Evidenced-based Treatment for Body Dysmorphic Disorder

Contributor: Crystal Karges, MS, RDN, IBCLC, Special Projects Coordinator at Eating Disorder Hope/Addiction Hope

Female Student Talking To High School CounselorSome individuals may experience the occasional dislike towards their body or desire to change something about themselves. Body dissatisfaction or general poor body image can cause poor self-esteem or influence individuals to take more drastic measures in attempt to change or alter their appearance, such as plastic surgery or other medical/aesthetic interventions.

However, for other people, body dissatisfaction can be so severe and intense that it literally interferes with an individual’s ability to live a normal and healthy life.

What Is Body Dysmorphic Disorder?

Identified as Body Dysmorphic Disorder (BDD), otherwise known as dysmorphophobia, this severe mental disorder causes a person to perceive and believe extreme distortions about their body and appearance. A person suffering with BDD may actually believe that certain parts of their body are deformed or distorted or that their general appearance is disgusting and repulsive.

These preconceived notions about their appearance can lead them to make drastic changes in their life, such as remain isolated from people and social events, withdraw from the workforce, end the pursuit of a career or academic goals, and end relationships.

A person with BDD is typically consumed by their body image concerns and fears, to the point that they can think of or engage in little else. The individual experiencing BDD will constantly obsess over a perceived flaw, even if the flaw is nonexistent or essentially minimal1.

The Clinical Symptoms of BDD

middleagewomenbodyissuesBody dysmorphic disorder is classified as a separate disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), defined by a preoccupation with an imagined defect in appearance; if a slight physical anomaly is present, the person’s distress is prominently excessive2.

Clinical features apparent in a person who is suffering with BDD include compulsive and repetitive behaviors which are aimed at improving, disguising, or examining the perceived “defect”, which may be an area of the head, face, or body.

Common behaviors that might be observed in an individual with BDD include:

  • Frequent body checking or measuring
  • Excessive grooming
  • Comparing body size and shape with others
  • Mirror checking
  • Camouflaging
  • Avoiding
  • Skin picking
  • Attempting to alter body size by excessive exercise or restrictive eating

Evidenced-Based Treatments for BDD

Depressed woman talking with her therapistBDD is a problematic disorder that can severely hinder a person from living a normal life. Early intervention and treatment can help prevent more complicated issues as well as allow a person to find healing and restoration. Finding health care providers that specialize in body dysmorphic disorder can be an important part of connecting to treatment that will allow for recovery.

Some evidenced-based treatments that may be utilized by practitioners who specialize in this area include various forms of psychotherapy in combination with medication management. While treatment research is limited and is ongoing, data has revealed that serotonin reuptake inhibitors (SRIs) in addition to cognitive-behavioral therapy may be the most effective treatment of choice for individuals struggling with Body Dysmorphic Disorder3.

Many studies have also looked at the effectiveness of exposure therapy and cognitive plus behavioral techniques, which have shown promising outcomes for sufferers of BDD.

Research on BDD

While research is limited, the data gathered from studies completed on treatment for BDD is promising helpful in understanding how to improve outcomes for those suffering. Ongoing research can also help emphasize that what BDD sufferers truly need to recover is not surgical interventions but appropriate psychiatric care and treatment.

Trying to fix a perceived flaw will not rid an BDD sufferer of their problem, as they will likely only move on to the next problem area. Treatment must hit the underlying causes to allow a person to truly heal and recover.

Community Discussion – Share your thoughts here!

Have you recovered from body dysmorphic disorder? What evidenced-based treatments were helpful for you in recovering and healing from body dysmorphic disorder? What encouragement might you offer to other individuals sharing a similar battle with body dysmorphic disorder?


References:

  1. Phillips KA Body dysmorphic disorder: the distress of imagined ugliness. Am J Psychiatry. 1991 Sep; 148(9):1138-49.
  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Association; 2013.
  3. Neziroglu F, Khemlani-Patel S A review of cognitive and behavioral treatment for body dysmorphic disorder. CNS Spectr. 2002 Jun; 7(6):464-71.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 29, 2016

Published on EatingDisorderHope.com