What is Body Dysmorphic Disorder?
Today’s Post by Kelsey Chadwick, MS RDN
August 1st, 2023
Today I want to talk about a diagnosis that isn’t talked about enough - Body Dysmorphic Disorder, or BDD. BDD is “is a DSM-IV disorder that is characterized by a distressing or impairing preoccupation with slight or imagined defect(s) in one's physical appearance” (Bjornsson). The first description of BDD was offered in 1891 by Enrico Morselli, an Italian physician who called this disorder “dysmorphophobia” (Bjornsson). While we have known of “dysmorphophobia” for some time now, it has only really been studied for the last two decades. During this time some great research has been done, but there is certainly still more research to be done. BDD is still very underrecognized and “because BDD causes substantial suffering and impairment in functioning, there is a need for increased recognition of this often-debilitating condition across all specialties”(Bjornsson).
Studies have shown that BDD has a prevalence of 0.7% to 2.4% in the general population, making BDD more common than schizophrenia or anorexia nervosa. BDD can be found in clinical settings, including a prevalence of 9% to 12% in dermatology settings, 3% to 53% in cosmetic surgery settings, 14% to 42% in atypical major depressive disorder (MDD), and 8% to 37% in those with OCD. (Bjornsson). However, because many individuals with BDD feel ashamed of their appearance, these estimates may underreport its prevalence.
Any area of the body can be the focus of preoccupation, but the most common areas are skin (73%), hair (56%) and nose (37%). “On average, over their lifetime, persons with BDD are preoccupied with 5 to 7 different body parts” (Phillips). Like most mental health disorders, BDD does not affect only a certain age group. BDD has been reported in children as young as 5 and adults as old as 80 years of age (Albertini).
Because the research is limited and like most mental health disorders the etiology of BDD is complex and not known for certain. Risk factors for BDD include a family history of BDD, abnormal levels of brain chemicals, personality type and life experiences.
Symptoms of BDD include, but are not limited to:
Avoiding mirrors or reflective surfaces
Avoiding social activities
Constant mirror checking
Constant exercise or grooming
Constant comparing yourself with others
Not leaving the house, especially in the daytime
Seeing several healthcare providers about your appearance
Having unnecessary plastic surgeries
Picking at your skin with fingers or tweezers
Feeling anxious, depressed and ashamed
Camouflaging - trying to hide or cover up disliked body areas
Reassurance seeking and questioning of others about appearance
Obsessive compulsive disorder, social anxiety, depression and eating disorders are also common in those with BDD. A mental health professional will diagnose BDD based on your symptoms.
The most common treatments for BDD are therapy and medication based treatment. Cognitive behavioral therapy (CBT) has been shown to be helpful and currently the only research supported type of psychological treatment for BDD. Medication based treatment is a type of medication called serotonin reuptake inhibitors (SRIs).
Lastly, I want to mention the role social media has in BDD. With constant access to the world of social media, whether it is through Instagram, Tik Tok, Facebook, Twitter and many others, we are continually surrounded by unrealistic expectations for our bodies. Social media offers that there is a ‘perfect body’ and we all must look a certain way to be accepted. I’m here to tell you that the perfect body does not exist, despite what social media tells you. It is important to take regular breaks from social media, as well as mute or unfollow anyone who may be impacting you in a negative way and begin to follow positive accounts. One recent addition to Instagram is the ability to “see less” weight loss ads. This can be done by going through the following steps:
Open the Instagram app and go to “Settings”
Next, click “Ads”
Select “Ad topics”
Click the search bar and “body weight control” should be listed as an option.
Select “See less”