Written by Hannah Reese, Ph.D.
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Please note: This episode contains very graphic footage of medical and surgical procedures.
The episode of Taboo entitled, “Beauty” by National Geographic vividly portrays four individuals who have gone to extreme lengths to alter their physical appearance. For the purposes of this commentary, I will focus on the first two individuals, Shayla and Marguerite, whose experiences resemble those often had by individuals with Body Dysmorphic Disorder (BDD).
Shayla is a young mother in Texas who has undergone over 30 cosmetic procedures including rhinoplasty, botox, liposuction, butt implants, a tummy tuck, the removal of two ribs, and 19 breast augmentations. At the time of this episode, Shayla is facing life-threatening complications from her most recent breast augmentation.
The pursuit of multiple cosmetic procedures is an all too common pattern for individuals with BDD. Because most individuals with BDD believe that they suffer from a physical problem rather than a psychological disorder, they naturally seek physical remedies. However, we know from studies and from talking to our patients that cosmetic surgery is rarely helpful for individuals with BDD. Often, as was the case with Shayla, an individual with BDD will feel compelled to continue having procedures in an attempt to reach an ever-elusive sense of physical perfection.
In addition, Shayla also demonstrates the profound disconnect between how an individual with BDD views him or herself and how other people view him or her. Despite frequent compliments, and a career in modeling, Shayla is convinced that her appearance still needs improving. Similarly, despite evidence to the contrary, many individuals with BDD remain convinced that they are hideous or ugly.
Marguerite, the second woman profiled in the episode, is a young woman in Siberia who has fixated on her height. She believes that she is too short and is willing to go through the extremely painful and prolonged process of having her legs surgically lengthened to gain slightly more than one inch in height. Marguerite demonstrates how individuals with BDD can hyper-focus on one aspect of appearance, in this case height, and subsequently feel that this one aspect determines their overall level of attractiveness. She has lost sight of all of the other parts of her and is pursuing a taller frame at great cost. She has equated height with not only beauty but also confidence, professional success, and eventually marriage. This is also common among individuals with BDD. We often hear from sufferers who feel that if they could just fix their appearance then all the other parts of their life would fall into place. Beauty is seen as the ticket to happiness and fulfillment in all domains.
These two young women, and many other men and women like them, are willing to pursue physical perfection at great personal cost. The catch for individuals with BDD is that the problem is internal and can’t be fixed with makeup, clothing, or surgery. Individuals with BDD suffer from a distorted body image. In other words, the way in which they see themselves is inaccurate and distorted relative to the way in which others view them. We don’t fully understand what causes someone to develop BDD. As the episode suggests, BDD may be related to negative events in childhood such as teasing or bullying. There is also evidence to suggest that many other factors may make play a role, including genetic factors, biological factors (e.g., chemical or functional brain abnormalities), certain personality traits (e.g., perfectionism), and cultural influences. Much more research is needed to figure out what causes BDD and how we can help those suffering from it.
This episode of “Taboo” can be accessed using the following link:
©2012 Massachusetts General Hospital OCD and Related Disorders Program | Reprint only with permission
