Body Dysmorphia and the Black Experience

By Melanated Womens Health LLC

1. What is body dysmorphia?

Body Dysmorphic Disorder (BDD) is a mental health diagnosis commonly referred to as "body dysmorphia". It is categorized by preoccupation with a real or imagined flaw/imperfection in one's appearance, which causes the person living with this condition to experience significant distress, psychological pain, and shame when navigating daily life. A few examples of a flaw or imperfection that can become the focus of preoccupation are: uneven skin texture/acne, facial symmetry, and shape or size of various body parts- nose, eyes, genitals, body build or muscularity, etc.

In extreme cases, body alterations or other cosmetic surgeries are completed to correct the flaw/imperfection that has been the focus of preoccupation. In other cases and if left untreated, people living with this condition tend to frequently check the flaw, compare themselves to others, and or engage in avoidance behaviors (e.g., avoiding mirrors, dating or other social interactions).

2. How do you know if you have body dysmorphia?

This condition is often confused with other medical and mental health conditions. Rather than taking the risk of inaccurately self- diagnosing, seek the help of a trained professional. If you find yourself constantly checking or avoiding mirrors, engaging in ritualized make-up application, excessive use of Facetune or other social media filters, obsession with cosmetic surgeries, difficulty getting dressed due to a desire to disguise parts of your body, or have fears about the functionality of parts of your body, you could benefit from a professional evaluation.

3. Do you think social media has played a role in the development of body dysmorphia?

At the moment we know that the condition usually begins in early adolescence when our sense of self is fragile because we are starting to become aware of our bodies and identities, relative to the people around us. This awareness begins to highlight the differences that makes us unique; no two people are exactly alike. Furthermore, young people are increasingly "growing up" online with direct exposure to Eurocentric beauty standards which is promoted on social media in the form of unnatural, surgically, or filtered images. This level of exposure and associated vanity metrics (e.g., likes and follow count) as well as cyber bullying, can cause differences that makes an individual unique be perceived as a flaw, imperfection or abnormality. Consequently, social media may influence the trajectory towards body dysmorphia.

However, it is difficult to determine cause and effect between the social media or usage of these platforms and body dysmorphia. Currently there is not enough empirical data or research to explicitly identify the role of social media on the development of body dysmorphia. Similarly, there is an absence of research on the positive benefits of exposure to medical and mental health content creators that are using their social media platforms to normalize and celebrate body diversity. Therefore, it is important to protect yourself from exposure to any content that may potentially contribute to body dysphoria by being intentional about the way you use social media.

4. What causes it?

Body dysphoria may be caused by a combination of issues, rather than one or two specific factors. A person who has other mental health conditions such as an eating disorder, generalized anxiety or clinical depression, history of trauma and excessive exposure to rigid expectations for beauty, may be at risk for developing body dysphoria. Additionally, a person who identifies as non-binary and is not provided with safe environments to express their gender, may also be at risk for developing body dysphoria.

5. Who experiences it? How common is it?

Information on the prevalence in the community is inconsistent. It is experienced by people of all genders, though it may be more common in populations based on demographics (eg., age, social identity etc.). Although body dysmorphia doesn't discriminate, due to the stigma in the Black community around receiving mental health care, it can be a challenge for folks to know they can receive help for body dysmorphia. Therapy has been considered something for white folks, and eating disorders especially, are seen as mental health conditions only white girls struggle with. However, this thought trap can prevent folks for getting the help they need.

6. What is the difference between BDD and an eating disorder?

On the surface, BDD and eating disorders share a similar feature in that they both involve body image concerns. That is, an individual with either of these conditions has concerns with the perception, appearance, and or experience of being in their body. This similarity may cause confusion, which can be detrimental if not correctly identified or diagnosed. To highlight the difference, Eating Disorders have to be described.

