The Surprising Reason Why You Can’t Stop Obsessing About Your Looks

Is the mirror your worst enemy? When you see your reflection, do you focus in on your flaws? Maybe you obsess over the extra weight around your midsection, the acne that can’t be hidden with concealer, or the shape of your nose. Most of us have had negative thoughts about our bodies at some point in our lives, but for people with body dysmorphic disorder, the obsession with physical imperfections—real or perceived—is all-consuming and interferes with daily life. That’s how 26-year-old Riverdale actress Lili Reinhart explains it in an episode of Scan My Brain with Dr. Daniel Amen. Her struggle with body dysmorphia began in 8th grade. “I was 12 or 13 and my skin was really bad,” she says. “I started to deal with it, not about my body, but very much focused on my skin. I was doing my makeup in the dark. I didn’t want to wake up and turn on the fluorescent lights in my bathroom and stare at my acne. So, I would do it in very dim lighting.” Most of us have had negative thoughts about our bodies at some point in our lives, but for people with body dysmorphic disorder, the obsession with physical imperfections is all-consuming and interferes with daily life.

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Reinhart is one of an estimated one in 50 Americans who struggle with body dysmorphia. People with this condition may feel so ashamed, unattractive, or embarrassed by their appearance that they isolate themselves or don’t live life to its fullest. Thoughts about imperfect features can cause extreme distress, anxiety, or depression, and can interfere with relationships, work, and home life.

WHAT IS BODY DYSMORPHIA?

Body dysmorphia is a brain-based disorder that distorts a person’s perception of their appearance to such a degree that it disrupts everyday living and steals their happiness. The imagined flaws people with this condition see may not even be noticeable to others. For example, you might obsess over the size of your ears, hips, or nose, but others may not think they are big at all. Some of the features that people with body dysmorphic disorder tend to scrutinize include:

• Face (most often the nose)
• Smile
• Skin
• Weight
• Hair
• Breasts
• Genitals
• Muscle mass or lack thereof

This disorder affects females and males equally and can develop at any time across the lifespan, however, it begins most commonly in adolescents or teens. People with body dysmorphia tend to have a love-hate relationship with the mirror. It is not uncommon for people with body dysmorphia to intentionally check their appearance in the mirror dozens of times a day. Reinhart says she has been in that category. “I would not want to look at myself, but then I was also obsessively looking at myself to try and see how I looked at different angles, to look at the acne at different angles. It’s kind of like a I hate looking in the mirror, but I have an obsessive sort of component there,” she says. “If I have swelling somewhere, or if I have a breakout or something’s wrong cosmetically, I’m very attached to it, obsessed with it, and have to look at it all the time.” For many people, it isn’t just one single feature that causes distress. In some cases, the feature that causes distress may change. For example, Reinhart’s attention has shifted in recent months from breakouts to her weight. “I’m obsessively looking in the mirror at my body,” she says. Even more anxiety-provoking is the fact that as an actress with a high profile, she is routinely subjected to media coverage. “I’m constantly exposed to pictures of myself all the time on social media,” says the actress, who also witnessed her weight changes documented on her show Riverdale, which she started when she was just 19. She can’t help but compare what she looks like now with her appearance when she was just a teenager. “It’s me versus me,” she says. How many others feel that way? Do you compare yourself to how you looked back in high school or college? It can feel like a losing battle. Fortunately, there are treatment options for people who struggle with body image.

BODY DYSMORPHIA IS A BRAIN DISORDER

Body dysmorphia is associated with abnormal activity in the brain. The brain imaging work at Amen Clinics, which involves SPECT (single photon emission computed tomography) scans, has identified overactivity in the following brain regions in people with body dysmorphia:

• Anterior cingulate gyrus (ACG): Considered the brain’s “gear shifter,” the ACG helps people shift from one thought to another or from one activity to another. Excessive activity in this region is associated with people getting stuck on thoughts and behaviors, such as obsessing over perceived physical imperfections and repeatedly checking appearance in the mirror. Overactivity in the ACG is also commonly seen in people with obsessive-compulsive disorder (OCD).
• Basal ganglia: The brain’s anxiety center, this region helps set the body’s anxiety level. Increased activity here is typically associated with higher anxiety levels.
• Limbic system: This is the brain’s emotional center, and heightened activity in this region is associated with an increased risk of negativity and depression.

Reinhart’s SPECT scan showed overactivity in these brain regions in a pattern referred to as the “diamond pattern,” which is often associated with past emotional trauma.

BODY DYSMORPHIA TREATMENTS

It is possible to treat body dysmorphic disorder. A study in the Journal of Nervous and Mental Disease found that more than three-fourths of people with body dysmorphia experienced full recovery after treatment and only 14% of them had a relapse of symptoms. Although these statistics are promising, the majority of those struggling with body image issues don’t get the help they need. Treatments for body dysmorphia may include:

• Psychotherapy
• Learning to kill the ANTs (automatic negative thoughts)
• Nutritional supplements
• Medication (when necessary)

Considering that body dysmorphia is a brain-based disorder, it is critical to target any nutritional supplements and medications to an individual’s brain. Understanding and addressing any co-existing mental health issues—such as OCD, anxiety disorders, or depression—is an important part of an effective treatment program. Body dysmorphic disorder, anxiety, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.