Rising dysmorphia among adolescents : A cause for concern (2024)

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  • J Family Med Prim Care
  • v.9(2); 2020 Feb
  • PMC7114025

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Rising dysmorphia among adolescents : A cause for concern (1)

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J Family Med Prim Care. 2020 Feb; 9(2): 567–570.

Published online 2020 Feb 28. doi:10.4103/jfmpc.jfmpc_738_19

PMCID: PMC7114025

PMID: 32318383

Himanshu,1 Avneet Kaur,1 Ashishjot Kaur,1 and Gaurav Singla2

Author information Article notes Copyright and License information PMC Disclaimer

Abstract

Introduction:

Body dysmorphic disorder is defined as a preoccupation with apparent defects in patient's appearance which causes significant distress and impairment. This study was conducted in 186 students who attended premedical preparation classes with the mean age of 16.81 years with the primary motive of determining body dysmorphia among adolescent age group.

Aim:

The main objective of this study is to assess body dysmorphia among teenage adolescents and young adults.

Methods and Materials:

This cross-sectional study was conducted in premedical preparation class in January 2019. The student's ages range from 16 to 18 years with mean age being 16.81 years. Once verbal consent was obtained the students were asked to fill an anonymous predesigned questionnaire. Continuous variables were summarized as mean and standard deviations, whereas categorical variables were summarized as proportion (%).

Statistical Analysis Used:

All the data from the questionnaire were extracted and compiled in MS Excel and percentage and frequencies were applied as needed.

Results:

The mean age of the participants was 16.81+/- 0.82 years with almost equal percentage of females (52.13%) and males (47.84%). Our study shows that in general females are more dissatisfied from their body than males. Both sexes have different areas of concerns. In females, there is more discontent about body fat, facial hair, height, and complexion. In comparison in males the frustration is more regarding muscular body, acne, height, weight, and hair thinning. Despite differences in areas of concern both males and females show dissatisfaction with their body image.

Conclusions:

It has been concluded that there is a rising surgence of body dysmorphia in adolescents.

Keywords: Adolescents, body dysmorphia, DSM V, social media

Introductions

Body dysmorphic disorder, previously known as dysmorphophobia, is a psychiatric illness characterized by the obsessive thoughts that some aspect of one's appearance is flawed and also warrants many time-consuming rituals such as constantly comparing and mirror gazing.[1] Other factors like repetitive behaviors like skin picking, mirror gazing, excessive grooming, or mental acts such as constant comparison along with preoccupation causing significant distress or impairment in social, occupational, or other areas of functioning, are also needed for a diagnosis (DSM 5).

Increasing social media influence and increasing screen time seems to be a factor in declining body image.[2] Recently a phenomenon called “snapchat dysmorphia” has presented in which patients seek surgical consult in order to appear as their filtered selves in real life.[3] This study was done to assess the impact of social media and filters on adolescent population and their body image and body dysmorphia.

Subjects and Methods

This study was carried out in premedical preparation classes in January 2019. Verbal consent was obtained and the children were asked to fill out predesigned body dysmorphia questionnaires. The study was kept anonymous.

The questions involved concerns about appearance of body parts, preoccupation with said concerns, the distress involving the concern, effect of the said concern on social life, school work, etc., and has the said concern ever caused avoidance of social gatherings.

All the data were entered in excel sheets and evaluated. Results have been presented in form of frequencies and percentages as applicable.

Results

A total of 186 adolescents filled the questionnaire and the mean age was 16.81+/ 0.82 years with ages ranging - from 16 to 18 years. The study had a nearly equal males and females with males being 47.84% and females being 52.13%. The various parameters studied are given in Table 1. The results obtained are depicted in Table 1, Figures ​Figures11 and ​and22.