Eating Disorders are characterized as a severe disturbance in eating behavior which typically falls into one of two types: (i) Anorexia Nervosa and (ii) Bulimia Nervosa, which are more commonly known as "anorexia" and "bulimia". Anorexia Nervosa involves a refusal to maintain body weight that is "normal" for an individual's age and weight, or efforts to maintain a weight that is less than 85% of the "normal" expected weight for that person's age and height. Bulimia Nervosa involves persistent episodes of binge eating or lack of control of eating followed by unhealthy behaviors to prevent weight gain. Both of these eating disorders involve unhealthy compensatory behaviors (e.g., fasting, excessive exercising, induced vomiting, etc.). Therefore, the difference between an Eating Disorder and body dysmorphia is that the former issue is a focus on weight and BDD is focused solely on specific body parts.

7. How does this show up in the Black community?

Black people have been stereotyped, ridiculed, dehumanized and examined based on European standards, as outlined in the book, "Fearing the Black Body". These responses to Black bodies contributes to self-esteem and self-image concerns within the Black community. According to ANAD, Black teenagers are 50% more likely than white teens to present bulimic behavior, like binge eating and purging. The Psychiatry and Behavioral Medicine department at John Hopkins, has identified that the most common age of onset for an eating disorder is between 12-25. Although much more common in females, 10 percent of cases detected are in males.

Black youth are often stereotyped in ways that their white counterparts are not. For example, they are viewed as closer to adulthood, or absent of innocence, which is displayed in the sexualization and criminalization of young Black bodies. Messages such as "she is too grown," or "he is a man now" in reference to pubescent Black girls or boys, reinforces these stereotypes. Books such as Pushout: The Criminalization of Black Girls in Schools by Monique W. Morris, The Body Liberation Project by Chrissy King, and The Body is Not An Apology by Sonya Renee Taylor helps to shed light on the way Black bodies are treated in society.

Additionally, beauty campaigns that exclude diverse bodies and Eurocentric anti-Black messages can influence childrens' brain development, causing them to absorb information that leads to false narratives about their bodies. These narratives can increase discomfort with their bodies, and create negative self-talk about their body. When these anti-Black thoughts become internalized, it creates a biased image of physical beauty, safety, and worth.

8. Since we are talking about eating, what are some ways Black folks experience food?

Black people have historically utilized food as a way of connecting to our community. Many activities start, or end with "breaking bread."Our family and culture encourage us to eat our cultural foods with pride. Many of us come from families that encourage multiple servings, and our elders cook with intentional love. We grow up taking joy in this until we are touched by societal standards and begin to limit intake. 

Society often labels foods as healthy or unhealthy. A registered dietician stated, "what is considered healthy is often associated with thinness, and thinness is often associated with whiteness. We need to redefine what healthy looks like to include different body shapes, colors and sizes". With cultural foods being labeled as unhealthy, it can have an impact on the way we view our food and our body image. However, the article also notes that this Eurocentric misconception is due to the nutrition world's lack of ethnic exposure.

9. What are some words of wisdom you would give to someone who experiences body dysmorphia or an eating disorder?

If you are a Black person reading this, know that you deserve to love yourself and your body. There may be societal and personal reasons why you struggle with body dysmorphia or self-image.You are not alone in this experience and there are many professionals and support groups available to support you to develop a healthy relationship with your body. Your body is not your enemy. You can recover from the narratives and beliefs that have led you to become preoccupied with perceived flaws in parts of your body.

10. How do I start to create a healthy relationship with my body?

Somatic techniques can help you connect with the body and begin to create body safety. You can also create non-judgmental positive or neutral affirmations of what you want to believe about your body. Delete or hide social media influencers that enforce thoughts of negative body image, and follow BIPOC accounts that create space for self-love, and encourage healthy habits. If you are looking for literature for your journey, The Body is Not an Apology is a great book (and workbook) that can help you reflect on messages you may have received that impact your body image. Please reach out to a professional if you need more assistance. There are providers that look like you, who can help.