It’s All in the Mind: Body Dysmorphic Disorder
Its’ all about appearance, be it perceived or real. Research suggests that most people form their opinion
about others in the first 3 – 5 seconds of meeting them. Is it any wonder then, that most of us place
undue emphasis on our appearance or image? And so do our young teens? While almost all of us have
normal appearance concerns, it becomes rather unhealthy when these concerns start resembling
obsessions / compulsions.
In my last blog, we had discussed body image issues, and one of the repercussions mentioned was
Body Dysmorphic Disorder or BDD. Let’s look into this in detail. What is BDD? Simply put, it is extreme
preoccupation with one or more perceived defects or flaws in physical appearance that are not really
observable to others. If at all these defects are observable to others, then, they are very minute and
easily ignorable. A person can be said to be suffering from BDD, if along with this preoccupation, the
person has also engaged in behaviours like skin picking or frequently compares oneself with others. It
is important to understand that we all have appearance concerns and engage in comparing ourselves
or our children to one another. But such behaviour can be labelled as BDD only if, these concerns
cause significant disturbance in almost all areas of life.
The most common areas of concern for people with BDD include:
In males especially, muscle dysmorphia (preoccupation with the idea that one’s body is too small or too
Face & hair;
Why is the concept of BDD relevant to parenting?
The most common age of onset for BDD is 12-13 yrs. This is the period marking the beginning of adolescence
and a time of crucial, emotional and physical changes for the teen. Roughly 2/3 rd of people with BDD have the
onset before they turn 18. These statistics make BDD a concern that needs to be addressed by everyone who deals
with teens and young adults. Factors such as having parents who have BDD, childhood abuse & neglect, presence
of low self-esteem, societal expectations, and presence of conditions like anxiety, predisposes one to developing
What are the early warning signs which suggest that someone you know may have BDD?
As already mentioned, a preoccupation with the physical appearance;
Frequent examination in the mirror or avoidance of it altogether;
Feeling of ugliness and often talking about it;
A need to stay housebound and avoid social situations;
Frequently seeking assurance from others regarding any specific feature or whole of one’s appearance;
Excessive grooming, for e.g., skin picking to the extent that it can cause severe skin damage;
What can you do if your teen shows the BDD symptoms?
Read up about what is BDD and how you can approach the subject with the concerned person;
Be open to your teen’s views about body image and discuss as to why they hold these views (if unhealthy);
Talk frequently about the importance of being content with oneself. Model being happy with your body, in
front of your teen if needed, as this will help them.
Seek professional help. The professionals that you will need to see in a suspected case of BDD include: (a) your
physician – who can conduct any physical examinations to ascertain the presence/absence and extent of the
perceived defect; & (b) psychologist / mental health provider- who can talk about the feelings, thoughts,
behaviour patterns, and help with changing the unfounded beliefs or actions.
It is important to remember that BDD goes hand in hand with suicide risk, and this risk is high in adolescence.
You need to find out if your teen is having suicidal ideation and seek professional help on an urgent basis if
Body dysmorphic disorder, may not seem to appear as life threatening as several other mental conditions. This is
not true, however, because an adolescent / adult suffering from BDD is often at the risk of poor everyday
functioning, including a high risk of hospitalisation, much like in the case of other mental conditions. For
instance, a normal looking teen having BDD, may suddenly start coming up with reasons not to go to school,
when the real reason is that she / he feels “ugly”. 20% of youth with BDD report dropping out of school mainly
because of their BDD symptoms.
Help for BDD is easily available in the form of psychotherapy, medications and if needed, in-patient care. Body
dysmorphic symptoms have the power to consume one’s life. Given its early age of onset, it’s important that we,
and all who deal with young minds, keep a track of any warning sign and provide help at the earliest. Also see
more info @ http://www.parentedge.in
1. DSM 5