-child relationship where the child’s needs are consistently ignored, disregarded, or devalued by the parent. Emotionally neglected parents often feel ambivalent towards their children’s emotional needs, particularly when they are distressed and crying (Didie et al., 2006). The parent may feel the child is impossible to please and—out of frustration—simply ignore and reject the child when they are upset. In this cycle, adults who were emotionally neglected as children tend to become emotionally neglectful as parents.

Emotional neglect is commonly found in both males and females diagnosed with BDD (Carey, Crocker, Elias, Feldman, & Coleman, 2009).

Emotional Neglect as Trauma

The body and the nervous system experience neglect in a way that is similar to abuse. The child who is not nurtured and cared for emotionally may experience continuous high levels of stress and sadness with no one to turn to for comfort. Over time, this can take a serious toll on the ability to develop resilience as the child matures into adolescence and adulthood.

Adults with histories of neglect often develop a range of emotional and mental health issues, including depression, low self-esteem, hyperactivity, and aggression. Neglect often leads to the child feeling unwanted and unloved, and it can lead to a distorted perception of the self.

In the case of BDD, emotional neglect may foster a distorted self-perception in terms of physical appearance. The individual with BDD may believe they are deeply flawed and unacceptable to others as a result of their physical appearance.

Developmental Timing and Neglect

The impact of physical and emotional neglect may be influenced by when it occurs during the child’s development. A child who is neglected during the early years of development can miss out on crucial opportunities for social, emotional, and cognitive development. An important factor that underlies each of these aspects of childhood development is the ability to develop resilience and cope with stress (Cicchetti & Toth, 1995).

Very young children and infants are not biologically capable of reducing the autonomic stress response once it is activated. During times of heightened emotional upset or fear, increased levels of stress hormones begin to circulate in the brain and nervous system. A child without comfort and guidance from an adult is forced to expend all of their energy in bringing the body and mind back to a balanced state. When the child is put in the position of having no help or comfort, all resources are expended and the child has little left for anything else. In this way, opportunities for development in other areas such as social and cognitive learning are lost.

As the child gets older, it is understandable why neglect can lead to intense feelings of shame and a distortion of body image. Body image is connected to self-esteem. When children grow and develop in circumstances that teach them they are unworthy of love and even send messages that there is something wrong with them, the child is likely to internalize these perceptions as they grow.

Therapy for Trauma and Body Dysmorphia

Exposure therapy (Neziroglu & Yaryura-Tobias, 1993; Linde et al., 2015) and cognitive behavioral therapy (CBT) can help some people process and heal the effects of past trauma and neglect. Cognitive behavioral therapy may be helpful for BDD because it helps the person discover the source of distorted and unrealistic perceptions. Once it’s understood where the negative thought patterns are coming from, CBT teaches us how to correct these patterns and then move into a more realistic and healthy way of thinking (Neziroglu & Khemlani-Patel, 2002). In this way, CBT can be effective in treating distorted perceptions of the body. At the same time, CBT can help in developing healthier thinking patterns that address depression and anxiety, which often co-occur with trauma and BDD.

If you think childhood emotional neglect or body dysmorphia are issues that could be impacting you, support is available. Reach out to a licensed and compassionate therapist.

References:

1. Body dysmorphic disorder (BDD). (n.d.). Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd
2. Carey, W. B., Crocker, A. C., Elias, E. R., Feldman, H. M., & Coleman, W. L. (2009). Developmental-Behavioral Pediatrics E-Book. Philadelphia, PA: Elsevier Health Sciences.
3. Cicchetti, D., & Toth, S. L. (1995). A developmental psychopathology perspective on child abuse and neglect. Journal of the American Academy of Child and Adolescent Psychiatry, 34(5), 541-565. doi: 10.1097/00004583-199505000-00008
4. Didie, E. R., Tortolani, C. C., Pope, C. G., Menard, W., Fay, C., & Phillips, K. A. (2006, September 26). Childhood abuse and neglect in body dysmorphic disorder. Child Abuse & Neglect, 30(10), 1105-1115. doi: 10.1016/j.chiabu.2006.03.007
5. Linde, J., Rück, C., Bjureberg, J., Ivanov, V. Z., Djurfeldt, D. R., & Ramnerö, J. (2015). Acceptance-based exposure therapy for body dysmorphic disorder: A pilot study. Behavior Therapy, 46(4), 423-431. doi: 10.1016/j.beth.2015.05.002
6. Neziroglu, F., & Khemlani-Patel, S. (2002). A review of cognitive and behavioral treatment for body dysmorphic disorder. CNS Spectrums, 7(6), 464-471. doi: 10.1017/s1092852900017971
7. Neziroglu, F. A., & Yaryura-Tobias, J. A. (1993). Exposure, response prevention, and cognitive therapy in the treatment of body dysmorphic disorder. Behavior Therapy, 24(3), 431-438. Retrieved from https://psycnet.apa.org/record/1994-26859-001
8. Phillips, K. A., & Castle, D. J. (2001, November 3). Body dysmorphic disorder in men: Psychiatric treatments are usually effective. The BMJ, 323(7320), 1015-1016. doi: 10.1136/bmj.323.7320.1015

Body dysmorphic disorder (BDD), or body dysmorphia, is a condition in which a person thinks their body is severely flawed. The flaw is either imagined or real but minor. For example, a person may have a small skin blemish that others hardly notice, but they develop a preoccupation with and an exaggerated perception of the flaw.

