Most of us have some feature of our face or body that we might change if given the chance, but most people don’t actually change these features, and don’t think about them very often. With body dysmorphia, these perceived flaws become a fixation, and thinking about them or trying to cover them up can become an obsession. If you or someone you know has a fixation on a part of their appearance, you might have questions. You might wonder exactly what is body dysmorphia? Can it be treated? How is body dysmorphic disorder caused?
What is Body Dysmorphia?
Your first question is probably, what is body dysmorphia? If you suspect you, a friend, or a family member has body dysmorphia, you may already be familiar with some aspects. Body dysmorphia, also called body dysmorphic disorder or BDD, is a fixation on a slight flaw or perceived flaw with one’s face, skin, or body. This flaw might be a skin blemish, the size or shape of a facial feature, muscle tone, facial or body hair, or something else. It is important to note that, with body dysmorphic disorder, this perceived flaw is not noticeable or barely noticeable to other people. Body dysmorphic disorder is mainly a struggle with perception and fixation; someone with BDD believes there is something very wrong with their appearance when there isn’t. This fixation is not merely dissatisfaction with one aspect of a person’s appearance. Body dysmorphic disorder dominates a person’s life, interfering with social activities, work, school, and everyday life.
What Are the Symptoms of Body Dysmorphia?
For people with BDD, it is difficult to stop thinking about a perceived flaw. BDD is now classified as a type of Obsessive Compulsive Disorder (OCD), and shows similar symptoms. Similar to OCD, people with BDD suffer from intrusive thoughts and take part in rituals, such as a particular work-out or make-up routine, and repetitive acts, such as checking a mirror or picking at the skin.
Someone with body dysmorphia might do some or all of the following:
- Frequently check their appearance in a mirror
- Try to hide features with makeup, clothing or posture
- Spend an inordinate amount of time on their makeup, clothing or muscle tone
- Pick at their skin or pull their hair
- Seek cosmetic surgery
- Avoid certain activities or meeting new people
- Missing events or showing up late due to excessive grooming, changing clothes or exercising
- Seek validation about their appearance
- Frequently compare their appearance to others
Though BDD can appear as a fixation with one’s body shape, it should not be confused with symptoms of an eating disorder. People with eating disorders tend to fixate on body weight or appearance, and these disorders are classified and treated separately. Skin picking or hair-pulling (excoriation and trichotillomania) may also exist independent of BDD, and should not be confused.
Who Suffers From Body Dysmorphia?
Studies indicate that body dysmorphic disorder affects approximately 2% to 2.5% of the population. Many are surprised to learn that body dysmorphia affects men and women in almost equal numbers. Body dysmorphia often begins during late adolescence at approximately 16 to 18 years old, though it can appear at a later or earlier age. Though beauty standards and cultural norms vary between countries, body dysmorphic disorder appears in populations around the world. And though popular media plays a role in our self-image and what we perceive to be physically or aesthetically “normal,” descriptions of patients suffering from body dysmorphic disorder date back much farther than modern media, with cases recorded as early as 1891.
What Causes Body Dysmorphia?
No one knows exactly what causes body dysmorphia. Though there are risk factors that can increase the likelihood that someone will develop BDD, it is far from certain. These risk factors also correlate with other mental, emotional and behavioral disorders, so it is difficult to pinpoint what causes body dysmorphia.
Some risk factors for developing body dysmorphia are genetic and inherited from parents. People with blood relatives who have had body dysmorphic disorder, another type of obsessive compulsive disorder, or other mental, emotional, or behavioral disorders are at higher risk for developing BDD. Personality traits, such as perfectionism, are also risk factors. Existing mental or emotional health disorders, such as anxiety or depression, can also increase the likelihood of developing body dysmorphia. Environmental factors, such as bullying, childhood neglect, abuse, or trauma also increase the chances of developing BDD.
What Are the Impacts of Body Dysmorphia on Children?
Body dysmorphia usually develops in late adolescence, though it can develop earlier or later. In children, body dysmorphia can have a number of negative effects. As the child fixates on their perceived flaw, it can be difficult to make friends, attend social events, or even focus on their studies. They might frequently miss school or ask to stay home. Body dysmorphia can quickly undermine a child’s confidence, which can cause them to withdraw, develop anxiety or depression, or express anger or frustration in unhealthy ways. As the child tries to hide or change their appearance, body dysmorphia can lead to eating disorders, skin-picking, hair-pulling, or other harmful behaviors. Detecting the signs of body dysmorphia early and working with a therapist or counselor can help to reduce these harmful outcomes.
Can Body Dysmorphia be Treated?
Body dysmorphia can be successfully treated with therapy, medication or a combination of both. The first and most challenging step is diagnosing the disorder. Body dysmorphia can be difficult to diagnose for several reasons. Often, people with body dysmorphia believe there is something seriously wrong with their body that must be corrected, and they do not believe their perception is incorrect. This means many people seek medical procedures such as cosmetic surgery before or instead of seeing a therapist. Body dysmorphia also occurs frequently with other disorders, such as anxiety, depression, or substance abuse. Often, therapists may attempt to treat these disorders without realizing that body dysmorphia is the underlying cause. Many people with body dysmorphia are unwilling to talk about their perceived flaw and may hide their attempts to cover it. For all of these reasons, it is important to recognize body dysmorphia and work with an experienced therapist.
How is Body Dysmorphia Treated?
Once body dysmorphia has been properly diagnosed, it can be effectively treated. Experts recommend cognitive behavioral therapy (CBT), mindfulness-based behavioral therapy, or emotion regulation therapy (ERT) to treat body dysmorphic disorders. All of these therapies focus on removing judgement and subjectivity from reality in an attempt to correct the person’s perception of the harmless flaw. These therapies also focus on interrupting obsessive thoughts and fixations. It can also be helpful to interrupt repetitive behaviors. For example, it may be helpful to cover mirrors or remove some types of make-up.
What to Say to Someone With Body Dysmorphic Disorder
It can be difficult to know what to say to someone with body dysmorphic disorder. Since people with BDD struggle with an inaccurate perception of themselves, it can be difficult or impossible to convince them that the flaw that they perceive isn’t real. It’s tempting to use language like, “it isn’t a big deal,” or “you can hardly see it,” when talking about a perceived flaw, but this isn’t likely to be effective. If your friend or family member opens up to you about the flaws that they perceive, try to be open and supportive. Ask questions about their experience and their life, such as “why do you feel [perceived flaw] is so important?” or “how often do you think about it?” Challenge their perception in a gentle way, such as asking whether or not they perceive such flaws in other people, or whether or not the flaws would matter.
Your friend or family member with BDD may express an interest in changing their appearance through cosmetic surgery or other means. Encourage them to see a counselor instead, or to see a counselor first. If you can, introduce them to information about BDD, and ask them if the signs or symptoms seem familiar. Emphasize the impact that counseling can have on their lives and how they can stop fixating on their perceived flaws.
Michigan Counseling Centers (MCC) is the premier clinical therapy provider in the State of Michigan. Our highly-educated and highly-experienced therapists use a variety of approaches including counseling services, psychotherapy, and assessment/referral services, and our actions are tailored to the individual needs of you or your loved one.
Body dysmorphia can be a very difficult disorder to live with, but it can also be successfully treated. If you, a friend or a family member may be struggling with body dysmorphia, request a consultation with a therapist and talk about these challenges. Give us a call at (888) 622-3345 to make an appointment with a therapist in Taylor, Michigan or Bloomfield Hills, MI. Whether you are seeking therapy for yourself, a family member, or jointly with your partner and family, we can help.