Does Sarah Michelle Geller Really Have Body Dysmorphic Disorder?

Sarah Michelle Geller stars in the new CW series, Ringer, in which she plays a recovering addict who assumes her dead twin's identity. In the first episode, several references were made to her being skinny, and one person jokingly asked her for tips on how to be anorexic. Ironically, in real life, the 34-year-old actress alludes to her own struggles when it comes to her appearance. She admits to viewing herself more negatively than others perceive her to look. When Health Magazine asked her if she had Body Dysmorphic Disorder, Sarah Michele Geller answered, "Oh God ... I'm a female! I totally have body dysmorphic disorder...I think most women do."

This perspective raises an important question regarding women and body image: Is it true that most women have Body Dysmorphic Disorder (BDD)? The bottom-line answer is no, most women do not have BDD. It is reported that 1-2% of the population has BDD, and that estimate would contradict the assertion that most women have this mental illness. If most women (i.e., the majority) have learned to view themselves as less attractive or heavier than they actually are, then it would be normative rather than abnormal thinking. The reasons for the distorted perceptions are varied, but two things American women have in common are regular exposure to selective (and often manipulated) media portrayals of ideal beauty as well as societal pressures to look good and be thin, both of which are pervasive within our culture. While women's self perceptions are often not particularly healthy and can lead to unhealthy responses, to label or diagnose most women with BDD would be incorrect. BDD has to do with more than just a skewed version of reality in your head regarding your appearance.

As presented in the Diagnostic Statistical Manual (DSM-IV-TR), in order to diagnose a person with BDD, he or she must meet the following criteria:
1) Preoccupation with an imagined or slight defect in appearance. If a slight physical anomaly is present, the person's concern is markedly excessive;
2) The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning;
3) The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa).

So yes, it is true that many women take issue with the way they look. It is unfortunately rather common for women to be dissatisfied, preoccupied, and uncomfortable about their appearance. However, having body issues does not mean that one has BDD. The two things are not the same. Compared to the typical angst women feel about how they look, BDD is a more serious or extreme focus on a specific perceived physical flaw that is minor or imagined, and the related thought process takes on an obsessive and sometimes delusional quality that is significantly distressing and/or disruptive to one's psychosocial functioning. Many of those who suffer from BDD are unaware of having a mental disorder, and simply believe they accurately perceive such flaws. Thus, those with BDD are more likely to seek medical intervention (i.e., plastic surgery) than psychological treatment. However, if someone suffering from BDD becomes aware that their thoughts are distorted and they wish to feel better, help is available. Cognitive behavioral therapy (CBT), medication (i.e., SSRIs), or both are effective in treating BDD.