While many of us are prone to thinking a little too much about certain flaws or blemishes on our bodies, for those living with body dysmorphic disorder (BDD) , these negative thoughts are overwhelming and cause significant distress.
With the right diagnosis and treatment, it is possible to manage body dysmorphic disorder and make daily life easier. With that in mind, let’s take a look at everything you need to know about diagnosing and treating body dysmorphia.
What is body dysmorphia?
Body dysmorphic disorder (BDD) is a mental health condition that affects both men and women. Those who suffer from body dysmorphia develop obsessions about flaws in their physical appearance. These perceived flaws may be minor or may not even exist at all.
Body dysmorphia is more than simply disliking certain physical attributes and body parts. In fact, people with body dysmorphia spend so much time fixating, worrying, and obsessing about their perceived defects that it prevents them from functioning in daily life.1
What causes body dysmorphic disorder?
There is no one specific cause for body dysmorphic disorder. In fact, medical experts believe it is a combination of numerous environmental, biological, and psychological factors.2
Some possible contributory factors include:
- Family history of body dysmorphic disorder
- Life experiences such as bullying or teasing at school
- Personality traits such as perfectionism or comparison to others
- Cultural influences such as diet culture
- Co-existing mental health diagnoses like depression, anxiety or OCD
- Low self-esteem or loneliness
What are the signs and symptoms of body dysmorphic disorder?
Like any mental health disorder, there are many possible symptoms of body dysmorphic disorder. Some people who suffer from BDD may display most of the common symptoms while others may only experience one or two. In order to receive an official diagnosis of body dysmorphia as per the Diagnostic and Statistical Manual of Mental Disorders, the patient’s preoccupation with a perceived flaw or imagined defect must cause significant distress and impact their ability to function day-to-day.
Common symptoms of BDD can include:3
- Avoiding mirrors
- Obsessive mirror checking
- Excessive grooming
- Compulsive behaviours like skin picking
- Exercising excessively or obsessively
What is muscle dysmorphia?
Muscle dysmorphia is a type of body dysmorphia. The key distinction is that those who suffer from muscle dysmorphia fixate on muscle tone and size.
Many of the symptoms of muscle dysmorphia are similar to body dysmorphia. However, there may also be more of a focus on exercise and diet. Some common signs of muscle dysmorphia include:
- Excessive exercise (particularly lifting weights)
- Obsessive calorie counting
- Avoiding eating in settings where there’s less control over food content
- Using steroids or other drugs to enhance appearance or muscle growth3
What are the complications and risks of body dysmorphia?
Body dysmorphia can be overwhelming and extremely intense. Left untreated, the symptoms can have a significant impact on one’s quality of life.
Living with body dysmorphia without professional help can lead to:3
- Severe social anxiety
- Low self-esteem
- Negative thoughts
- Feelings of isolation
- Relationship problems (with friends, romantic relationships, family members, or colleagues)
- Performance problems at work or school
- Reckless behaviour such as excessive cosmetic surgery or dangerous dieting
- Suicidal thoughts
Can you have body dysmorphic disorder and other mental health conditions?
Like many mental health conditions, it is possible to suffer from BDD and other conditions at the same time. In fact, it’s common for BDD patients to also suffer from anxiety disorder, depression, or obsessive-compulsive disorder (OCD).2
BDD can often be misdiagnosed as OCD and other disorders due to the similarity in some of the symptoms in patients. It’s therefore extremely important to seek a proper diagnosis from a mental health professional. This will help make sure that you are receiving the best treatment for you.
What are the body dysmorphia treatment options?
Living with body dysmorphic disorder can be truly overwhelming. The good news is that there are many different ways to treat body dysmorphia. With the right support and guidance from healthcare professionals, you can learn to control repetitive behaviours and significantly improve your quality of life.
Therapy options for treating body dysmorphic disorder
Once you reach out to your healthcare provider for support, they may suggest that you try Cognitive Behavioral Therapy (CBT). This is a type of psychotherapy (sometimes referred to as talk therapy) that is used to treat a number of different mental health conditions. Its main focus is to help patients to identify and change their thought and behaviour patterns.3
Using a method called exposure and response prevention (ERP), cognitive behavioural therapy is designed to help decrease repetitive and compulsive behaviours like mirror checking and camouflaging by gradually exposing patients to situations that they fear.5
Medication for body dysmorphia
Selective serotonin reuptake inhibitors (SSRIs) such as Fluoxetine are the most commonly used drugs for body dysmorphia. This antidepressant medication can help to control compulsive behaviours and symptoms associated with BDD.3 .
Different drugs will work better for different people, so it’s important to seek professional medical advice from a qualified clinician before you take any medication for body dysmorphia. It’s also worth noting that some people may respond better to therapy and will therefore not require the use of medication at all.
How to help a loved one with body dysmorphia
It can be hard to know exactly how to help a loved one. It’s a deeply personal and overwhelming experience.
Some useful tips for helping a family member or loved one with body dysmorphia include:
- Listen (you don’t always need to provide a solution — just listen)
- Accept their feelings (even if you don’t understand them)
- Provide practical support so that they can prioritise their therapy sessions or self-care practices
- Acknowledge and celebrate the small wins
- Learn and understand their triggers
- Remember to take care of yourself too!
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References:
- MIND, What is body dysmorphic disorder?, https://www.mind.org.uk/information-support/types-of-mental-health-problems/body-dysmorphic-disorder-bdd/about-bdd/, published July 2022
- MIND, What causes BDD, https://www.mind.org.uk/information-support/types-of-mental-health-problems/body-dysmorphic-disorder-bdd/causes/, published July 2022
- NHS, Body dysmorphic disorder, https://www.nhs.uk/mental-health/conditions/body-dysmorphia/, published October 2020
- International OCD Foundation, Muscle dysmorphia (MD), https://bdd.iocdf.org/about-bdd/subtypes-of-bdd/, reviewed January 2023
- NICE, Obsessive-compulsive disorder and body dysmorphic disorder: treatment, https://www.nice.org.uk/guidance/cg31/chapter/Recommendations#steps-3-to-5-treatment-options-for-people-with-ocd-or-bdd, published November 2005