Editor’s Note: This article contains mentions of eating disorders and disordered eating. Please take care while reading, and note the helpful resources at the end of this story.
Face-altering filters and videos of influencers discussing their cosmetic surgeries are a dime a dozen on TikTok. Influencers like Alix Earle (@alixearle), who’s been open about her surgical history, post several videos after procedures. The viral “Bold Glamour” filter — which is currently used in over 58 million TikTok videos — changes the facial construction of users’ images with more defined jaw lines and eyebrows. Not every filter is as dramatic as the “Bold Glamour” one, but the constant barrage of them has its effects on users.
“When we’re looking at social media, specifically the ones that are using things like filters, the image that’s being put out is altered and it’s not always completely apparent,” Dr. Kelli Johnson, Ph.D., a practicing therapist and dean of the College of Psychology and Behavioral Sciences at Chicago’s National Louis University, told In The Know by Yahoo. “What people are perceiving and interpreting as reality is a distorted comparison group.”
With hyper-realistic filters and endless body-changing content, it’s easy for people — especially the younger Gen Z — to develop negative feelings towards their natural bodies.
“To try and attain something that’s not real, it can sometimes lead people to engage in behaviors that might not be healthy for them,” Dr. Johnson said. “One of the challenging outcomes of that as a culture is body dysmorphia.”
Body dysmorphic disorder (BDD) is becoming an increasing problem among the younger generation, as social media and unrealistic bodies continue to skew expectations. In 2022, the New York Times published a piece in which teenagers spoke on how social media negatively affected their body image. The teens mentioned their issues with comparisons, questions about overeating and other triggers. Not all the students admitted to having BDD, but their struggles were issues that could serve as the foundation for the disorder.
According to Dr. Johnson, BDD falls under the obsessive-compulsive classification of psychological disorders in which an individual becomes preoccupied with one or several parts of their body they consider to be flawed.
“The individual literally has a distorted view of themselves,” she said.
How BDD can manifest itself
There are several ways BDD can manifest itself, with experts seeing a difference between boys and girls.
“We see, particularly in males, what’s called muscle dysmorphia,” Dr. Johnson said. “As we’re looking at that comparison group, [it has] a distorted view of what your musculature should look like and how that relates to one’s sense of their masculinity. …Whereas body dysmorphic kinds of disorders tended to be associated with female identifying individuals.”
The National Organization of Women cites a study saying that about 50% of 13-year-old American girls reported feeling dissatisfied with their bodies. In the same study, about 20% of boys reported being “concerned” about their muscularity and leaness — which would fall into the category of muscle dysmorphia.
People often turn to food and dieting to try and obtain the standards they see on social media.
“It may be mild to begin with, with dieting or even a wellness philosophy,” said Dr. Nicole Garber, the chief medical officer at Alsana, an eating disorder treatment center with multiple locations across the country. “For those people that are already predisposed to an eating disorder, that can set off the actual eating disorder.”
She also said that when the body is malnourished, the brain follows — leading BDD levels to rise in this case.
These issues can also cause people with potential disorders to turn to cosmetic surgery to fix their perceived flaws.
In 2018, experts coined the term “Snapchat dysmorphia,” and they examined the risk of users taking filtered images of themselves on certain platforms and using them to inspire their quest for plastic surgery.
Dr. Mark Albert, a board-certified plastic surgeon, told In The Know about some of the changes he’s seen among the Gen Z population when it comes to surgery.
“With the Gen Z crowd, rhinoplasty has absolutely exploded,” Dr. Albert said. “Five years ago, it wasn’t even near the top two or three procedures. I believe that last year and the year before, during COVID, it’s by far the number one procedure being done.”
Dr. Albert has had patients show him social media pictures that reference how they want to look. He also acknowledges that social media has a role in the rise of plastic surgery. However, he doesn’t believe plastic surgery is a direct cause of BDD, rather a potential side effect for those with the disorder.
He’s also treated patients who have BDD, and he uses a questionnaire to scan for potential signs of the disorder.
“BDD is there and it’s up to surgeons and other providers to recognize it and help people treat it rather than feeding them surgery, surgery, surgery, which is not going to help anybody,” he said.
HOW TO TREAT BDD
If you suffer from BDD, getting professional help is one of the best and most crucial steps on the road to recovery.
Angela Ficken, a Boston-based psychotherapist, spoke with In The Know about the specific therapies she uses to help treat BDD.
“There’s three behavioral therapies that are very helpful in treating BDD,” Ficken said. “There’s cognitive behavioral therapy (CBT), and that essentially is rewiring our brain to see the same situation from a different view.”
After CBT, there is dialectical behavioral therapy (DBT), which involves regulating emotions so a person doesn’t get too high or too low. Ficken said this form of treatment was originally created for people with borderline personality disorder (BPD). However, her research shows that many people, especially teenagers, can benefit from taking part in it.
“Those two therapies are what I consider the armor,” Ficken said. “Then the exposure and response prevention — ERP — which is, ‘All right. Now I have to go face these fears.’”
These strategies can help patients take steps forward such as going out in public, not constantly picking at their appearance in the mirror and properly eating.
How to Use Social Media
Social media sits at the heart of this issue, but that doesn’t mean that it is off limits — even for people who have been clinically diagnosed with BDD.
Experts agree that there is a healthy way to use your favorite platforms, as long as you are able to be truthful about the things you see and how it makes you feel.
“If social media is triggering you to feel badly about yourself, it’s probably a red flag and [I recommend] to take a break,” Ficken said.
Dr. Johnson also said that if you are aware of your social media usage and are on it for fun rather than to fulfill a need, then that can be a healthy way to be online.
Social media’s presence is hard to ignore. With features that make it easy to instantly compare yourself to others — which can lead to a feeling of being lesser than — using social media is all about an understanding that what people see isn’t what they should necessarily aspire to emulate.
If you or someone you know is struggling with an eating disorder or disordered eating habits, contact the National Eating Disorder Association (NEDA) at 1-800-931-2237. You can also connect with a Crisis Text Line counselor at no charge by texting the word “HOME” to 741741. Visit the NEDA website to learn more about the possible warning signs of eating disorders and disordered eating.
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