Not to put too fine a point on it, but on Sunday night’s episode of Keeping Up with the Kardashians, Kim Kardashian West kind of freaked out after seeing a series of unretouched paparazzi photos, which were taken during a girls’ getaway to Mexico with her sister Kourtney. Seeing those images—and the mean online comments they inspired—made Kim feel horribly about her body, she said.
That’s right, even the woman who posed with a champagne coupe on her caboose has body insecurity. In fact, Kardashian West even went so far as to say that the constant scrutiny was “like literally giving [her] body dysmorphia,” which had many viewers heading to Google to find out more about the complex and serious mental disorder she was describing. Here’s what you need to know.
What is body dysmorphia?
Body dysmorphia, a.k.a. body dysmorphic disorder (BDD) is a mental disorder, wherein a person is consumed by a perceived or slight defect in their appearance to the point of obsession. Classified under the larger umbrella of obsessive compulsive disorder (OCD), BDD is characterized by the tendency to inflate (or invent) physical imperfections, as well as the inability to place one’s insecurities about their appearance into a bigger picture. “With BDD, the underlying logic vanishes,” says Dr. Laird Birmingham, a UBC psychiatrist who has treated the condition (though not Kardashian West). “It’s like if a person with OCD is checking a door ten times—they know it’s locked. The reason they’re checking it again is because a circuit in the brain.”
How common is body dysmorphia?
About 2 percent of the population experiences some form of BDD, though those numbers are higher in groups diagnosed with anxiety and/or depression.
Does Kim Kardashian West actually have body dysmorphia?
Given the somewhat casual context of Kardashian West’s comments and the fact that she did not mention a confirmed diagnosis, there’s a chance that she was “like, literally” not being literal. According to Birmingham, KKW’s seemingly healthy self-esteem and tendency to court attention suggest she does not, in fact, suffer from BDD. “The people who actually have body dysmorphia tend to avoid things like going out in their bathing suit,” he says. While pop culture moments can be a good way to shine a light on underdiscussed mental health issues, Birmingham emphasizes that BDD “is a real disorder and the people who suffer from it aren’t just looking at one bad picture.”
Have there been any other prominent discussions of body dysmorphia in the media?
Miley Cyrus, Hayden Panettiere, Robert Pattinson and Sarah Michelle Gellar have all spoken out about their experiences with BDD, however, it’s hard to say whether these celebrities fit the clinical definition. In 2011, Gellar told Health Magazine, “’I’m a female! I totally have body dysmorphic disorder. I think most women do.”
Per Birmingham: “BDD is not having insecurity around one or many aspects of your physical appearance, which is far more common. If someone says, ‘I don’t like my nose,’ but that doesn’t really affect they way they live their life, that is different from BDD, where the disorder takes up so much space in their brain, it gets in the way of how they function.”
One celebrity example that does appear to fit the bill is Reid Ewing, the 28-year-old actor who plays Dylan on Modern Family. In a piece for , Ewing explains how he obsessed over his “ugly” appearance to the point of getting a lot of plastic surgery that he now regrets.
What does body dysmorphia look like in a non-celebrity context?
In some cases, a person with BDD may need to constantly look at and review the body part in question—and might actually see it growing (in the case of a perceived large stomach) or shrinking (in the case of a perceived hair loss). “A person might feel that they’re gaining weight, or their tummy is getting larger when in fact, it is not,” says Birmingham. Of women in particular, who often have slight changes in body weight and fluid retention around menstruation, Birmingham says: “a person with BDD would take this as a huge change—they can’t go out because of it.”
Is there a cure for the body dysmorphia?
There is no miracle cure, but there is treatment. Birmingham says that both cognitive behavioural therapy and anti-depressants can be effective in treating those with BDD.
Is our obsession with celebrities like Kim Kardashian West part of the problem?
“BDD is not something that a person develops by looking at a magazine,” says Birmingham. However, societal pressure may heighten stress and anxiety, which facilitates dysmorphic self-evaluation. “That could be from a parent or a friend, who might mean well, but says something to increase pressure,” he says.