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Body Dysmorphic Disorder

Body Dysmorphic Disorder

What is body dysmorphic disorder (BDD)?

Body dysmorphic disorder (BDD) is a type of anxiety disorder where people become preoccupied with perceived defects or flaws in their appearance.

These perceived defects are usually minor or can’t be seen by others. BDD usually begins during the teen years or during early adulthood.

What causes body dysmorphic disorder?

The exact cause of BDD is not known but it commonly occurs in people with other mental health disorders, such as major depression and anxiety, suggesting a problem with processing or coping mechanisms within the brain.

BDD is also more likely to occur in people who have:

  • Experienced traumatic events, conflict, or abuse during childhood
  • Low self-esteem
  • Had relatives or friends who verbally criticized or commented on their appearance

Many modern societies tend to equate physical appearance with beauty and value which can also have an impact on the development of BDD

What are the symptoms of body dysmorphic disorder?

Symptoms of body dysmorphic disorder may include:

  • Concern, which is centered around one or more body parts or areas. The most common areas of concern are the skin, hair, facial features (such as the nose), or bodyweight or muscle tone. Some people have excessive worry over the size of their penis, breasts, thighs, buttocks, or the presence of certain body odors
  • Attempts to cover up or hide the perceived defect
  • Ritualistic behaviors, such as constantly looking in the mirror or picking at their skin
  • Behaviors that are repetitive and time-consuming
  • Constantly seeking reassurance from others that the defect is not visible or obvious
  • Constantly measuring or touching the perceived defect
  • Feeling self-conscious or anxious when around other people
  • The obsession about the defect becomes so consuming that social, work, or home life suffer
  • Repeated consultations with medical professionals to find ways to remove or improve the appearance of the defect

How Is body dysmorphic disorder diagnosed?

Many people with BDD feel ashamed, embarrassed or reluctant to talk about their preoccupation and do not seek help from a medical professional meaning that many cases of BDD go unrecognized.

Doctors may suspect the condition if people repeatedly seek plastic surgery for the same or multiple perceived physical defects and may consider questioning the person further.

If BDD is suspected, the doctor will take a thorough history and do a physical examination. A referral to a psychiatrist or psychologist may be considered. No specific tests are warranted as the diagnosis is made based on an assessment of the person's attitude, behavior, and symptoms.

How is body dysmorphic disorder treated?

Treatment for BDD usually includes a combination of different treatments such as:

  • Psychotherapy, including cognitive-behavioral therapy which aims to correct the false belief about the defect and to minimize the compulsive behavior
  • Medication, such as SSRI antidepressants or antipsychotics (eg, olanzapine, aripiprazole, or pimozide)
  • Group or family therapy