Typically a person’s focus is on their face, head, or the shape of their body. Excessive mirror-checking, grooming, or exercising can all be signs of BDD. The condition is closely related to obsessive compulsive disorder (OCD).

BDD usually begins to develop in adolescence. The average age of onset is 17 years, and studies have shown prevalence begins to drop off after age 44. Body dysmorphia is more common than one might think, occurring in around 2% of the population.

Symptoms of Body Dysmorphia

The following are common signs of body dysmorphia:

1. Extreme preoccupation with a physical flaw that is minor or can’t be noticed by other people.
2. A strong belief that said flaw makes you ugly or unattractive, no matter what the rest of your body looks like.
3. A belief that others take notice of the flaw or flaws in your appearance.
4. Constantly comparing your appearance to others.
5. Avoiding social situations due to shame about your appearance.
6. Always seeking reassurance about your appearance.

We live in a society that places much emphasis on beauty and youth, so it is normal to be concerned about our appearance. However, if your concern over how you look becomes obsessive, begins to interfere with your daily functioning, and/or causes significant distress, you may have BDD.

What Causes Body Dysmorphia?

A survey of individuals with body dysmorphic disorder found a significant association with child maltreatment. Specifically, 78.7% of individuals diagnosed with BDD reported early-life abuse, including:

• Emotional neglect (68.0%)
• Emotional abuse (56.0%)
• Physical abuse (34.7%)
• Physical neglect (33.3%)
• Sexual abuse (28.0%)

A child raised by a neglectful parent is unlikely to have had the opportunity to develop good coping skills. For some individuals with BDD, it seems that as a result of maltreatment, they may internalize grief and pain. In time, the individual comes to believe that there is something wrong with them or their body.

Researchers have found that individuals suffering from BDD have abnormal brain network organization. The greater the symptom severity, the greater the disturbances in functioning and organization compared to people without BDD. Researchers also found evidence of abnormal connectivity in visual regions and emotional processing, indicating a deficit in information processing within these brain regions.

Treatment and Outcomes for Body Dysmorphia

Body dysmorphia is a serious issue and should not be treated as simple vanity. Individuals experiencing BDD have a higher risk of suicide as well as impeded social and occupational development. BDD often does not go away without treatment. If left untreated, body dysmorphic disorder can lead to depression, anxiety, and extensive medical expenses.

Body dysmorphia is a serious issue and should not be treated as simple vanity. Given the long-term course of BDD and the significant impact on quality of life, it is important for affected individuals to seek treatment. While there are neurological differences in patients with BDD, it is possible to effect changes in neurological functioning. The brain is plastic and retains the ability to change throughout the entire lifespan.

The most common forms of treatment for BDD are cognitive behavior therapy (CBT) and pharmacotherapy. In a recent study, the medication of choice was a selective serotonin reuptake inhibitor (SSRI). Investigations examining the use of pharmacotherapy and CBT in tandem have found combined therapy to be effective.

BDD may require long-term therapy, and many patient populations are not willing or are unable to take SSRIs, such as pregnant women. However, CBT has been shown to be very effective and is often a preferred course of treatment. CBT has been shown to improve outcomes both when it is the only treatment and when it is combined with medication.

If you or a loved one is experiencing body dysmorphia, you can find a therapist here.

References:

1. Arienzo, D., Leow, A., Brown, J. A., Zhan, L., GadElkarim, J., Hovav, S., & Feusner, J. D. (2013). Abnormal brain network organization in body dysmorphic disorder. Neuropsychopharmacology, 38(6), 1130-1139.‏ Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629399
2. Bjornsson, A. S., Didie, E. R., & Phillips, K. A. (2010). Body dysmorphic disorder. Dialogues in Clinical Neuroscience, 12(2), 221-232. Retrieved from ‏ https://www.ncbi.nlm.nih.gov/pubmed/20623926
3. Buhlmann, U., Marques, L. M., & Wilhelm, S. (2012). Traumatic experiences in individuals with body dysmorphic disorder. The Journal of Nervous and Mental Disease, 200(1), 95-98. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22210370
4. DeVos, K. (2017, September 5). Examining the link between body dysmorphia and PTSD. Retrieved from https://www.eatingdisorderhope.com/blog/examining-body-dysmorphia-ptsd
5. Hong, K., Nezgovorova, V., & Hollander, E. (2018). New perspectives in the treatment of body dysmorphic disorder. F1000Research, 7.‏ Retrieved from https://f1000research.com/articles/7-361/v1
6. Koran, L. M., Abujaoude, E., Large, M. D., & Serpe, R. T. (2008). The prevalence of body dysmorphic disorder in the United States adult population. CNS Spectrums, 13(4), 316-322.‏ Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18408651
7. Vitiello, B. (2009). Combined cognitive-behavioral therapy and pharmacotherapy for adolescent depression. CNS Drugs, 23(4), 271-280.‏ Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671638