2054

A disorder resulting in preoccupation of a patient with what they regard as defects in their bodies or faces.

Body dysmorphic disorder (BDD), is a mental disorder defined by an overwhelming preoccupation with a perceived flaw in one’s physical appearance.

It is a delusional variant, the flaw is imagined.

If an actual visible difference exists, its importance is disproportionately magnified in the mind of the individual.

Ruminations concerning this perceived defect become pervasive and intrusive, consuming substantial mental bandwidth for extended periods each day.

This preoccupation induces severe emotional distress but also disrupts daily functioning and activities.

BDD is placed within the obsessive–compulsive spectrum, distinguishing it from disorders such as anorexia nervosa.

BDD is estimated to affect from 0.7% to 2.4% of the population.

It usually starts during adolescence and affects both men and women.

The BDD subtype of muscle dysmorphia, perceiving the body as too small, affects mostly males.

The sufferer compares the perceived flaw repetitively and can adopt unusual routines to avoid social contact that exposes it.

BDD is underdiagnosed.

The BDD disorder severely impairs quality of life due to educational and occupational dysfunction and social isolation, those experiencing BDD tend to have high rates of suicidal thoughts and may attempt suicide.

Dislike of one’s appearance is common.

People with BDD have extreme misperceptions about their physical appearance.

Vanity involves a quest to aggrandize the appearance.

BDD is experienced as a quest to merely normalize the appearance.

Although delusional in about one of three cases, the appearance concern is usually non-delusional, an overvalued idea.

The bodily area of focus in BDD is commonly face, skin, stomach, arms and legs, but can be nearly any part of the body.

Multiple sites can be focused on simultaneously.

A subtype of body dysmorphic disorder is bigorexia or muscle dysphoria.

In muscular dysphoria, patients perceive their body as excessively thin despite being muscular and trained.

Many seek dermatological treatment or cosmetic surgery, which typically does not resolve their distress.

BDD is an obsessive–compulsive disorder.

BDD involves more depression and social avoidance despite a degree of overlap with obsessive-compulsive disorder.

BDD is often associated with social anxiety disorder (SAD).

Some BDD individuals experience delusions that others are covertly pointing out their flaws..

Cognitive testing and neuroimaging suggest both a bias of detailed visual analysis and a tendency toward emotional hyper-arousal.

Most ruminate over the perceived bodily defect several hours daily or longer, and use either social avoidance or camouflaging with cosmetics or apparel, repetitively check their appearance, comparing it to that of other people, and might often seek verbal reassurances.

BBD patients may sometimes avoid mirrors, repetitively change outfits, groom excessively, or restrict eating.

Its severity can wax and wane.

Flareups tend to yield absences from school, work, or socializing, sometimes leading to protracted social isolation, with some becoming housebound for extended periods.

Social impairment can approach avoidance of all social activities.

Poor concentration and motivation impair academic and occupational performance .

The distress of BDD tends to exceed that of major depressive disorder and rates of suicidal ideation and attempts are especially high.

As many as 45% of teenage boys may suffer from body dysmorphic disorder (BDD), a mental illness whereby an individual compulsively focuses on self-perceived bodily flaws.

BDD’s cause is likely intricate, biopsychosocial factors through an interaction of multiple factors, including genetic, developmental, psychological, social, and cultural.

BDD usually develops during early adolescence.

Many patients note earlier trauma, abuse, neglect, teasing, or bullying.

In many cases social anxiety earlier in life precedes BDD.

Though twin studies are few, one estimated its heritability at 43%.

Other risk factors may be introversion, negative body image, perfectionism, heightened aesthetic sensitivity, childhood abuse and neglect.

The development of body dysmorphia can stem from trauma caused by parents/guardians, family, or close friends.

The prevalence of childhood maltreatment among adults with body dysmorphia, is more than 75%

The constant use of social media and “selfie taking” may translate into low self-esteem and body dysmorphic tendencies.

Messages given by media and peers about the importance of appearance may be internalized by individuals who adopt others’ standards of beauty as their own.

Due to excessive social media use and selfie taking, individuals may become preoccupied about presenting an ideal photograph for the public.

Females’ mental health has been the most affected by persistent exposure to social media: Girls with BDD present symptoms of low self-esteem and negative self-evaluation.

A factor of why individuals have body dysmorphia can come from women comparing themselves with media images of ideal female attractiveness, a perceived discrepancy between their actual attractiveness and the media’s standard of attractiveness is likely to result.

Individual’s who have low self-esteem participate more often in trends of taking selfies along with using social media to mediate their interpersonal interaction in order to fulfill their self-esteem needs.

The self-verification theory, explains how individuals use selfies to gain verification from others through likes and comments.

Social media may trigger misconceptions about their physical look.

Individuals with body dysmorphic tendencies, such behavior may lead to constant seeking of approval, self-evaluation and even depression.

Social media use is found to be significantly associated with greater body image dissatisfaction.

It is highlighted that comparisons appear between body image dissatisfaction and BDD symptomatology. They concluded that heavy social media use may mediate the onset of sub-threshold BDD.

Individuals with BDD tend to engage in heavy plastic surgery use.

Women are still considered the predominant gender to experience BDD.

With social media platforms, individuals are able to seek validation and openly compare their physical appearance to online influences, finding more flaws and defects in their own appearance.

Such a process leads to attempts to conceal the defect such as seeking out surgeons to resolve the issue of perceived ugliness.

Different cultures place much emphasis on correcting the human body aesthetic, and that this preoccupation with body image is not exclusive to just one society.

Physically editing the body is not unique to any one culture, and is more common throughout Western society and is on the rise.

In Western societies, there has been an increase in disorders such as Body dysmorphic disorder, arising from ideals around the aesthetic of the human body.

BDD is linked to high comorbidity and suicidality rates.

Caucasian women show higher rates of body dissatisfaction than women of different ethnic backgrounds and societies.

Thinness is valued, and beauty is obsessed in Western culture, where advertising, marketing, and social media play a large role in promoting the perfect body shape, size, and look.

Cultural groups who experience food insecurity generally prefer larger-bodied women.

However, many societies that have abundant access to food also value moderate to larger bodies.

BDD is commonly misdiagnosed as social anxiety disorder, obsessive–compulsive disorder, major depressive disorder, or social phobia.

Social anxiety disorder and BDD are highly comorbid.

Those with BDD, 12–68.8% also have SAD; within those with SAD, 4.8-12% also have BDD).

BDD is also comorbid with eating disorders, up to 12% comorbidity in one study.

Both eating and body dysmorphic disorders are concerned with physical appearance, but eating disorders tend to focus more on weight rather than one’s general appearance.

BDD has a high suicide rate, at 2–12 times higher than the national average.

Treatment:

Anti-depressant medication, such as selective serotonin reuptake inhibitors (SSRIs), and cognitive-behavioral therapy (CBT) are considered effective.

SSRIs can help relieve obsessive–compulsive and delusional traits, while cognitive-behavioral therapy can help patients recognize faulty thought patterns.

For many people with BDD, cosmetic surgery does not work to alleviate the symptoms of BDD as their opinion of their appearance is not grounded in reality.

Body dysmorphic disorder (BDD), is a mental disorder defined by an overwhelming preoccupation with a perceived flaw in one’s physical appearance.

It is Ia delusional variant, the flaw is imagined.