Body Dysmorphia Disorder (BDD)

Body dysmorphic disorder (BDD) is an anxiety disorder in which you become fixated on one or more ‘flaws’ about your appearance. Anyone can develop BDD about any part of their body, though BDD is more prevalent in the LGBT+ community. BDD can lead to social ostracization, depression, and anxiety. BDD is not curable though it is treatable; many with BDD go through cognitive behavioral therapy (CBT), start medication, and others opt for cosmetic surgery. Transgender individuals may suffer from BDD though it is more likely that they are suffering from gender dysphoria (GD). Those with gender dysphoria do not have a distorted version of themselves they know who they are on the inside though it does not match their sex assigned at birth. BDD and GD are separate diagnoses and this article will be focusing on treatment options for BDD.  

Cognitive-behavioral therapy (CBT) works to change ones thinking patterns and focus on three core principles. Psychological problems are in some part based on faulty or unhelpful ways of thinking, learned patterns of unhelpful behaviors, and those suffering from psychological problems can learn how to cope with their psychological problems. Some of these coping strategies include: Learning to recognize one’s distortions in thinking that are creating problems, gaining a better understanding of the behavior and motivation of others, using problem-solving skills to cope with difficult situations, and learning to develop a greater sense of confidence in one’s abilities. CBT can be used to treat a wide range of psychological distress, including BDD.

The most common medication used to treat BDD are serotonin reuptake inhibitors (SRIs), these antidepressants that help reduce obsessive thoughts and compulsive behaviors. Studies done on fluoxetine and clomipramine showed their effectiveness. A study was done where ½ the group would receive the medication and the other half would receive a sugar pill; this was done to reduce the placebo effect. There were positive results from the medication and the examiners were able to distinguish between the placebo effects and medication effects.    

Cosmetic surgery is not the most prevalent treatment for BDD though some opt for it in hopes to ‘fix’ their perceived flaw. Some research has shown that cosmetic surgery is not a reliable option for those living with BDD, the reason being that most then move to fixate on another part of their body or become unsatisfied with the surgery. Cosmetic surgery has been found helpful in transgendered individuals living with BDD and GD. However, in transgender individuals, gender reassignment surgery and other cosmetic surgeries are treating gender dysphoria (GD) not body dysmorphic disorder, as stated prior these are separate diagnoses.   

In some men, BDD appears as muscle dysmorphia where men believe that their body is not muscular or lean enough. A 2014 study found that this type of BDD causes an increase use of illegal use among bi and gay men. The media can cause a spike in BDD though altering pictures, this affect is increased in the LGBT+ community. BDD can’t be cured, though cosmetic items can be worn to minimize the effects, some opt for cosmetic surgery to help alter their body and limit the effects of BDD. Transgender individuals in the LGBT+ community are the most likely to receive cosmetic surgery. Anyone can have BDD and should seek treatment with a professional.

References

Walen, A., Founder, B., Thom Rutledge Author of Embracing Fear, & Dr. Elizabeth Winter Associate Professor of Psychiatry at Johns Hopkins Medical School. (2018, September 24). Talking about Lbgtq, BDD, and Ed (but NOT GD). Retrieved February 05, 2021, from https://thebodyimagecenter.com/news-blogs/nutrition/talking-lbgtq-bdd-ed-but-gd/#:~:text=While%20BDD%20may%20impact%20anyone,or%20multiple%20unnecessary%20cosmetic%20surgeries.

Walen, A., Founder, B., Thom Rutledge Author of Embracing Fear, & Dr. Elizabeth Winter Associate Professor of Psychiatry at Johns Hopkins Medical School. (2017, June 20). A “modern” diagnosis: Body dysmorphic disorder. Retrieved February 07, 2021, from https://thebodyimagecenter.com/news-blogs/body-image/modern-diagnosis-body-dysmorphic-disorder/

Callahan, K. (2014, August 08). Stop confusing gender dysphoria with body dysmorphia already. Retrieved February 07, 2021, from https://roygbiv.jezebel.com/stop-confusing-gender-dysphoria-with-body-dysmorphia-al-1583049920

Mayo Clinic. (2019, October 29). Body dysmorphic disorder. Retrieved February 07, 2021, from https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/symptoms-causes/syc-20353938#:~:text=Body%20dysmorphic%20disorder%20is%20a,may%20avoid%20many%20social%20situations.

APA. (2017). What is cognitive behavioral therapy? Retrieved February 07, 2021, from https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

Phillips, K. A., MD. (2019, January 10). Diagnosing bdd. Retrieved February 07, 2021, from https://bdd.iocdf.org/professionals/diagnosis/

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