What to know about body dysmorphia, the condition affecting Megan Fox

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Megan Fox said she’s among those affected by body dysmorphia. Experts explain the symptoms, effects and treatments available.

Editor’s note: Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being. Actor Megan Fox, a 2023 Sports Illustrated Swimsuit issue cover star who has long been regarded as a sex symbol, has said she’s among the 5 million to 10 million people in the United States affected by body dysmorphia. “I don’t ever see myself the way other people see me. There’s never a point in my life where I loved my body, never ever,” Fox said in a video interview with Sports Illustrated. “When I was little, that was an obsession I had of like, ‘But I should look this way.’ And why I had an awareness of my body that young, I’m not sure.” A discrepancy between how someone perceives themselves and how others see them is a hallmark symptom of body dysmorphia. Also known as body dysmorphic disorder, it’s “characterized by excessive preoccupation with an imagined defect in physical appearance or markedly excessive concern with a slight physical anomaly,” according to the American Psychological Association. What people actually look like — or how attractive they are — often has little to do with it. “If this person had, like, a very visible scar or other physically noticeable deformity, that’s not what we’re talking about,” said Ramani Durvasula, a clinical psychologist and author based in California. “The individual gets preoccupied, almost even obsessive, over a small physical feature. It could be a little blemish, a little bump in their nose, a tooth that’s a little bit out of line, the shape of something, but it would not be noticeable to other people,” she added. “It’s never good enough. … And it will kind of basically take over their lives.” Around 2% of the global population has body dysmorphia, and the disorder affects men and women almost equally, according to the Anxiety & Depression Association of America. Symptoms usually begin to appear in adolescence when bodies start drastically changing. There is a subform of body dysmorphia: Muscle dysmorphia, which primarily affects men, is marked by preoccupation with the perception that one’s body isn’t lean or muscular enough — often regardless of how muscular a person may be. Here’s what living with body dysmorphia is like, and how people can find help. What body dysmorphia isn’t Body dysmorphia is commonly mistaken as an eating disorder, but that’s not the case due to some distinctions, according to Durvasula and Ann Kearney-Cooke, a Cincinnati-based psychologist specializing in eating and body image disorders. People with eating disorders are preoccupied with a distortion in how they perceive their shape or weight, Durvasula said. “The person engages in (disordered eating) behaviors as well as what we call compensatory behaviors, which could be things like not eating for certain periods of time, hyper exercise, the use of diuretics or laxatives, that kind of thing.” Body dysmorphia, however, generally centers around an imagined or real feature, experts said. What causes body dysmorphia There isn’t a sole cause of body dysmorphia, but there are some contributing factors. “Body dysmorphia is in the same family of disorders as obsessive-compulsive disorder,” Durvasula said. “The only genetic evidence we see is that if a person has a first-degree relative (a parent or sibling) with OCD, they might be more likely to develop body dysmorphia.” Researchers have suggested that the brains of some people with body dysmorphia might have “abnormalities in processing visual input when it comes to examining their own face,” according to a 2010 study. Body dysmorphia sometimes occurs at the same time as anxiety. If someone’s preoccupied with certain things because of anxiety, a bodily feature might just be another issue to focus on, Durvasula added. “Social media has definitely not helped this. There’s a lot more social comparison to what other people look like. Many people put false images out there,” Durvasula said. “In adolescence, that form of evaluation — physical appearance, fitting in and all that — is going to be much more pronounced.” Having family members who evaluate, validate or love themselves or others based on appearance can also play a role, she added. “That makes the person overly sensitive to (perceiving) flaws in their appearance,” Kearney-Cooke added. “And what often happens is, somewhere deep inside, whether it’s because of difficult childhoods or whatever, they feel like, ‘I’m not enough. I’m not attractive.’ And then they project it onto their body.” A perfectionist mindset intensifies this view, she added. Living with body dysmorphia The effects of body dysmorphia can extend to all aspects of life — social, occupational and financial — especially if the disorder worsens over time without treatment. “Because they’re so obsessed with this sort of sense that there is this physical problem, they will spend significant amounts of time and money either getting cosmetic medical treatments or cosmetic dental treatments, dermatologic treatments, even surgical treatments,” Durvasula said. People with body dysmorphia also have “checking” behaviors, which can look like spending lots of time looking in the mirror and taking countless selfies and assessing those, Durvasula added. Compulsively looking in the mirror can ease fears about how people think they look or help them see if a perceived flaw is still there or has worsened, according to the National Association of Anorexia Nervosa and Associated Disorders. They think the feature is abnormal or ugly. Body dysmorphia was originally described as “the imagined ugliness syndrome,” Kearney-Cooke said. Someone with the disorder might also seek reassurance from others by asking if they see the flaw, if a feature looks OK, or if something’s wrong with or different about the feature. People with body dysmorphia might isolate themselves out of shame or from spending too much time worrying over their appearance, experts said. They can also burn out their social support by constantly seeking reassurance, Durvasula added. Spending so much time analyzing their