In modern society, we are constantly bombarded by media images portraying a certain standard of ‘beauty’. We idolise models, celebrities and actors who look all seem to look a certain way – thin women and muscular men. This archetype of beauty can become so ingrained within a culture – and therefore within people’s minds – that individuals will develop body image issues and then go to extreme lengths to match that archetype.
The individual may become so obsessed with living up to this media-generated standard that they will distort their bodies into a caricature of that standard. Delusion sets in and they become unable to see how they are sacrificing their health, as well as their attractiveness.
Anorexia nervosa is an eating disorder and mental health condition that can be life-threatening. It involves an extreme degree of food restriction and an irrational fear of gaining weight, not based on any rational basis, such as one’s health. Anorexics also tend to suffer from body dysmorphic disorder (BDD), which is what I want to focus on in this article. BDD is characterised as a mental illness and involves an unhealthy concern with a perceived defect of one’s physical appearance. Many will have seen anorexia-awareness images showing a scarily thin girl in front of a mirror, with the reflection of herself being much heavier than she actually is. A sufferer of BDD has a distorted body image (a person’s sense of their physical appearance). The negative perception of their body may be so strong that they become unable to see the same body that everyone else sees. The depressing irony of anorexia is that those who suffer from it are convinced that they need to be thin to be attractive, whereas everyone else recoils at how bony and malnourished they look. Those most susceptible to anorexia nervosa are teenage girls and young women.
A paper, published in the Journal of Social Issues, details the compelling evidence suggesting that the media has a powerful influence on BDD and eating disorders. Based on the evidence, the authors conclude with the following: “Given that minimal exposure to these images [on print media and television] results in transitory increases in psychological distress and body image dissatisfaction, long-term, daily exposure is potentially even more damaging.” What is uncertain, however, is whether these images partly cause eating disorders or whether those with eating disorders expose themselves to these images more frequently. But what is clear is the negative effects that such images have. The authors also recognise that the media cannot be the only contributing factor towards eating disorders. Images and messages of ‘thinness’ may be condoned and reinforced by one’s family, friends and peers as well. To tackle these cultural pressures to be thin, the authors offer several solutions.
A study conducted by researchers from UCL found, through a cleverly designed experiment, that the brain in healthy individuals can distort their perception of their hands, making them seem wider than they actually are. One of the researchers, Dr Longo, said: “These findings may well be relevant to psychiatric conditions involving body image such as anorexia nervosa, as there may be a general bias towards perceiving the body to be wider than it is. Our healthy participants had a basically accurate visual image of their own body, but the brain’s model of the hand underlying position was highly distorted. This distorted perception could come to dominate in some people, leading to distortions of body image as well, such as in eating disorders.”
But how does this “general bias” arise in anorexia? Perhaps the belief of being fat can be so strong and obsessive that it completely re-shapes our brain’s map of our body. It is, therefore, this abnormality of brain functioning which leads to the abnormality of perception and abnormality of behaviour which characterises anorexia nervosa. The unhealthy and life-threatening lifestyle of an anorexic can be considered a mental disorder because it has its roots in a brain malfunction. However, there is not currently enough evidence yet to pinpoint the biological cause of anorexia and other forms of BDD. Nonetheless, Dr Longo’s research offers some interesting avenues to explore.
Muscle dysmorphia is usually considered to be the opposite of anorexia nervosa. It is a type of BDD and is also referred to as the Adonis Complex, named after the ancient Greek god of beauty and desire. It is similar to anorexia in that it involves conforming to some unrealistic ideal. Furthermore, it is characterised by obsessive and compulsive thinking and behaviour. Those suffering from muscle dysmorphia are convinced that they have small musculature or are skinny, even when outside observers can see that they are highly and unusually muscular. Like anorexia, some people are more likely to suffer from the condition than offers. With anorexia, for example, models and dancers feel the industry’s pressure to conform to how their peers and other professionals look. Those most susceptible to muscle dysmorphia are male bodybuilders.
This obsessive preoccupation with muscularity and leanness is more recent than anorexia. It was first described in 1993 by Poper, Katz and Hudson as ‘reverse anorexia’. They noted that male bodybuilders who were blatantly larger than the average male would feel embarrassed of how small they felt they looked. They declined social invitations, wore heavy clothes to cover themselves up (even in the summer heat), and refused to be seen at the beach. This condition can be so distressing that the bodybuilders in question will ruin their lives. Due to their obsession with their workout schedule, they may lose their job or lift weights even when injured, only to exacerbate the problem. The use of anabolic steroids further testifies to how obsessive bodybuilders are. Of course, there is an unfortunate necessity to use steroids and other performance-enhancing drugs in professional bodybuilding since every other competitor is using them. If you don’t use them, you stand no chance. Former Mr Olympia, Dorian Yates, is very honest about his steroid use and how prevalent it is in professional bodybuilding.
Muscular dysmorphia, like anorexia nervosa, leads to behaviours that are very unhealthy; anabolic steroid use being the most obvious one. Prolonged use of steroids is associated with raised cholesterol, prostate enlargement, male-pattern baldness, mood swings, the growth of male breasts (gynecomastia), various heart problems, testicular atrophy, decreased sperm count and impotence. Withdrawal from a cycle of steroids has also been linked to depression and suicide. Even bodybuilders who don’t suffer from muscular dysmorphia may still be affected by body image concerns to the extent that they experience significant levels of distress. Moreover, in the world of bodybuilding, since leanness is valued so highly, body fat can be cut to unhealthy levels. When body fat is at a low percentage muscle will be more visible. Thus, the lower the percentage the better. The problem is you need body fat for many bodily functions, so cutting your fat intake to unnaturally low levels can be unhealthy and sometimes very dangerous. This focus on low body fat may lead many bodybuilders to develop an obsessive eating disorder.
