Body dysmorphia gets thrown around a lot these days. And I’m not just talking about on the internet, my humble reader—your very own Tommy is just as guilty.
The DSM-V (the diagnostic manual psychologists use to define, categorize, and diagnose different forms of psychic damage) defines body dysmorphia as a kind of obsessive compulsive disorder.
The main features are a preoccupation with a perceived flaw (it doesn’t have to be real, and when it is real, the flaw is grossly exaggerated).
This flaw distorts the patient’s thinking and causes them to exhibit compulsive, repetitive habits, like skin picking, gazing deeply into the mirror for too long or too often, plucking or over plucking hair, taking a skin regimen too seriously, or simply seeking reassurance and affirmation everywhere they go.
Importantly, these repetitive behaviors can be mental and internal as well, like if the patient constantly compares themselves to others.
This preoccupation and ensuing behaviors must also cause a significant disruption or distress to the patient’s life.
Pardon the pun, but body dysmorphia is somewhat more broad than similar illnesses like anorexia nervosa, which is a fixation on weight and body shape specifically. While eating disorders tend to be diagnosed in women, in recent years researchers have found an increase in male diagnosis of what’s called muscle dysmorphia, a fixation on musculature.
Some researchers believe that muscle dysmorphia is merely anorexia nervosa, only from a male perspective—rather than fixating on traditionally feminine body assets of thinness, it fixates on traditionally masculine assets.
This would imply that these illnesses are social in nature. That’s obvious on the face of it, but still worth remarking on: our ideas of what is beautiful, what is fat, and what is thin all create and maintain these disorders. Without some idea of what bodies should be, we wouldn’t care so much about what they could be. And what ours are.
I sometimes find myself posting photos like these and in the moment I enjoy them. But just hours later my eye drifts to my center. It imagines not just that I should be thinner, but that I should be shaped differently.
The waist should be brought in. The shape should be more feminine and more masculine depending on where I look at the photo. I see a column where I long for an hourglass.
In this way, I wonder about the intersections of body dysmorphia, anorexia nervosa, muscle dysmorphia, and gender dysphoria (a depressive state brought on by the dissonance between one’s assigned sex and gender identity).
I wonder if merely staring, thinking, prodding, poking, and wondering about these things is enough to be disordered. Even though I know that a person can have an eating disorder at any size, the facts are the facts: I eat, I don’t purge, but I do regret.
Sure I think about my body features a lot, but the line between obsession and priority is as thin a demarcation as that between love and lust—apparent to all but the sufferer themselves. And sure, this is wrapped in gender, because everything is. But is it really about that, I wonder. And I wonder. And I wonder again.
And sure, I feel sadness. And sure, I feel a great deal of sadness when I see the columnar shape of my body, and sure this is only a priority for me and not to anyone else, and sure I am preoccupied with all the little ways I fall short as both a gay boy and Anything Else.
Experts agree that there is a difference between body dysmorphia, anorexia nervosa, gender dysphoria, and body image issues. They all have different names, for one thing. And for another, that last one is basically normal to some extent. And it is in defining the extent—defining that Thin Line—that I am driven mad.
This time it is the line between the disordered and the disordered society: between an illness and an illness so prevalent it can no longer be called aberrant. A pandemic.
I text my good friend that my body dysmorphia is wylin because the alternative is writing a 700 word article about it. But more than that, the words are a map. A paradigm. A way of understanding the fixations that vortex around me every time I look in the mirror or glance back at a selfie or, god forbid, encounter a photo of myself that someone else took.
I say body dysmorphia because no one understands what I mean if I say “the Column.”