Marin Independent Journal
Unknown but dangerous
What to know about body dysmorphic disorder
While eating disorders have been widely publicized for decades, far less attention has been given to a related condition called body dysmorphic disorder, or BDD.
Body dysmorphic disorder is often hidden from public view due to the shame people feel about one or more parts of their body, yet it is a devastating, debilitating psychological condition. People with the disorder suffer from obsessive thoughts and repetitive behaviors related to their appearance.
Whereas people with eating disorders might view their underweight body as too fat, those with body dysmorphic disorder see themselves as ugly or disfigured even though they appear normal or attractive to others.
Body dysmorphic disorder is more common in both men and women than bulimia or anorexia. About 2.5% of women and 2.2% of men in the U.S. meet the criteria for body dysmorphic disorder — that's higher than the prevalence of generalized anxiety disorder, schizophrenia or bipolar disorder in the general population.
For comparison, at any point in time, bulimia is seen in roughly 1.5% of women and 0.5% of men in the U.S., and anorexia in 0.35% of women and 0.1% of men.
We are a team of communication and mental health researchers and clinicians from Colorado State University Global, Hofstra Medical School and the University of Toronto. One of us, Eva Fisher, lived with the disorder for almost 15 years before getting help and recovering. My book, titled
“The BDD Family,” provides insights into my daily struggles with body dysmorphic disorder along with information about diagnosis and treatment.
In our view, body dysmorphic disorder needs to be better understood and publicized so that more people suffering from the condition can be properly diagnosed and treated.
People with body dysmorphic disorder and those with eating disorders share similar negative emotions such as shame, disgust and anger about their appearance. They also engage in some similar behaviors, such as mirror checking, taking photos to check themselves, seeking reassurance from others about their appearance, and using clothing to camouflage or conceal perceived defects.
People who suffer from these disorders commonly avoid places and activities due to self-consciousness about their appearance. In addition, those with eating disorders and body dysmorphic disorder may lack the knowledge that their body image beliefs are distorted.
Depression is common in people with body dysmorphic disorder, and they have a higher rate of suicidality than those with eating disorders, including thoughts about committing suicide and suicide attempts. Although both eating disorders and body dysmorphic disorder can be severe and lifethreatening, people with body dysmorphic disorder on average experience more impairment in daily functioning than those with eating disorders.
Although both eating disorders and body dysmorphic disorder can be severe and lifethreatening, people with body dysmorphic disorder on average experience more impairment in daily functioning than those with eating disorders.
A personal view
My (Eva's) body dysmorphic disorder symptoms started at age 16. Some causes could have been childhood bullying and perfectionism about my appearance. I would obsess about the shape and size of my nose for more than eight hours a day and constantly compare my appearance to models in fashion magazines.
I was convinced that oth