Megan Fox is opening up about her health and how a medical condition has affected the way she sees herself.
In an interview with Sports Illustrated Swimsuit, the Transformers actress revealed she has body dysmorphia, which Fox says has caused her to see herself differently compared to the public's perception.
"There is never a point in my life where I loved my body, never ever," Fox said in the interview.
"The journey of loving myself is going to be never-ending, I think."
Fox joins millions of other people around the world who suffer from this specific mental health condition.
According to the International OCD Foundation, between 5 to 10 million people in the U.S. alone are impacted by body dysmorphia. The Cleveland Clinic also highlights that females are affected at a higher rate (2.5%) compared to men (2.2%).
While there is no cure for body dysmorphia, treatment is essential as the disorder can get worse over time.
From what living with body dysmorphia looks like and available treatment options, here's everything you need to know about the condition.
What is body dysmorphia?
Body dysmorphia or body dysmorphic disorder (BDD) is a mental health condition in which a person obsesses over a perceived flaw that can become overwhelming and "hard to control," according to Johns Hopkins Medicine.
Karla Buchholz, a registered provisional psychologist based in Edmonton, says the caveat is that the flaw is oftentimes not noticeable by others.
"The preoccupation would be considered clinically significant if it creates distress or impairment in social, occupational or other areas of functioning," she explained to Narcity.
As a kind of rule of thumb, Buchholz says that spending between three to eight hours a day on a preoccupation that is difficult to resist would indicate body dysmorphia.
It's also important to understand that BDD is not an eating disorder.
The Body Dysmorphic Disorder Foundation says someone with an eating disorder is worried about their body weight and shape and will therefore try to lose weight.
Meanwhile, a person with BDD is typically not worried about their weight but rather fixate on "specific areas of concern," and they may restrict what they eat to deal with the "perceived flaws."
There are two subtypes of BDD, including muscle dysphoria, which causes a person to have negative thoughts about their build and more specifically, the appearance of their muscles. Then there's BDD by proxy, which involves a person being overly concerned with "perceived imperfections with another person's appearance," as noted by the International OCD Foundation.
What causes body dysmorphia?
Body dysmorphia can be caused by a combination of environmental, psychological and biological factors.
Buchholz says that can range from things like experiencing abuse, bullying, neglect, trauma, and a fear of being rejected or abandoned.
"Perfectionism, often associated with societal pressures, beauty, comparison to others, and family history can also give you a genetic predisposition," she added.
While the Cleveland Clinic says BDD can develop at any age, it often starts in early adolescence, as it did for Fox.
In her interview with Sports Illustrated Swimsuit, the actress shared that her "obsession" with the way she looked started at a young age.
"Why I had an awareness of my body that young I'm not sure and it definitely wasn't environmental because I grew up in a very religious environment where bodies weren't even acknowledged," Fox shared.
What are the signs of body dysmorphia?
A person with BDD can become obsessed with any part of their body. However, Johns Hopkins Medicine says the most common areas include the face, hair, skin, chest and stomach.
Some symptoms of body dysmorphia include:
- Constantly checking yourself in a mirror
- Avoiding mirrors
- Skin picking
- Constantly comparing yourself to others
- Attempting to hide the body part with something like a hat, scarf or makeup
- Avoiding social activities
- Having unnecessary plastic surgeries
- Experiencing anxiety, depression or shame
- Contemplating suicide
How serious is body dysmorphia?
Body dysmorphia can become serious, especially if a person who has it doesn't get help.
Buchholz says a person with BDD can become so fixated on their perceived flaw that it could lead to suicidal thoughts.
"Around 20% of adolescents might drop out of school because of body dysmorphia, and 80% of individuals might report suicidal ideation, and 25% might attempt suicide at some point in their life," she added.
The registered psychologist emphasizes that there is less support out there for younger individuals, and that's why seeking treatment and having a strong social support system is so important.
How do you treat body dysmorphia?
There is no cure for BDD, but it can be treated in a variety of ways.
In an interview with the Washington Post, Ann Kearney-Cooke explained why seeking help is so important for people who are diagnosed with body dysmorphia.
“It really doesn’t get better on its own and, when not treated, can actually get worse over time,” the Cincinnati-based psychologist said in the interview.
Buchholz reiterated the importance of getting help for BDD and said a starting point would be to screen for depression, anxiety, obsessive-compulsive disorder (OCD) and substance use.
Mental health support is also highly encouraged.
"Being able to access mental health support is incredibly valuable for people of all ages because this starts so young, and it can carry on into becoming an older adult," the Canadian provisional psychologist said.
"I know some individuals who prefer individual therapy, some prefer group therapy with consistent homework to keep them constantly accountable and working through those things."
Aside from mental health support, Buchholz says cognitive behavioural therapy is also beneficial, as is dialectical behavioural therapy, which "balances our rational side with our emotional side so that we can find the middle road."
Other helpful treatments include mindfulness, stress management, relaxation therapies and solution-focused therapy.
Some doctors may also prescribe certain medications, including selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant.
Before taking any medications or seeking certain therapies, a person who has BDD is advised to meet with their doctor, who can get them on the right path to getting the help they need.
If you or someone you know is struggling with depression or mental health concerns, please reach out to a trusted peer, parent or health care professional. You can also contact the Crisis Services Canada helpline, which is available 24 hours a day, or consult these additional resources. If you need immediate assistance, please call 911 or go to your nearest hospital. Support is available.
If you or someone you know is struggling with thoughts of harming themselves, please reach out to a trusted peer, parent or health care professional. You can also contact the Crisis Services Canada helpline, which is available 24 hours a day, or consult these additional resources. If you need immediate assistance, please call 911 or go to your nearest hospital. Support is available.
This interview has been condensed and edited for clarity.
A tea cup filled with tea leaves. 
Jan Doughty reading tea leaves.