Table 1

Distribution of participants on basis of various variables

Do you find some feature (s) of your body especially ugly or unattractive?1 No concern - 27.42%
Females 47.06%
Males 52.94%
2 A little concern- 34.95%
Females 46.15%
Males 53.84%
3 Moderate concern- 23.12%
Females 67.44%
Males 32.55%
4 Extreme concern- 14.52%
Females 51.85%
Males 48.15%
If you are a little concerned, how often do you find yourself thinking about said feature?1 Maybe once in a while- 23.12%
Females 72.09%
Males 27.91%
2 Less than 1-2 times a day but do not check in the mirror- 40.86%
Females 27.63%
Males 72.36%
3 Less than 1-2 times a day but check in the mirror- 27.96%
Females 69.23%
Males 30.77%
4 More than 1-2 times a day may check in the mirror- 8.06%
Females 60%
Males 40%
Does the said feature and the way you look cause you discomfort?1 No discomfort- 22.04%
Females 34.14%
Males 65.85%
2 A little discomfort- 56.45%
Females 58.09%
Males 41.90%
3 Moderate discomfort but still manageable- 17.74%
Females 54.54%
Males 45.45%
4 A lot of discomfort and has caused crying spells- 3.76%
Females 57.14%
Males 42.85%
Has the said feature ever caused you to not attend social gatherings like birthday parties, annual functions, family gatherings etc.?1 Never- 43.55%
Females 35.80%
Males 64.20%
2 1-2 incidents remembered- 46.77%
Females 66.67%
Males 33.33%
3 More than two incidents remembered- 8.60%
Females 50%
Males 50%
4 Many incidents- 1.08%
Females 100%
Males 0%
Has the said feature ever interfered with your schoolwork, tuition, and other everyday activities?1 Never- 68.28%
Females 48.03%
Males 51.96%
2 Some days- 30.65%
Females 61.40%
Males 38.59%
3 Don’t want to go to school because of the said feature (s)- 1.08%
Females 50%
Males 50%

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Figure 1

Concerns about features specified in question 1 in males. Others (Facial hair)

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Figure 2

Concerns about features specified in question 1 in females. Others (Acne, Shape of nose)

Discussion

In body dysmorphic disorder due to a distorted body image, patients experience social isolation, anxiety, increased depression, and suicide rates.[4] The hidden nature of the disease makes it difficult to diagnose even in clinical setting.[4] BDD has a heavy mental toll on the patient, plus it is very difficult to diagnose unless the clinician is aware about the nature of the disease, with the increasing incidence and influence of social media there needs to be increased awareness among caretakers as well as professionals working with adolescents like teachers to promote positive body image. BDD affects about 2.4% of the population[4] affects both men and women and generally starts in adolescent age group.[5] BDD most often develops in adolescent years[6] and many patients also report early trauma, bullying, childhood abuse, and neglect.[7] Patients with BDD often seek dermatological and surgical consult often with no resolution; on the contrary, patients also try self-treatment like skin picking, etc.[4] Though there is high degree of overlap between BDD and anorexia in that both root in perfectionism and certain differences in the overall physical concerns, some researchers argue that both of these can be classified under “body image disorders.”[8]

The present study consists of 186 students attending pre medical classes. Nearly, equal percentage of males (47.84%) and females (52.13%) were asked to fill out a predesigned questionnaire. The questionnaire was designed to determine the ranging body dysmorphia and the effect of said dysmorphia on everyday life.

Our current study revealed females participants to be more dissatisfied with their body in comparison to male counterparts, and various areas of concern mainly being fat, hirsutism, complexion, height, etc., Whereas in males the areas of concern were muscular build, height, acne, hair thinning, weight, etc..

Recent studies show emerging concern linked with increased social media use and decreased body image satisfaction. Studies show that Facebook use is directly linked with negative mood and increased body image dissatisfaction in women.[9] Exposure to media images leaning toward thin body ideation is related to increased body image distress in women.[10] Not only women but also men are engulfed by rising preoccupation with their outlook, there is a dynamic shift from thinness oriented to muscularity oriented eating disorders in adolescent males.[11] Males in their adolescence are at risk for muscle dysmorphia and individuals who work with adolescent boys should be aware of harmful and compensatory behaviors.[12]

Not only gender, but also sexual orientation has proven to be an indicator of perceived notions of physical attractiveness, media influence, and exposure and dissatisfaction with one's body. Studies show that gay men tend to be more vulnerable to media influence and tend to have higher drive for thinness and increased body image concerns compared to their straight counterparts.[13] hom*osexual and bisexual men tend to be more vulnerable and prone to disordered eating and negatively impacted body image than straight men, though the reason stays unclear it has been hypothesized that social messages and their influence are partially linked with sexual orientation and vulnerability toward eating disorder and body image dissatisfaction.[14]

Patients with body dysmorphia have increased eating disorders (32.5%) and also comparisons between groups with lifetime eating disorders and no eating disorders show than females are prone to significant body dysmorphia and body image dissatisfaction.[15]

Currently, growing body dysmorphia especially among adolescent age group is a cause of concern and interventions are being made to decrease the influence of media on young adults. Identification of superficiality of media images has shown to protect teenage girls from being negatively impacted by exposure of thin idealized body.[16] Briefer exposure to Facebook has shown that it does not negatively impact body image.[17]

