What is body dysmorphia?
Body dysmorphia is the term for a condition that causes an individual to be overwhelmingly focused on perceived flaws in their appearance. This is a distorted perception – evident to the affected individual in a very different way than everyone else.
There is compulsive checking of the imperfections or flaws which causes high levels of distress and disruption to the individual’s life. For example, the person may become socially isolated because they fear responses to their perceived flaws or become overwhelmed by repeated actions to hide perceived flaws. Body dysmorphia may be expressed as mirror checking repeated so often as to disrupt normal life and negative comparison with others, often on social media.
Is body dysmorphia an eating disorder?
Body dysmorphia is not about overall weight, shape and body image. A person with body dysmorphia may be highly distressed about perceived flaws in their face or skin, for example, but eat normally, without concerns about weight, shape or body image.
As such, body dysmorphia is not in itself, an eating disorder. However, some forms of body dysmorphia can be a trigger for the development of an eating disorder.
How is body dysmorphia diagnosed?
Body Dysmorphia, also known as Body Dysmorphic disorder, is a recognised mental health condition described in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition). According to these key guidelines, these are the features of body dysmorphia used to make a diagnosis:
- The individual is highly preoccupied with perceived flaws which are not apparent to others
- There is a repetitive behaviour component associated with the perceived flaws, for example, very excessive mirror checking
- Diagnosis will consider the individual’s insight and response to reassurance: people with a mild disorder can be distracted and reassured to some extent. Those with more severe body dysmorphia will be wholly convinced of the imperfection and overwhelmed by it.
How common is body dysmorphia?
Body dysmorphia can occur at any age, but most commonly develops during adolescence. According to the DMS-5 data, the average age when body dysmorphia developed is 16 to 17. The condition affects males and females roughly equally, at around 2.5 per cent and 2.2 per cent respectively (American Psychiatric Association, 2013).
What causes body dysmorphia?
The causes of body dysmorphia are not fully understood. There is likely to be a range of possible factors and higher risk groups. These include:
- There is a link between Obsessive Compulsive Disorder (OCD) and body dysmorphia. Some clinicians believe body dysmorphia is a form of OCD. Studies have shown people with OCD themselves, or with OCD within their close family are more likely to develop body dysmorphia
- There is a theory that body dysmorphia is linked to chemical imbalances in the brain, particularly in low levels of serotonin
- Trauma and distressing experiences, such as bullying, can be a trigger for the development of body dysmorphia
- There is a link between perfectionism and body dysmorphia
How is body dysmorphia treated?
There is a good evidence base for the use of Cognitive Behavioural Therapy (CBT) as a way of treating body dysmorphia by challenging the distorted perceptions underpinning the disorder. If there are impacts such as depression, this may need to be treated with medication. For some people, body dysmorphia will be interlinked with an eating disorder and in this situation, a full assessment is required and treatment programme that addresses all aspects of the eating disorder, including body dysmorphia.