addition, the appearance concerns cause significant distress
(for example, anxiety or depression) or significant problems
in functioning. Although some people with this disorder manage
to function well despite their distress, many find that their
appearance concerns cause problems for them. For example,
they may find it hard to concentrate on their job or school
work, which may suffer, and relationship problems are common.
People with BDD may have few friends, avoid dating, miss school,
and feel very self-conscious in social situations.
severity of BDD varies. Some people experience manageable
distress and are able to function well, although not up to
their potential. Others find that this disorder ruins their
Clues to the Presence of BDD
comparing your appearance with that of others; scrutinizing
the appearance of others
checking your appearance in mirrors or other reflecting
the perceived defect with clothing, makeup, a hat, your
hand, your posture, or in some other way
surgery, dermatological treatment, or other non-psychiatric
medical treatment for appearance concerns when doctors or
other people have said your flaws are minimal or such treatment
seeking reassurance about the flaw or attempting to convince
others of its ugliness
grooming (for example, combing hair, shaving, removing or
cutting hair, applying makeup)
touching the perceived defect
the disliked body part
reading about the defective body part
or dieting excessively
drugs (for example, anabolic steroids) to become more muscular
or lose fat
your clothes a lot to try to find something that makes you
look betterAvoiding social situations in which the perceived
defect might be exposed
very anxious and self-conscious around other people because
of the perceived defect
you think you may have Body Dysmorphic Disorder?
following questions ask about the features of BDD that are
required for diagnosis:
Are you very concerned about the appearance of some parts(s)
of your body which you consider especially unattractive?
If yes: Do these concerns preoccupy
you? That is, do you think about
them a lot and wish you could
How much time do you spend thinking about your defect(s) per
day on average? (add up all the time you spend)
a) Less than 1 hour a day
b) 1-3 hours a day
c) More than 3 hours a day
Is your main concern with your appearance that you aren't
thin enough or that you might become too fat?
What effect has your preoccupation with your appearance had
on your life:
- Has your defect(s) often caused you a
lot of distress, torment, or emotional pain?
- Has your defect(s) often significantly
interfered with your social life?
- Has your defect(s) often significantly
interfered with your school work,
your job, or your ability to
function in your role (e.g., as a homemaker)?
Are there things you avoid because of your defect(s)?
likely to have BDD if you gave the following responses:
Yes to both parts.
Answer B or C.
While a "yes" answer may indicate that BDD is present,
it is possible that an eating disorder is a more accurate
Yes to any of the questions.
note that the above questions are intended to screen
for BDD, not diagnose it; the answers indicated above
can suggest that BDD is present but can't necessarily give
a definitive diagnosis.
about Muscle Dysmorphia?
society demands a fitter body, frowning on every pinch of
fat, clinicians suspect an increasing number of people are
crossing the line into exercise addiction. Signs of obsession
include feelings of acute anxiety over a missed workout and
an urge to make exercise a priority over friends and family.
Most trainers recommend working out no more than an hour a
don't just worry that they are too fat; many worry that they
are too thin. Researchers at McLean Hospital have just defined
a body-image distortion disorder that they liken to "reverse
anorexia." Called muscle dysmorphia, the syndrome
appears in athletes (both male and female) who, despite being
dramatically muscular, are convinced that they are too small.
Imagine a bodybuilder 250 pounds, 20-inch biceps, 6
percent body fat horrified to take his shirt off for
fear he looks out of shape.
there treatment available?
Body Dysmorphic Disorder is mis-diagnosed because doctors
tend to have a lack of familiarity with the disorder. Many
times those afflicted feel so ashamed and worthless that they
down-play the problem or do not even recognize that they need
help, so they end up staying in hiding. Families may even
trivialize this problem, not realizing that this extreme distortion
cannot be resolved through "getting over it" or
calling it a "phase." However, when you or someone
you know is ready to accept help and is willing to get it,
there are therapists out there that specialize in treating
distortion cases while new methods of treatment for Body Dysmorphic
Disorder are currently being studied.
above test is from the Body
Dysmorphic Disorder & Body Image Program at Butler