Misaligned teeth, bumpy nose, protruding ears… For some, these physical details are small flaws. In others, these imperfections become big complexes that turn into obsession. It has a name: dysmorphophobia. Dominique-Adèle Cassuto, endocrinologist-nutritionist specializing in eating behavior and author of the book Silhouette, my friend my enemy, explains how this disorder arises and manifests itself.
Why doctor: Megan Fox, Marina Foïs, Lili Reinhart, Cœur de Pirate… In recent years, some celebrities have admitted to suffering from dysmorphophobia. But what is it?
Dominique-Adèle Cassuto: A “dysmorphophobe” is obsessed with a slight or non-existent physical defect, which he perceives in an excessive way. He thinks his body is deformed and he hates it, because he is afraid of the gaze and judgment of others. We speak of “banal and transient” dysmorphophobia when this image disorder occurs in adolescence. At this age, one can feel insecure, because the body changes considerably. It is considered that dysmorphophobia is not normal, if it continues into adulthood.
What parts of the body are perceived as abnormal?
A particular part of the body or the whole body can become an object of rejection. In adolescence, young women generally fixate on their stomachs, hips and thighs. As for the young men, they see themselves as too thin.
How many people have dysmorphophobia?
According to the MSD Manual, 2-3% of the population are affected by this disorder. But in reality, it is impossible to really know. This disorder is still underestimated, because its diagnosis is based on a clinical examination. During an exchange, a psychologist or a nutritionist will see if there is a gap between what the patient evokes and reality.
“After the confinements, I noticed an increase in cases of dysmorphophobia”
Dysmorphophobia: have you recently noticed an increase in consultations?
I have always been used to receiving people affected by this image disorder, because I am an endocrinologist-nutritionist specializing in the eating behavior and nutrition of adolescents. But, after the periods of confinement, I noticed an increase in cases of dysmorphophobia.
What is the patient profile?
This disorder affects women more frequently. It can appear in people who suffered from being overweight during childhood or in those who constantly diet because of the yoyo effect.
What are the causes of this disorder?
Body dysmorphic disorder is associated with low self-esteem and low self-confidence. It can present itself depending on the way an adult constructs himself. Nowadays, social networks, especially Instagram, accentuate this disorder, because these platforms are based on social comparison. If we follow, for example, an influencer who has thin thighs in her photos, we will want to compare ourselves to her.
Dysmorphophobia has “an impact on social, romantic and professional life”
How does dysmorphophobia manifest itself?
In general, a “dysmorphophobe” looks at himself for a long time or often in the mirror, scrutinizing himself or, on the contrary, he will try to avoid the mirror or a shiny surface. This disorder can also lead to camouflaging physical defects perceived as monstrous. Patients may also feel a sense of shame, transient worry, or even anxiety. They may begin to adopt pathological behaviors, such as going on numerous diets or repeatedly turning to cosmetic surgery without being happy and satisfied with the result.
In case of dysmorphophobia, we risk isolating ourselves and not leaving our homes in order to avoid social situations and public places. Clearly, this disorder will have an impact on social and love life, but also on professional life. Within a company, a “dysmorphophobe” may be afraid to speak up or hold a position of responsibility.
What are the solutions to fight against dysmorphophobia?
When the patient is a teenager, he may be asked to look at pictures of himself at different ages to see his evolution. Parents can also show him their evolution using snapshots so that their child understands that he is in full construction.
When it comes to an adult, he can turn to a psychomotrician. This specialist will help him work on his body image. Another solution: behavioral and cognitive therapy (CBT), which allows you to work on obsessions, self-affirmation and the way of seeing your body using exercises and therapeutic approaches.
