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Body Dysmorphic Disorder

What is Body Dysmorphic Disorder?

Body Dysmorphic Disorder (BDD) is an obsessive preoccupation with a perceived defect or subtle imperfection(s) in physical appearance that can begin in childhood and become more pronounced during adolescence and adulthood. Generally individuals with BDD view themselves as unattractive or disfigured. The preoccupation causes excessive distress and may interfere with academic, employment, or social functioning. In some extreme scenarios individuals may go to great lengths to avoid interacting with others (quit their job, divorce their spouse, or seldom leave their home). Most notably, individuals find themselves spending a lot of time and energy thinking about, monitoring, masking, avoiding or attempting to improve their physical appearance. Some individuals may find the intensity of their obsession increases and decreases with little or no warning. Alternatively, they may find their obsession shift from one region of the body to another which can lead to further distress.

Approximately 5-40% of individuals receiving treatment for anxiety or depression and 6-15% evaluated for cosmetic surgery or dermatology services have been identified with BDD. While it is not entirely understood what triggers the onset of BDD, environment and genetics likely influence symptoms. BDD is thought to occur equally in men and women.

Common Physical Appearance Obsessions

  • Acne
  • Body or facial hair
  • Thinning hair on head
  • Scars or markings on skin
  • Moles
  • Coloring of skin complexion
  • Wrinkles
  • Facial asymmetry
  • Shape or size of facial features, various body parts, or muscles

Common Repetitive Behaviors

  • Frequent checking of the “defective” region(s) in mirrors or windows for reassurance about or an attempt to correct the perceived defect
  • Avoid examination of “defective” regions
  • Excessive grooming
  • Covering up “defective” region using make-up, hair products, clothing or positioning body in a particular way
  • Isolating self from others for fear others will see “defects”
  • Skin picking
  • Constant comparison between self and others physical appearance

Cognitive Behavior Therapy

Cognitive behavior therapy, particularly exposure and response prevention and challenging distorted beliefs about physical appearance, have been identified in research studies to improve overall body image by reducing obsessions, repetitive behaviors and overall distress associated with BDD. Clinical trials have also found medication combined with cognitive behavior therapy to be effective.

How to Get Started in Treatment

For further information about cognitive behavioral treatment for body dysmorphic disorder, or if you would like to schedule an appointment, please call the American Institute for Cognitive Therapy at 212-308-2440.

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