“You have been criticising yourself for years and it hasn’t worked. Try approving of yourself and see what happens” – Louise Hay

What is Body Dysmorphic Disorder (BDD)?

BDD is a mental health condition which is characterised by obsessive thoughts and preoccupations that one’s physical appearance is flawed. These flaws tend to be unnoticeable to others.

Whilst BDD can affect any age group, it is most commonly seen in teenagers and young adults, and it affects both males and females. BDD is a closely related mental health condition to Obsessive Compulsive Disorder (OCD).

What are the Symptoms of BDD?

Individuals with BDD tend to excessively worry about one or more areas of their body, which they perceive to be ‘unattractive’, ‘abnormal’ or ‘flawed’. This preoccupation with appearance tends to fuel further self-critical judgements and thinking biases.

Often, the individual will engage in repetitive behaviours such as skin picking, checking the body area, comparing themselves to others, and reassurance seeking to relieve their distress. It is not uncommon for individuals with BDD to also research and seek cosmetic surgery. Furthermore, individuals with BDD tend to avoid situations where they believe their perceived flaws could be exposed.

According to cognitive and behavioural theory, the combination of thinking patterns and biases, as well as behavioural coping strategies and avoidance, are hypothesised to maintain the cycle of BDD, and ultimately exacerbate the individual’s overall anxiety and distress.

BDD can result in significant impairment to daily functioning, such as in relationships and work. This may explain why individual’s with BDD commonly present with other areas of difficulty, such as depression, eating disorders and substance misuse.

What Causes BDD?

The exact causes of BDD are unknown, however the factors that contribute to its development are likely multifaceted and may be explained by a biopsychosocial model:

Biological Factors:

• A genetic predisposition and/or history of familial mental health – BDD is common amongst those with a first-degree relative with OCD, such as a parent or sibling.
• An existing mental health condition (e.g. depression, OCD)

Psychological Factors:

• History of childhood abuse or neglect
• Growing up in an invalidating social environment, where beliefs about ‘not being good enough’ were reinforced

Social Factors:

• Socio-cultural beliefs and norms such as idealized beauty standards, which are reinforced via social media and the press

What is the Evidence-Based Treatment for BDD?

Whilst cosmetic surgery may feel like an ‘obvious quick fix’, we would encourage individuals who suspect they have BDD to arrange a psychological assessment in the first instance. Cosmetic treatment does not address the underlying psychological processes contributing to BDD, and thus is not a ‘guaranteed cure’.

The evidence-based treatment for BDD is Cognitive Behaviour Therapy, which involves an Exposure and Response Prevention (ERP) component.

To arrange an assessment, please get in touch: hello@thefitzroviaclinic.com. To read more about BDD, visit https://thefitzroviaclinic.com/what-we-treat/body-dysmorphic-disorder-bdd/.