appearance can result in often being late to work or not doing schoolwork, she said. Some people put themselves in financial peril by buying cosmetic products or procedures — incurring debt for themselves or their families, and sometimes doing so in secret because of concerns of what might happen if people knew. Kearney-Cooke had a patient who was so obsessed with a perceived flaw on her nose that she was always looking in the mirror, even while driving, the psychologist said. Crashing a car into a tree while doing so was a wakeup call for the patient, she noted, leading to treatment and eventually some improvement. Getting treatment for body dysmorphia Body dysmorphia can’t be cured, and it’s a “difficult clinical condition” to manage because “it’s a pattern that’s very resistant to change,” Durvasula said. But some effective treatments are available. One preferred by many experts is cognitive behavioral therapy. A person’s distortions or thoughts are believed to drive this behavior, so therapists work on the person’s distortions and go from there, Durvasula said. Since body dysmorphia is in the same category as obsessive-compulsive disorder, treatments for OCD, such as “exposure and response prevention,” could also be helpful for managing body dysmorphia. In a safe environment, this therapy exposes people to situations provoking their obsessions or triggers and requires them to choose to not respond with compulsive behaviors. When undergoing such treatment, a person with body dysmorphia doesn’t get to look in the mirror much or take selfies, Durvasula said. “They’re having to actually tolerate the discomfort of not engaging in the checking behavior. But that has to be complemented with the cognitive behavioral work.” A history of trauma would require trauma-informed therapy as well, which would involve a mental health professional acknowledging how the person’s trauma could be a root cause of body dysmorphia. “Some of the therapy may also be very educational — on sort of the images that we see out in the world and how unrealistic they are,” Durvasula said. Researchers have been looking into brain chemicals, such as serotonin, being a cause of body dysmorphia as well, Kearney-Cooke said — so antidepressants known as selective serotonin reuptake inhibitors or SSRIs can also be helpful in treatment. If you can’t find a mental health professional specializing in body dysmorphia, try working with someone who has expertise in OCD or eating disorders, Durvasula said..Just a third of Americans say that Biden winning in 2024 would be a step forward or a triumph for the country (33%). At the same time, the survey finds a decline in favorable views of Biden over the past six months, from 42% in December to 35% now. And results from the same poll released earlier this week showed Biden’s approval rating for handling the presidency at 40%, among the lowest for any first-term president since Dwight Eisenhower at this point in their term. Within his own party, 60% of Democratic and Democratic-leaning voters say they back Biden for the top of next year’s Democratic ticket, 20% favor activist and lawyer Robert F. Kennedy, Jr., and 8% back author Marianne Williamson. Another 8% say they would support an unnamed “someone else.” Biden’s primary supporters are largely locked in: 58% say they would definitely support him and 42% say that they could change their minds. In contrast, those backing other candidates are far from committed, with just 19% in that group saying they definitely will support their first-choice candidate and 81% saying that they could change their minds. The poll suggests that Biden would likely win the support of the vast majority of Democratic-aligned voters in 2024. Just 14% in that group say they wouldn’t back him in the primary. And only 7% say they definitely would not support him in November 2024 should he win the party’s nod. But the results signal that Biden could face a challenge keeping Democratic-aligned White non-college voters in his camp in next year’s general election: 16% of these voters say they definitely won’t support Biden in November 2024, compared with 1% of White Democratic-aligned voters with college degrees and 5% of Democratic-aligned voters of color. Biden’s weak spots in the race for the nomination are concentrated among independents who lean Democratic (40% back Biden for the nod, compared with 67% among self-identified Democrats) and younger voters (49% of those younger than 45 say they back Biden compared with 68% among those age 45 or older). Majorities of all Democratic and Democratic-leaning voters say they would at least consider backing either Kennedy (64% support him or would consider him) or Williamson (53% back her or would consider her), but when asked to explain the main reasons they would consider each of them, few seem deeply tied to either candidate. Among those who would consider Kennedy, 20% cite his connections to the Kennedy family as the main reason. One said, “I liked his dad (RFK) and his uncle (JFK) a lot. I would hope he has a similar mindset.” Many suggested they are merely open to learning more: 17% say they just don’t know enough about him to rule him out and 10% that they are open-minded and would consider any candidate. One respondent explained they would consider him, “Because a reasonable person considers things before making choices. It has nothing to do with RFK himself, just that I wouldn’t automatically say ‘no’ without consideration first.” Some say they’d back any Democrat (10%) or anyone who is not Trump (5%). About 1 in 8 (12%) say they would consider him because they support his views or policies and 4% mention his views specifically on environmental issues. Nearly 3 in 10 who say they would consider Williamson say they don’t know enough about her (28%), 16% say they’d consider her because she’s a Democrat, 8% that they’d consider any candidate or are open-minded, and 9% say that they see her as an alternative to Biden. One said, “She is better than Joe Biden. I haven’t heard of her though.” Another 10% point to the desire for a female candidate, and 12% say they support her views or policies. “She may not have a great political resume but she cares about important issues,” said one respondent. Most Democrats