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Body Dysmorphic Disorder

Saba Ashraf's picture

Saba Ashraf                                                                                                    February 23, 2010


Body Dysmorphic Disorder


            Despite the fact that body dysmorphic disorder has been described in European, Russian, and Japanese literature for a century, little is still known about this debilitating disorder in America (4). Body dysmorphic disorder is the obsession over an imagined or slight defect in appearances, which causes the inability of an individual to function normally (3).   Many with body dysmorphic disorder remain house bound and avoid any social situations.  Body dysmorphic disorder affects 2-3% of the American population and the average age at which individuals develop this disorder is about 15 years old (4). The average duration of body dysmorphic disorder happens to be about 18.3 years, so people with this disorder can be cut off from having a normal, healthy lifestyle for almost two decades or more (4). 


The symptoms of this disorder differ depending on the severity and in all cases body dysmorphic disorder cannot be treated by the individuals themselves.  Professional help is essential (2). In any case, individuals with this disorder tend to worry about hair thinning, acne, wrinkles, or scars (3). In fact, an individual that had body dysmorphic disorder had asked his father, “Dad, do you think I’m losing my hair?” about 20 times in a duration of 30 minutes (4). It is common for people with the disorder to continuously ask others whether the defect is noticeable. Others also scrutinize the shape and size of a certain body part including the nose, eyes, ears, mouth, and breasts (3). Excessive hours are spent looking at the mirror or trying to cover the “defects” with makeup or clothing(4). They may even analyze their “defect” so harshly, that they resort to being hospitalized, committing suicide, or numerous plastic surgeries(4). In particular, one woman with body dysmorphic disorder couldn’t bear to see her breasts because she thought they were so ugly, so she decided to slash them(4). 


Many with body dysmorphic disorder think delusional thoughts, thoughts that are false, in which the body part they are preoccupied with appears normal to those who do not have the disorder (4). There are also those who have body parts that slightly resemble what the individual believes his/her defect is; however, their actual looks are nowhere near how exaggerated the individuals make them(4).   There was actually a study on 30 patients with body dysmorphic disorder regarding delusional and non-delusional thinking(4). 53% of the 30 patients that had been evaluated had obsessions over body parts somewhere between delusional and non-delusional thinking(4). Basically, they didn’t think their distortions were exactly accurate, but they also didn’t believe they were unrealistic. 40% of these patients had completely delusional thoughts in which they even tried to convince others of their distortions(4). Finally, only 7% of the patients actually knew that their beliefs had no credibility to them(4). 


Body dysmoprhic disorder is also classified as a somatoform disorder, in which the physical symptoms fail to be explained by a physical disorder (3). Basically, there is no physical evidence in for example, the brain, for body dysmorphic disorder. However, those with body dysmorphic disorder tend to have other mental illnesses as well such as depression and social phobia, so there may be a biological or physical cause (2). For this reason, the classification of body dysmorphic disorder as a somatoform disorder is being questioned (4). There is a theory that problems with the neurotransmitters, chemicals that allow nerve cells to communicate and send messages to one another, may cause body dysmorphic disorder (1). Genetics may also cause the disorder, but not all with body dysmorphic disorder have relatives with the disorder (4). There have been many attempts at explaining what actually causes the disorder, but currently the definite cause is not known. Still, other possible causes include societal and psychological factors (1). 


There is a strong possibility that societal factors play a significant role in causing body dysmorphic disorder. It is obvious that there is a particular image of beauty for women and men in the society. This image of beauty is advertised on major magazines and television shows constantly.    It has become normal for models and celebrities to be edited and airbrushed to look thinner and flawless. The truth is that the models and celebrities don’t even look like what the magazines and TV commercials depict them to look like. When those with body dysmorphic disorder compare themselves to these images of unattainable beauty, they end up worsening their condition (4). In fact, some with body dysmorphic disorder avoid the magazines and television commercials that advertize physical appearance all together (4). This proves that the media does affect individuals with this disorder. Even if one doesn’t have the disorder, an individual can start obsessing over minor things on their body due to the pressure to look good from society. Before you know it, they can possibly end up with body dysmorphic disorder.   


Psychological factors such as childhood teasing, physical or sexual abuse, or low self-esteem can also contribute to causing body dysmorphic disorder (2). For example, many individuals have undergone plastic surgery for a body part they were continuously made fun of for, even though the “defect” may be completely normal.   In fact, about 10% of those who see dermatologists or plastic surgeons may have body dysmorphic disorder (3).  Some who have had parents that were critical of other’s looks also grew accustom to scrutinizing their own body (1). 


The treatment of body dysmorphic disorder involves medication and cognitive behavioral therapy. In terms of medication, there is no exact medicine to treat body dysmorphic disorder (2). However, those with body dysmorphic disorder tend to also suffer from depression, so antidepressants such as selective serotonin (neurotransmitter) reputake inhibitors in larger doses can be used to treat the disorder (2). Cognitive behavioral therapy can also be used to prevent automatic negative thoughts that those with body dysmorphic disorder tend to get (2). 


Even though very little is known of body dysmorphic disorder, more information about those who suffer from the disorder is being found. This disorder may not have a definite physical cause for the physical symptoms that individuals with this disorder possess, but it will be interesting to find out if this theory stays true in the future. As our technology becomes more advanced, we may be able to find a physical cause in the brain for this disorder just as we did with epilepsy. 








1)   “Body Dysmorphic Disorder.” Clevelandclinic. 09 Jun 2009. 21 Jan 2010.


2)   “Body dysmorphic disorder.” Mayoclinic, 23 Jun. 2009. 21 Jan 2010.


3)   “Body Dysmorphic Disorder.” Mercksource. Jun 2008. 21 Jan 2010. 


4)   Phillips, Katharine A. “Body dysmorphic disorder: 30 cases of imagined

ugliness.” The American Journal of Psychiatry. 150.2 (1993) : 302-308.



Paul Grobstein's picture

body dysmorphic disorder and the brain

Maybe we can make more sense of this in terms of the brain constructing not only the sky but the body as well?  If so, then people with body dysmorphic disorder aren't any more "delusional" than people without it.  Maybe its just that their constructions of their own body are different from those of most people looking at them?