Questions & Answers: Robbie Williams suffers from body dysmorphic disorder - what the disease means for sufferers

Robbie Williams fans have been concerned for the pop star for some time now that the singer has lost a lot of weight in recent months.

Questions & Answers: Robbie Williams suffers from body dysmorphic disorder - what the disease means for sufferers

Robbie Williams fans have been concerned for the pop star for some time now that the singer has lost a lot of weight in recent months. A few days ago he announced on Instagram that he suffers from dysmorphophobia. A body image disorder in which those affected perceive a supposed flaw in their body.

"My ideal weight is when people are worried about me," Robbie Williams jokes about his illness in a drawing with black humor. But in his post he describes how he has suffered from dysmorphophobia throughout his life. "I could write a book about self-loathing when it comes to my body image," says the star.

Sometimes he weighs 20 kilos too much, what his head thinks then the fans can imagine – or not. It's a disaster. At the moment he is very thin, but his head says: "Damn great Rob, you managed to get thin and now you're old. Congratulations." What dysmorphophobia exactly is, what symptoms sufferers suffer from and how it can be treated - an overview:

With dysmorphophobia, also known as body dysmorphic disorder, the thoughts of those affected are constantly revolving around their appearance. They think they are blemished or disfigured when objectively they are not. Those affected have a distorted perception of reality and deal with the perceived flaw for several hours a day. Those affected often fixate on a certain part of the body that is perceived as ugly. In women, these are often the hips, face, chest or legs, while in men the thoughts often revolve around too few muscles, supposedly too much body hair or unsightly genitals. Those affected can also imagine that they are suffering from hair loss or acne.

Everyone probably has a body part they don't like about themselves, but that's not like body dysmorphic disorder. Those who suffer from this often withdraw from family and friends out of shame for their own appearance. Those affected often neglect their work. Worried about not looking perfect, sufferers often go to great lengths to style themselves, compare themselves heavily to others, or constantly check their appearance in the mirror. Dysmorphophobia sufferers do a lot to conceal, hide or get rid of the supposed blemish.

Dysmorphophobia usually begins in adolescence; Women are affected slightly more often than men. The disorder occurs in two to three percent of the population, according to the MSD Diagnostics and Therapy Manual.

Symptoms can develop gradually or appear suddenly. They can also vary in severity and become chronic if the body dysmorphic disorder is not treated. Many people with dysmorphophobia also have other mental disorders, such as anxiety or obsessive-compulsive disorders.

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The exact cause of dysmorphophobia is not yet known. The research is based on biological and sociocultural factors. Gender is also an issue – women are affected slightly more often than men. Bullying in childhood and adolescence can also play a role when victims have been repeatedly bullied because of a perceived flaw. Likewise, childhood abuse, extremely high standards of appearance by parents, and caregivers who describe themselves as ugly are factors in the development of dysmorphophobia.

Stagings on social media platforms such as Instagram or Tiktok can also contribute to the development of the disorder, since bodies are often depicted unrealistically. And people then compare themselves with these pictures. Above all, filters that change faces significantly are problematic, according to the Oberbergkliniken.

Body dysmorphic disorder is classified under OCD in the American Psychiatric Society's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), while the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD-10) classifies dysmorphophobia without delusional disorders as a variant of hypochondriasis. If a delusional body dysmorphic disorder is present, it is assigned to the delusional disorders.

It can often take many years for sufferers to be diagnosed, as they actually believe they are ugly and have a physical problem. However, people with body dysmorphic disorder may also feel too afraid or ashamed to reveal their symptoms. Or those affected have other psychological problems such as depression or anxiety disorders that make it more difficult to recognize the body dysmorphic disorder.

Numerous tests are offered on the Internet with which those affected can find out whether they suffer from dysmorphophobia. Such tests cannot replace a diagnosis by a psychiatrist or psychotherapist. When making a diagnosis, psychiatrists try to get a comprehensive picture of those affected and ask them about the symptoms.

Depending on the severity of the body dysmorphic disorder, the treatment looks different. In a mild form, cognitive behavioral therapy is an option. In behavioral therapy, research is carried out into the causes of dysmorphophobia and the patients learn step by step how to discard their old habits and thought patterns. The aim of the therapy is to give those affected an appropriate body awareness. Behavioral patterns such as the excessive control of one's own appearance in the mirror can be discarded through therapy. In severe cases, experts recommend a combination of behavioral therapy and the administration of antidepressants.

Quellen:  MSD-Manual, Oberbergkliniken, Klinik Friedenweiler,NHS, Mayo Clinic, ADAA, Instagram Robbie Williams