and Democratic-leaning independent voters do think it is likely that Biden will become the party’s candidate, though, with 55% saying that it is extremely or very likely that Biden will win the nomination, 28% that it’s somewhat likely, 11% not too likely and just 5% that it’s not at all likely. Convincing the overall public that he deserves a second term could prove a challenge. Two-thirds (66%) of all Americans say a Biden victory would either be a setback or a disaster for the country. The leading contender for the Republican nomination, former president Donald Trump, fares slightly better (43% say a Trump win would be a triumph or a step forward, 56% a disaster or a setback), though the two are about even in the share who say each of them winning would be a disaster (44% say so about Trump, while 41% say the same about Biden). And among independents, 45% say a Trump win would be a disaster while 35% say a Biden win would be. The broader negativity toward Biden stems from a more pessimistic assessment among his own partisans than Trump faces, while strong opposition across the aisle is about even for both of them. More than 8 in 10 Democrats say a Trump win would be a disaster (82%) while a near-identical share of Republicans say a Biden win would be a disaster (83%). But Republicans are more likely to call a Trump win a triumph or a step forward (85%) than Democrats are to say the same about Biden (73%). The poll finds that one advantage Biden held over Trump in their first matchup in 2020 – a stronger favorability rating – may have evaporated. Among all Americans, 35% say they have a favorable view of Biden and 57% an unfavorable one, numbers near identical to Trump’s. Positive views of Biden stood at 42% as recently as December, and among independents over that time, his favorability has dipped from 35% to 26%. Views of Biden are sharply more negative than are views of each of the three living Democratic past presidents. Barack Obama is the most positively viewed of all the living presidents tested in the poll, 57% hold a favorable view, 35% an unfavorable one. Impressions of 98-year-old Jimmy Carter, who recently entered hospice care, break positive, 43% favorable to 21% unfavorable, with 36% unsure or unable to rate him. And the public divides over Bill Clinton, with 41% expressing a favorable view and 42% an unfavorable one. The CNN Poll was conducted by SSRS from May 17-20 among a random national sample of 1,227 adults drawn from a probability-based panel, including 432 Democrats and Democratic-leaning independents who are registered to vote. Surveys were either conducted online or by telephone with a live interviewer. Results among the full sample have a margin of sampling error of plus or minus 3.7 points; among Democratic and Democratic-leaning voters, the margin of sampling error is 6.2 points..The sanctions come after a US official told CNN that Wagner has been trying to ship military equipment for use in Ukraine through Mali and falsifying paperwork for the transactions, citing recently declassified intelligence. The Treasury also confirmed the findings of a CNN investigation into Wagner’s support for the Sudan paramilitary Rapid Support Forces in the current war devastating the country. “Today, the U.S. Department of the Treasury’s Office of Foreign Assets Control (OFAC) sanctioned Ivan Aleksandrovich Maslov (Maslov), the head of Russian Private Military Company ‘Wagner’ (Wagner Group) paramilitary units and its principal administrator based in Mali,” said the Treasury. “The Wagner Group may be attempting to obscure its efforts to acquire military equipment for use in Ukraine, including by working through Mali and other countries where it has a foothold. The United States opposes efforts by any country to assist Russia through the Wagner Group,” it added. The US official told CNN last week there were no signs yet that Wagner has successfully procured the equipment, but the group has continued working to procure mines, drones, radar and counter-battery systems from contacts in Mali for use in Ukraine. “We are monitoring this closely,” the official added. Wagner has sought to expand its presence in Africa in recent years and has been operating alongside Mali’s armed forces for more than a year, fighting against a jihadist insurgency. Russian Foreign Minister Sergey Lavrov said in September 2021 that the Malian government would be hiring private Russian mercenaries for help with security. Under Secretary of the Treasury for Terrorism and Financial Intelligence Brian E. Nelson said: “Treasury’s sanctions against the most senior Wagner Group representative in Mali identify and disrupt a key operative supporting the group’s global activities. “The Wagner Group’s presence on the African continent is a destabilizing force for any country that allows for the deployment of the group’s resources into their sovereign territory.” Maslov is a senior Wagner Group security official who was tasked by Wagner head Yevgeny Prigozhin and Dmitriy Valeryevich Utkin to lead the Wagner Group’s mercenary units in Mali, according to the press release. Both Prigozhin and Utkin have been sanctioned by the US, the UK, the EU and Canada. “In his role as the Wagner Group’s principal administrator, Maslov has secured living accommodations for the Wagner Group’s incoming forces deployed to Mali. Maslov arranges meetings between Prigozhin and government officials from several African nations. Maslov has worked to carry out the Wagner Group’s interests in the extractive sector,” said the Treasury. The press release added that Wagner has meddled in and destabilized countries in Africa, committed widespread human rights abuses and appropriated natural resources. In Sudan, Wagner has also been supplying the country’s Rapid Support Forces (RSF) with “surface-to-air missiles to fight against Sudan’s army, contributing to a prolonged armed conflict that only results in further chaos in the region,” the release said. This comes after a CNN investigation revealed that Wagner had supplied Sudan’s RSF with missiles to aid their fight against the country’s army..Florida’s governor tried to put the best face on things after Trey Gowdy’s quips..


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