Obsessing Over a Body Part Like Your Belly or Nose?

Source: Pexels/Nikita Pishchugin

When I had an eating disorder, I was obsessed with a particular part of my body, and any reflective storefront or car window was an opportunity. I needed to check and see if it was still as dreadful as I saw it. I needed to make sure that it was hidden well enough—I mean, I didn’t want to disgust or offend others by having to witness it. I also needed to check if it had changed somehow, becoming more or less offensive. I felt ashamed.

Looking back, I can only imagine how many sat behind those reflective mirrors and watched me look at myself. I probably appeared narcissistic or self-absorbed. And I kind of was, but differently than it probably appeared.

A fixation on the nose, a mole, skin coloration, the belly, or something else

Many of us have a body area (or areas) we wish could be different or that causes anxiety. For some, active self-acceptance might mitigate the dissatisfaction enough. Others might “fix” the angst about what’s bothersome by wearing makeup or clothing that covers the area, editing their image in photos, or having a medical procedure like plastic surgery.

Still others move into the realm of body-related obsessions and compulsions. Their appearance problem seems to grow more intense and frequent—as does the stress, worry, and sadness related to it. And no remedy calms the anxiousness or pain. These folks could be experiencing body dysmorphia.

A brief overview of body dysmorphia

When someone experiences body dysmorphic symptoms or body dysmorphic disorder, their own eyes seem to lie to them. Remember the distorting funhouse mirrors at carnivals? Someone with clinical body dysmorphic disorder or body dysmorphic symptoms might see something equally twisted or exaggerated as they gaze at their image. And when their friends and family reassure them that what they see is inaccurate, they’ll usually struggle.

They tend to trust what they see and perceive over someone else’s report, which makes logical sense, right? Yet, research has shown us that people with body dysmorphic disorder process visual input in atypical ways (Feusner, J. D., 2010).

Body dysmorphic disorder is a condition where a person is preoccupied with perceived defects or flaws in physical appearance that aren’t observable or appear minimal to others. The person enacts behaviors related to the preoccupations, such as mirror/reflection checking and comparing with others. Also, the preoccupation causes significant distress and negatively affects functioning (e.g., time dedicated to the flaw interrupts responsibilities).

Whether the person is clinically in the realm of clinical body dysmorphic disorder or they’re scared that, for example, their nose is too big or shaped too weirdly, tummy bulges too much, skin tone is too uneven, or muscles are too undefined, the following is probably true: When people are bothered by something appearance-related, they tend to focus on it. Refer back to my own story: even in pre-internet times, nearly every physically reflective surface tempted me to check my area of insecurity.

Gazing in contemporary times

The opportunities to get sucked into a vortex of staring at oneself have increased exponentially. There’s social media—with its endless parade of selfies—and video meetings. In addition to our computers, we now carry with us a powerful, 24/7 accessible force: our cell phones. And research shows that looking at the face or reflection for a sustained period (e.g., five minutes) seems to increase dissociation and dissatisfaction. That’s whether someone has body dysmorphia or not (Möllmann et al., 2020).

The American Academy of Facial Plastic and Reconstructive Survey reported that in 2019, 72% of patients sought cosmetic procedures to “look better for their selfies” (2020). They continued: “Whether you call it the ‘Kardashian Effect,’ ‘Selfie Mania,’ ‘Snapchat Dysmorphia,’ or the ‘Glow-Up’ challenge, every single taggable trend points to the same thing: social media’s ensuring an ever-increasing impact on the facial plastic surgery industry.” (It’s also probably ensuring the activation and amplification of body dysmorphic disorder and milder struggles.)

In 2020, Dr. Shadi Kourosh and her team discovered a new type of dysmorphia that kept the offices of aesthetic physicians busy during the pandemic: Zoom-dysmorphia (Rice, Graber, & Kourosh). It seemed to come from hours of staring at one’s automatically distorted image on video conferencing apps. In a study of 134 providers (board-certified dermatologists, residents, and advanced care providers) across the United States, 86.4% reported their patients cited videoconferencing as a reason for seeking care for new cosmetic concerns (Rice et al., 2021).

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If you’re wondering if Zoom-dysmorphia ended with the official conclusion of the pandemic, it did not. As recently as March 2024, a presentation at the annual meeting of the American Academy of Dermatology focused on the need for a new screening tool for it (Krebs et al., 2024).

If you are stuck staring at something body-related that upsets you

The following could sound overly simple, and I get that. Still, any of the below options might help you improve your mood and reduce body-related anxiety:

• On Zoom, hide self-view when in meetings. To do that, go to “View,” and you’ll find the option. If you use a video conferencing app where you can’t do that, try something that won’t hurt your screen but sticks and blocks you from watching yourself. (A small Post-It note can do wonders!)
• On social media, if you notice you’re staring at and comparing someone else’s face or feature with yours, remind yourself that photo-editing could be at play. Then, scroll away immediately. Consider taking a break from following that account for a bit if they consistently post shots that activate you. Also, add more non-body content to your feed (nature, puppies, kitties). That can help fill your feed with fewer temptations and non-triggering content.
• When walking around in real life, if you catch yourself looking at your “flawed” part on a reflective surface, disengage ASAP. Look away. Please do what you need to distract yourself (smile at a human, count clouds, whatever). This is about breaking the trance-like stare before dissociation and increased dissatisfaction happens.

If you discover that you cannot do any of the above at this time, please give yourself compassion. Perhaps you could benefit from a self-help book or a therapist specifically trained in helping people find more freedom from the obsessions and compulsions related to body dysmorphia. It’s a treatable illness (Singh & Veale, 2019).

This post is for informational purposes and does not provide therapy or professional advice.