Like with anorexia, contemporary Western culture plays a pivotal role in the rise of muscular dysmorphia. Pope argues in his book, The Adonis Complex, that males are influenced by muscular physiques from an early age. After all, action figures, cartoons and movies tend to promote the idea that the ‘hero’ or ‘good guy’ should have that physique. The depressing irony of bodybuilding, however, is that many men are convinced that being highly muscular is attractive, whereas many people will find their large muscles grotesque and caricature-like. Gregg Valentino is a bodybuilder who used steroids so excessively that his biceps actually exploded. His arms became so muscular that they just looked freakishly large and insanely disproportionate from the rest of his body. This is a classic case of muscular dysmorphia and BDD.
The last example of body distortion I want to explore is cosmetic surgery. In this study, published in The British Association of Plastic Surgeons, the authors discovered that 5% of patients seeking cosmetic surgery had signs of BDD, whilst up to 20% had signs of a mild form of BDD. The 5% of patients were dissatisfied with their surgery and their symptoms (low self-esteem, depression and anxiety) did not decrease after surgery either. It was found that the BDD patients were more obsessed with their noses.
Once again, we find cultural influences shaping the way that many women think and behave. Advertising and images of celebrities create this standard of beauty. The ideal face has smooth perfect skin, a small thin nose and plump lips. Big breasts are also sought after. Sufferers of BDD may turn to cosmetic surgery in order to replicate these features. But because the nature of the disorder is obsessive, the individual will never be satisfied with the changes and will always display an unhealthy level of perfectionism. Many will become addicted to cosmetic surgery since they will never see their nose as thin enough, their skin as tight enough, their breasts as big enough, or their lips as plump enough. Cheekbone and chin augmentation is also desired by many women since it helps to achieve a small slender face with accentuated features.
Obsessive cosmetic surgery, like anorexia and bodybuilding, involves many risks. One plastic surgery addict, Monique Allen, was left disabled and disfigured after an astonishing 200 surgeries. In fact, you will find countless horror stories involving plastic surgery addiction, some even involving fatal blood clots and heart attacks. After all, it is a surgery, so going under the knife, again and again, is very risky. It is no wonder that so many cases of disfigurement and botched jobs occur, especially when the procedure is unregulated. Scarring is of course very common, while other risks include infection, excessive bleeding and even death if the surgery goes wrong.
The depressing irony of cosmetic surgery is that the BDD sufferer is striving towards some ideal form of beauty, yet in doing so, they are only making themselves more hideous. An example of this would be the New York socialite Jocelyn Wildenstein who is rumoured to have spent $4,000,000 on plastic surgery. Many have called her the ‘cat woman’ because of how exaggerated her features are now. People, as deluded as her, have such a distorted body image that they mistakenly see their original body as ugly, but yet see their new bizarre one as beautiful. Everyone else, on the other hand, finds the new appearance to be cartoon-like and disfigured out of all recognition. Sometimes it is difficult to see that it is even the same person.
The fact that celebrities like Joan Rivers would sacrifice their ability to make facial expressions for a face with no wrinkles is bewildering. Caricature facial features and breasts are hardly attractive. They reflect the negative influence of the media on body image. And in some unfortunate cases, people will mutilate their bodies, in risky and life-threatening surgeries, just to achieve some ideal that exists in fantasy, not reality. The media is also very deceptive. In terms of models in adverts, the photos are likely to be airbrushed and photoshopped, giving the false impression of perfectly smooth skin. The women likely to be selected for models will be those whose genetics give them accentuated cheekbones, a slender face, a small thin nose, etc. This does not mean that these features are what the general population would instinctively find beautiful – it’s what the industry finds valuable. And the result is a shift in women’s attitudes towards beauty, especially those who expose themselves to these images all the time.
Let’s not forget that cosmetic surgery can become a problem for men as well. The obsessive desire to be muscular can lead some men to get muscular implants. The most popular form of muscular implants is for the biceps, triceps, traps, shoulders, chest and calves. From all the examples of muscular implantation I’ve seen, the final result is an obviously unnatural and grotesque looking person. The implant is disproportionately large compared to the rest of the body and just looks embarrassing. In the case of pectoral implants, it can even look like the guy has breasts.
Some writers are sceptical as to whether BDD and its various types are valid mental disorders. As James Davies assets in Cracked: Why Psychiatry is Doing More Harm Than Good (2013), most mental disorders listed in the DSM 5 (the manual used to diagnose mental disorders) do not have a known biological basis. In other words, there is currently no evidence that anorexia nervosa or muscular dysmorphia (both in the DSM 5) are caused by a brain malfunction.
However, absence of evidence is not evidence of absence. People who starve themselves to be thin or take steroids to become big or disfigure their body and face clearly have different mental lives from the rest of us. When such thinking and behaviour interrupts their normal lives and puts their health at risk, I think it is safe to say that an underlying change in the brain is the cause. The anxiety experienced by these sufferers is not just a normal reaction to a stressful situation. It is definitely an abnormal reaction. While anti-anxiety or anti-depressant medication may not be the solution (as Davies rightly argues) some sort of intervention is necessary. Perhaps the very root of the problem needs to change first: cultural attitudes towards beauty.