So what exactly does the disease entail?
“Body dysmorphic disorder is characterized by someone who becomes focused or obsessed with a particular part of their body, and they see it in a distorted way,” clinical psychologist Dr. Susan Albers, who has not treated Ewing, tells PEOPLE. “It’s often characterized by shame, embarrassment and disgust.”
Albers – who authored the book Eating Mindfully – says the disorder can cause severe distress and anxiety to those suffering from it, and lead a person to go to extreme lengths to fix or conceal whatever body part they are obsessing over – including plastic surgery.
Plastic surgery addiction is “very common” among people with body dysmorphic disorder, says Albers. “They’ve often had multiple procedures, and they’re still not happy.”
Ewing, 27, said that he was never satisfied with the results of his various procedures – including cheek and chin implants – but he kept going back for more and more operations.
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“There’s nothing that they can do externally to fix the issue,” says Albers. “It really comes down to an internal issue. A knife isn’t going to fix it.”
Ewing recalled that throughout his visits to numerous plastic surgeons over the years, not one asked to do a mental health check, even though having excessive cosmetic surgery is a clear symptom of the disease. Albers believes seeing warning signs of body dysmorphic disorder should be part of the training for surgeons in the field.
“They should be trained how to ask those questions, how to identify some of the common signs of body dysmorphic disorder, and then refer them to a mental health professional,” she says. “It’s surprising that no one caught it if the signs were there, or that no one followed up on it.”
According to the International OCD Foundation, one in 50 people suffer from body dysmorphic disorder, but fortunately, it can be treated with therapy, and medications when appropriate.
“Talk to a psychologist or a qualified professional,” says Albers. “Sometimes medication can be helpful, because there’s often a high comorbidity of obsessive compulsive disorder, depression, self-esteem issues and eating disorders. It is a very treatable condition.”