Experts: Zoom meetings could cause body image issues

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The reliance on Zoom for work and school during the COVID-19 pandemic could be exacerbating serious psychological issues, experts say.

Specifically, Sherry Pagoto is concerned about people who suffer from body dysmorphic disorder, or BDD.

“One of the characteristics of people with BDD is that they do spend a lot of time looking in the mirror, and it's a source of a lot of anxiety,” said Pagoto, a psychologist and director of the University of Connecticut’s Center for Health and Social Media. “To the extent that Zoom has become an all-day mirror, I don't think that's a great mix.”

A cousin of obsessive compulsive disorder, people with body dysmorphic disorder focus on a specific perceived flaw in their physical appearance.

“Maybe they think their ears are too big, or something's funny about them, or their arms are too long and then they become really hyper-focused on that thing,” said Karen Steinberg-Galluci, a clinical psychologist and associate professor of psychiatry at UConn Health.

It’s not just a casual dislike of an aspect of one’s appearance. The disorder is diagnosed when that dislike becomes an obsession, and the patient compulsively tries to fix or hide that perceived flaw, which Pagoto called “camouflaging.”

“Whereas, the average person might get up in the morning, they might look in the mirror or brush their teeth and put on some makeup or wash their face, five, 10 minutes and they're out the door,” she said. “Someone with body dysmorphic disorder may get a little bit stuck in the mirror trying to do the camouflaging, and some people could be spending hours a day within that particular behavior.”

It becomes a problem, said Steinberg-Galluci, when the obsession with a perceived flaw interferes with a patient’s daily life.

“So, you want to see: How much is it interfering? How much are their thoughts preoccupied with this particular thing? Are their behaviors or compulsions related to it? Are they doing compulsive exercising or not eating? Are they getting surgeries, trying to do things that could be costly or, or harmful to them to try to try to create some perfect image that they want to achieve?”

One of the treatments for the disorder, Pagoto said, is to encourage patients to stay away from mirrors, to break that hyper-focus on that perceived flaw.

“For someone with BDD, particularly if the perceived imperfection was visible in your Zoom box, it would be a very anxiety-provoking experience,” Pagoto said. More, in fact, than being in class or at a party, in-person.

It’s not just that you are staring at yourself for hours a day, but that people are staring at you.

“Because, the thought that ‘Everybody's staring at me, everybody can see this thing.’ It's basically a social interaction, but it's very focused on how everybody's staring at your face,” she said. “Whereas, maybe if you were in the room with people, you might not feel like everybody's staring at you right now. But on Zoom, it might even feel a little bit more like people are staring at you, especially if you're talking.”

Another problem is that Zoom and other video-conferencing tools don’t offer a precise mirror. The image you see in the window is not an accurate representation of how you look.

On one hand, unless you have professional lighting and the best camera, “When you're on Zoom or whatever, it actually doesn't look like a mirror, it looks not as good,” Steinberg-Galluci said.

But then there are filters, ways the programs allow you to appear with touched-up eyebrows or altered skin tone.

“It's like technology camouflaging, so I don't need to put all kinds of makeup on my face, because the only way people are seeing me is through these filters that are doing it for me better than I can ever do it myself,” Pagoto said.

But that only makes the reality of your appearance more stark, encouraging yet more focus on any perceived flaw.

“Then I look at my regular self, and I'm like, ‘Oh, I didn't think I looked that bad, but now compared to the beauty that it gave me, I look awful,’” Pagoto said. “I almost worry that even people who may not be prone to something like body dysmorphic disorder, something that severe, if it's all nudging us towards having more body image issues, because now we get to see before and after pictures of us very unrealistic to what we usually are.”

Schools often require students to keep their cameras on when in remote learning. It’s a way to make sure students are engaged and not, for example, asleep.

But Steinberg-Galluci said one idea is camera breaks, giving students a chance to not be seen if they don’t want to be.

“I know from the perspective of being an educator. That's kind of hard to teach and feel like you're interacting with people,” she said. “I think it is important for teachers to feel like the student is really there, is getting this material. But it's not good for us to just be constantly staring at a screen and whether it's the teacher or ourselves or other students that’s not good for your eyes. It's really draining after a while.”