Our study concludes that there is a rising body dysmorphia among adolescents and young adults and physicians, legal guardians, parents, and teachers must deem it important to nudge the youth in the right direction by intervening and helping to understand the shallowness and superficiality of body image representation in the media. Media library intervening via awareness videos, power point presentations, etc., can prove to be great sources to influence vulnerable adolescents in the right direction. Regular meetings with nutritionists and shifting the focus from being thin to being fit and healthy are of up most importance to impact the students positively.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1. Veale D. Body dysmorphic disorder. Postgrad Med J. 2004;80:67–71. [PMC free article] [PubMed] [Google Scholar]

2. Suchert V, Hanewinkel R, Isensee B. Screen time, weight status and the self-concept of physical attractiveness in adolescents. J Adolesc. 2016;48:11–7. [PubMed] [Google Scholar]

3. A new reality for beauty standards: How selfies and filters affect body image | EurekAlert! Science News. [Last accessed on 2019 Jul 29]. Available from: https://www.eurekalert.org/pub_releases/2018-08/bmc-anr080118.php .

4. Bjornsson AS, Didie ER, Phillips KA. Body dysmorphic disorder. Dialogues Clin Neurosci. 2010;12:221–32. [PMC free article] [PubMed] [Google Scholar]

5. Mufaddel A, Osman OT, Almugaddam F, Jafferany M. A review of body dysmorphic disorder and its presentation in different clinical settings? Prim Care Companion CNS Disord. 2013;15 doi: 10.4088/PCC.12r01464. [PMC free article] [PubMed] [Google Scholar]

6. Phillips KA. Body dysmorphic disorder: Recognizing and treating imagined ugliness. World Psychiatry. 2004;3:12–7. [PMC free article] [PubMed] [Google Scholar]

7. Didie ER, Tortolani CC, Pope CG, Menard W, Fay C, Phillips KA. Childhood abuse and neglect in body dysmorphic disorder. Child Abuse Negl. 2006;30:1105–15. [PMC free article] [PubMed] [Google Scholar]

8. Phillipou A, Castle DJ, Rossell SL. Direct comparisons of anorexia nervosa and body dysmorphic disorder: A systematic review. Psychiatry Res. 2019;274:129–37. [PubMed] [Google Scholar]

9. Fardouly J, Diedrichs PC, Vartanian LR, Halliwell E. Social comparisons on social media: The impact of Facebook on young women's body image concerns and mood. Body Image. 2015;13:38–45. [PubMed] [Google Scholar]

10. Grabe S, Ward LM, Hyde JS. The role of the media in body image concerns among women: A meta-analysis of experimental and correlational studies. Psychol Bull. 2008;134:460–76. [PubMed] [Google Scholar]

11. Murray SB, Griffiths S, Mitchison D, Mond JM. The transition from thinness-oriented to muscularity-oriented disordered eating in adolescent males: A clinical observation. J Adolesc Health. 2017;60:353–5. [PubMed] [Google Scholar]

12. Skemp KM, Elwood RL, Reineke DM. Adolescent boys are at risk for body image dissatisfaction and muscle dysmorphia. Californian J Health Promot. 2019;17:61–70. [Google Scholar]

13. Carper TLM, Negy C, Tantleff-Dunn S. Relations among media influence, body image, eating concerns, and sexual orientation in men: A preliminary investigation. Body Image. 2010;7:301–9. [PubMed] [Google Scholar]

14. Gigi I, Bachner-Melman R, Lev-Ari L. The association between sexual orientation, susceptibility to social messages and disordered eating in men. Appetite. 2016;99:25–33. [PubMed] [Google Scholar]

15. Ruffolo JS, Phillips KA, Menard W, Fay C, Weisberg RB. Comorbidity of body dysmorphic disorder and eating disorders: Severity of psychopathology and body image disturbance. Int J Eat Disord. 2006;39:11–9. [PubMed] [Google Scholar]

16. Halliwell E, Easun A, Harcourt D. Body dissatisfaction: Can a short media literacy message reduce negative media exposure effects amongst adolescent girls? Br J Health Psychol. 2011;16:396–403. [PubMed] [Google Scholar]

17. Fardouly J, Vartanian LR. Social media and body image concerns: Current research and future directions. Curr Opin Psychol. 2016;9:1–5. [Google Scholar]

Articles from Journal of Family Medicine and Primary Care are provided here courtesy of Wolters Kluwer -- Medknow Publications

Rising dysmorphia among adolescents : A cause for concern (2024)

FAQs

What can body dysmorphia lead to? ›

BDD can also lead to depression, self-harm and even thoughts of suicide.

