In a world where social media frequently establishes unattainable beauty standards, many believe that appearance equals to power. Some invest excessive time and effort in their appearance and may develop debilitating obsession with perceived flaws, which can manifest a condition called Body Dysmorphic Disorder (BDD). Individuals with BDD constantly check themselves and compare themselves with others, concealing flaws through camouflage and avoiding social activities. The repetitive and dysfunctional behaviours related to appearance concerns may disrupt daily functioning and result in anxiety and depression and even suicidal thoughts. BDD is a growing mental health concern, but is often misinterpreted and under-diagnosed.
Is Body Dysmorphic Disorder Only for Women?
No. While it is true that women are frequently surrounded with ideation about beauty and body image on social media, men are equally affected by this disorder due to societal expectations about appearance. The variation lies in the different areas of focus and different reactions to such concerns. Women tend to be more preoccupied with skin, face, hair, and weight, and they may engage in excessive mirror checking, makeup application and skin picking. They also have a much greater tendency to opt for cosmetic procedures in dealing with their BDD. Men are more likely to be concerned about physical build, muscle, and hair loss. They may engage in activities like excessive bodybuilding, misuse of steroids, and extensive grooming to attain their desired image.
Is Body Dysmorphic Disorder Specific to Certain Groups?
No. BDD symptoms are broadly similar across various races and cultures, as atheistic ideals and body dissatisfaction are becoming more universal, and the pressure to appear “perfect” affects all cultures. However, cultural factors may impact the content and presentation of BDD symptoms in certain ways. For example, in America, White and Latina women are more dissatisfied with their face features and body shape compared to black women. Cultural values and societal pressures related to aesthetic standards may have contributed to this disparity.
Is Body Dysmorphic Disorder Caused by Perfectionism?
Partially, but not completely. While BDD can be strongly influenced by personal values and beliefs, recent research has highlighted that trauma and shame are among the most critical psychological factors for the manifestation of BDD. Childhood experiences of maltreatment, abuse, and neglect are identified to have contributed to the development of BDD. Individuals with BDD commonly have a past of suffering from shame experiences, i.e. being bullied and teased about their appearance and abilities.
Will Cosmetic Surgery End My Body Dysmorphic Disorder?
No. BDD can trigger endless pursuit of unnecessary and excessive plastic surgery. In reality, over 90% of BDD patients who undergo cosmetic procedures are left unsatisfied with the results, which can further deteriorate their mental condition. Individuals with BDD may develop new preoccupations over time if they do not recognise the issue as a psychological condition rather than a physical one. They tend to shift their attention to different parts of their body even after one aspect of their appearance is considered “improved”. Studies showed that approximately 15% of plastic surgery patients had BDD, of which over 70% were women. There are risks associated with such procedures, which may exacerbate the BDD symptoms.
Body Dysmorphic Disorder’s Impact on Life
BDD is detrimental to social functioning, resulting in avoiding social situations altogether, withdrawing from friends, and difficulty having intimate relationships. In worst cases, BDD may stop people from leaving their homes completely for years. Individuals with BDD perform worse on cognitive functioning than healthy individuals which may inhibit their occupational success. Over one-third of the individuals with BDD are incapable of staying employed because of psychosocial dysfunction, which produces devastating financial outcomes.
Psychological Intervention for Body Dysmorphic Disorder
Cognitions play an critical role in the development of BDD. Cognitive-Behavioural Therapy (CBT) can help individuals recognise and challenge negative thoughts about their appearance, replacing them with more realistic and adaptive ones. A high-quality CBT course should help individuals gradually engage in activities and tasks, learn to shift their focus away from appearance, and build self-esteem. Acceptance and Commitment Therapy (ACT) has also shown good efficacy in addressing appearance-related anxiety concerns, which sheds more light on the importance of acknowledging and accepting one’s inner emotions and thoughts as a typical part of life rather than avoiding or denying them, so that individuals can make better choices that enable them to move forward.
Suggestions for Self-management
Individuals with BDD are encouraged to make lifestyle adjustments, engaging in moderate exercises, getting enough sleep, having a healthy diet, and practicing relaxation techniques such as breathing exercises, muscle relaxation and mindfulness. To refrain from obsessive body-checking, individuals with BDD may rely on various approaches to facilitate this process, including self-monitoring of patterns and duration of body checking, self-affirmations, and using distractions.
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References
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). American Psychiatric Publishing.
2. Grogan, S. (2021). Body image: Understanding body dissatisfaction in men, women and children. Routledge.
3. Malcolm, A., Pikoos, T. D., Grace, S. A., Castle, D. J., & Rossell, S. L. (2021). Childhood maltreatment and trauma is common and severe in body dysmorphic disorder. Comprehensive Psychiatry, 109, 152256.
4. Schneider, S. C., Turner, C. M., Eric A. Storch, E. A., & Hudson, J. L. (2019). Body dysmorphic disorder symptoms and quality of life: The role of clinical and demographic variables. Journal of Obsessive-Compulsive and Related Disorders, 21, 1–5.
5. Singh, A. R., & Veale, D. (2019). Understanding and treating body dysmorphic disorder. Indian Journal of Psychiatry, 61(1), S131.