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Body Image Disorders

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Body Image Disorders

Body Dissatisfaction

Dissatisfaction with one's appearance is a common problem: 43% of men and 56% of women reported discontent about their overall appearance. People may be concerned about flaws in their skin, hair, face, or general body build. However, some people worry so much about their appearance that is causes them great distress and interferes with their daily functioning.

Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is a severe example of body dissatisfaction. It is an extreme preoccupation with an imagined or very minor defect in appearance. Concerns about the defect can cause significant distress and problems with occupational, educational, and social functioning.

BDD has some similarities with Obessive-Compulsive Disorder (OCD). Like OCD, BDD sufferers often have compulsive behaviors that are intended to temporarily reduce anxiety. For example, individuals with BDD may check their appearance by looking in mirrors to relieve fears or ask for reassurance from a loved one about their looks. Unfortunately, at best these techniques result only in short-term relief. The obsessions in BDD are centered on appearance and are generally specific, e.g. believing one has a disfiguring crooked lip, but may also be vague, for example that something is wrong with one's face. The focus of concern is most often the face and head, but may include other body parts or body frame as a whole.
The prevalence of BDD is estimated to be 1 to 2% of general population. In mental health settings the prevalence ranges from 5 to 40%, and in dermatology or cosmetic surgery settings it can range from 6 to15%.

Cognitive-Behavioral Description of Body Dissatisfaction

Body dissatisfaction is maintained through attempts to reduce distress without correcting maladaptive beliefs. Situations that are likely to cause distress include mirrors and public places. Maladaptive beliefs that people may have include being too ugly to be loved or to have good things happen for them, and they believe these fears to be unmanageable. A preoccupation with a physical defect (e.g., embarrassment, not being accepted, looking ugly) can include taking actions to reduce distress comparing oneself to others, checking in mirrors or avoiding them altogether, seeking reassurance, camouflaging the defect, searching for medical remedies, excessive grooming, and avoiding social events. These behaviors keep the person from learning that attractiveness is not the sole determining factor in happiness and success. It can also lead to extreme social isolation, which falsely confirms the conviction that if one is unattractive, one can be happy with oneself or perform well around others.

Cognitive-Behavioral Treatment

Cognitive-behavioral treatment can help individuals with body dissatisfaction. Treatment includes managing symptoms of anxiety and depression, challenging maladaptive beliefs, and increasing functional behavior. Patients begin by learning more about their difficulties and techniques for managing their anxiety. Therapists work with their patients to challenge irrational beliefs such as "only extremely attractive people can be happy and successful" or "no one will love me until my appearance changes". Patients learn to respond more effectively to their beliefs by examining the evidence, considering alternative explanations, and changing standards of worth and self-image. Finally, patients are supported in improving their daily functioning. Therapists help their patients actively participate in meaningful activities, such as attending school or work, participating in social events, and resuming previous interests.

For More Information:

Broken Mirror: Understanding and Treating Body Dysmorphic Disorder
Katharine Phillips
ISBN 0195121260

The BDD Workbook:
Overcome Body Dysmorphic Disorder and End Body Image Obsessions
James Claiborn & Cherry Pedrick
ISBN1572242930

The Feeling Good Handbook
David Burns
ISBN 0688017452

Neysa Jane
Body Dysmorphic Disorder Fund, Inc.
239-594-5421
neysabdd@comcast.net

If you suspect that you or someone you know is struggling with Body Dissatisfaction, contact one of our eating disorder specialists for help.