Body Image in Los Angeles | Body Dysmorphic Disorder 101

Watch CNS Executive Medical Director, Michael Mamoun M.D., discuss B.D.D. and body image in Los Angeles on Dr. Drew’s Lifechangers:

Can dissatisfaction about a perceived body flaw be a sign of a serious psychiatric disorder?

Yes. Body dysmorphic disorder, or B.D.D., is an unusual condition in which people become obsessed about perceived body flaws and repetitively seek extreme actions to change those perceived flaws. Research suggests that approximately 56% of women and 43% of men are dissatisfied with their overall appearance. But, not everyone who dislikes something about their appearance has B.D.D. -– in fact, most don’t.

The skin, hair, and nose are frequent areas of concern in BDD. Given these common areas of obsession in BDD, the fields of dermatology and surgery have extensive literature on BDD. Dermatologists and primary care physicians, non-psychiatric professionals, usually recognize BDD in patients that repeatedly seek cosmetic surgery. The shame associated with BDD prevents people from seeking psychological care. Therefore, BDD is an under-diagnosed and under-treated disorder.

BDD presents challenges to life-functioning, in addition to the issue of self-esteem. Patients may worry about acne, marks, pale skin, balding, or a large nose. Obsessions may manifest as obstructive grooming rituals, such as styling or cutting hair for hours each day.

It may seem that a simple surgery may relieve B.D.D. That’s not the case. Often, one procedure does not eliminate the obsession over a body part, which may remain or be redirected to another bodily feature. Usually, one procedure does not eliminate the desire for more cosmetic surgery. Internal factors associated with B.D.D. remain.

Treatments for B.D.D. attempt to address underlying issues:

• Cognitive therapy attempts to dispel the false belief about the perceived defect
• Behavioral therapy works to eliminate compulsion to fix the supposed defect
• Group or family therapy offers social support, which has been proven to helpful in B.D.D.
• Medications are also effective treatments, given that B.D.D. is associated with other anxiety disorders. SSRIs help in decreasing obsessions and repetitive behaviors of B.D.D., as well as OCD

These treatments have been proven to be effective in treating B.D.D., especially when multiple methods are used in conjunction.

Learn more about Body Dysmorphic Disorder:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181960/pdf/DialoguesClinNeurosci-12-221.pdf