Why is body dysmorphia increasing? ›

Apps and filters that improve the way we look online can also contribute to this. If you try to appear physically 'perfect' or you regularly compare your appearance to other people, you may be more likely to develop BDD.

What is dysmorphic concerns? ›

Dysmorphic concern (DC) may be defined as excessive preoccupation about one or several physical characteristics perceived as defects or imperfections usually unnoticeable by others (Oosthuizen, Lambert, & Castle, 1998).

How does body dysmorphic disorder affect the brain? ›

This suggests that emotional brain systems in those with BDD, compared with healthy controls, may more strongly influence visual systems. This could result in enhanced visual detail perception – noticing small imperfections – which those without BDD tend not to notice.

What are the risk factors of body dysmorphic disorder? ›

Factors that may contribute to BDD include:
  • A family history of BDD or a similar mental disorder.
  • Abnormal levels of brain chemicals.
  • Personality type.
  • Life experiences.

What are the most common problem areas for people living with BDD? ›

Body dysmorphic disorder's (BDD's) perceived physical defects cause the person to think they are unattractive, ugly, hideous, or deformed. These preoccupations can focus on any bodily area, but they typically involve the skin, face, or hair.

When did body dysmorphia become a thing? ›

Dysmorphophobia was first described in the American Diagnostic and Statistical Manual (DSM III) in 1980 as an example of an “atypical somatoform disorder” without any diagnostic criteria. The term “Body Dysmorphic Disorder” was first used as a diagnosis in DSM III-R in 1987 and has continued in future editions.

Do people with body dysmorphia see themselves differently? ›

One of the most conspicuous symptoms of BDD is the distorted perception of one's own appearance.

Which gender has more body dysmorphia? ›

BDD affects: Both men and women – about 40% of people with BDD are men, and about 60% are women.

What are the 2 types of dysmorphia? ›

There are two subtypes of BDD: Muscle Dysmorphia and BDD by Proxy. Both of these subtypes appear to respond to the same basic treatment strategies as BDD (cognitive behavior therapy or CBT and medications). However, the CBT therapist in particular needs to adjust the treatment so that it has the right focus.

What not to say to someone with body dysmorphia? ›

Don't tell someone with BDD that there's nothing wrong with their body. This might seem helpful, but it may cause them to feel like they can't talk to or ask you for help. Don't judge or argue.

Is body dysphoria a mental illness? ›

Body dysmorphia, also called body dysmorphic disorder (BDD), is a mental health disorder that leads to distress over your appearance. You may think certain parts of your body are defects. Other people may not be able to see the things you perceive as flaws.

Who is more likely to be seen in body dysmorphic disorder? ›

BDD is more common in women than in men in general population studies (approximately 60% women versus 40% men). However, it is more common in men than in women in cosmetic surgery and dermatology settings.

What is the science behind body dysmorphia? ›

Researchers have determined that the brains of people with body dysmorphic disorder (BDD), a psychiatric condition that causes them, wrongly, to believe they appear disfigured and ugly, have abnormalities in processing visual input when it comes to examining their own face.

What is the behavior of a person with body dysmorphic disorder? ›

Body dysmorphic disorder (BDD) is a mental illness characterised by constant worrying over a perceived or slight defect in appearance. Repetitive behaviours are performed in response to these concerns about appearance. BDD usually starts in the teenage years, when concern over physical appearance is common.

How does body dysmorphia affect work? ›

Having BDD can negatively affect your work performance, your relationships and interactions with your coworkers and supervisors, as well as your ability to perform your everyday job duties. In fact, a substantial proportion of people with BDD are unable to hold a job or go to work because of BDD symptoms.

What are the different types of body dysmorphia? ›

There are two subtypes of BDD: Muscle Dysmorphia and BDD by Proxy. Both of these subtypes appear to respond to the same basic treatment strategies as BDD (cognitive behavior therapy or CBT and medications).

Can overweight people have body dysmorphia? ›

A distorted body image is a feature of both BDD and eating disorders, which also share many other symptoms, such as low self-esteem. A preoccupation predominantly focused on being “too fat” or overweight may lead patients to check frequently in reflective surfaces or camouflage their body.

What causes dysmorphic facial features? ›

A dysmorphic feature is an abnormal difference in body structure. It can be an isolated finding in an otherwise normal individual, or it can be related to a congenital disorder, genetic syndrome or birth defect.

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