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Body Dysmorphic Disorder


Updated March 10, 2009

On the Horizon for BDD

There is a new study currently underway which takes a look at the way BDD sufferers visually process information. The goal of the study is to determine whether the brains of BDD sufferers process visual information differently from the brains of normal healthy control subjects. If that is the case, it may explain the distortions in BDD patients’ perception of their appearance.

The study will use a functional MRI to compare brain activity of BDD patients when asked to process certain visual information to the brain activity of the subjects in the control group. The hope is that the results will give researchers clues to help develop and refine treatments for the disorder.

Risks of leaving BDD untreated

BDD significantly affects the lives of those who suffer from it. Patients tend to isolate themselves from others, pushing away family members or potential romantic partners, and avoiding social situations. In extreme cases, patients may feel emotionally unable to face venturing out of their homes, even to go to work, and many of those patients will become housebound.

In addition to the potential loss of friends, jobs, and a life away from the mirror, there are even more serious risks if BDD goes untreated. Suicide is the most troubling risk factor in dealing with BDD patients. In fact, BDD patients display a suicide attempt rate that is on par with bi-polar disorder and schizophrenia. Also disconcerting are the statistics about BDD and substance abuse. It is estimated that chemical dependency and/or alcohol abuse become a factor in close to 50% of BDD cases.

Secondary Disorders

The most common “side-effect” of BDD is depression, which can make BDD even harder to diagnose. Treatment is also more difficult, since depression tends to produce a patient who is unmotivated to participate in his or her own healing. In addition, the BDD patient in fact has a high likelihood of becoming anorexic or bulimic.

Misconceptions About BDD

Misconceptions about BDD abound, with some people assuming it is synonymous with vanity. In fact, it is the exact opposite. People with BDD do not want to think about their looks, and do not enjoy their reflections in the mirror. They simply can’t stop their obsessive thoughts, and they become defined by what they imagine to be their “deformity”.

BDD patients suffer from distortion in their perception of their own appearance, and selectively zero in on the smallest details of their defects. They also tend to closely scrutinize the details of the appearance of others, constantly (and unfavorably) comparing them to their own defects.

BDD & Plastic Surgery

Most BDD sufferers, especially those who remain undiagnosed, fail to recognize that their problem originates in the brain. Instead, they mistakenly believe that if they could only fix their “deformed” physical appearance, all would be right with the world. So they seek out plastic surgery, assuming that the surgeon will immediately see how severe their defects are, and will correct them, thereby almost magically transforming their lives.

Unfortunately, people who suffer from BDD are rarely satisfied with the outcomes of their surgeries, and may end up even more obsessed with any imperfections left after the surgery. They may obsess over scars, or they may be driven to near-madness over the slightest asymmetry of the result. Others shift their focus to another perceived defect that was not fixed by the surgery. Either way, the BDD patient often doesn’t take long to seek out the next surgery…and the next…and so on.

As a result, these patients are highly likely to become what the world at large deems as “plastic surgery addicts”. No matter what “flaws” these patients manage to fix, it is never enough. There is always something else that they will perceive as being “wrong” with the way they look. There seems to be no amount of reassurance by loved ones that will convince the patient, even for a moment, that he or she is not ugly or deformed.

Many doctors who study BDD believe that plastic surgeons come into contact much more often with BDD patients than do therapists of psychiatrists, and that is probably true. It is a surgeon’s ethical responsibility to take into account the mental and emotional state of his patient before agreeing to operate, and most plastic surgeons are very aware of the nature and symptoms of BDD. Therefore, many people who suffer from BDD are finally diagnosed as a result of a referral from a plastic surgeon to a qualified therapist or psychiatrist.

Learn More About BDD

If you suspect that you or someone close to you may be suffering from BDD, you should arrange to speak with a medical health professional as soon as possible. More information on BDD can also be found at: www.bddcentral.com.


DSM-IV, 1994, American Psychiatric Association, p. 468


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