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Body dysmorphic disorder: when a negative body image becomes a mental health condition


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Advice for parents on helping your child deal with body dysmorphic disorder (BDD)

Body image in the digital age

Research from YMCA reveals that 34% of teenage boys and 49% of teenage girls had been on a diet in an effort to change their body shape.[1] An issue which was previously seen as one primarily affecting girls has now been shown to be a problem for both genders.

The worrying state of young people’s body confidence has been an ongoing issue in recent years and some companies are beginning to respond.

Mattel, the company behind Barbie, has recently introduced a new range of the doll that comes in a range of shapes, heights, and hair and skin colours in an effort to broaden their representation of the female figure.

Having a positive body image is an important part of your overall sense of self-esteem. Having negative thoughts about how you look can impact on your entire life, and make it difficult to feel happy.

As a parent, you play a key role in building your child’s confidence about their body, and making sure they have a healthy body image.

Sadly, a growing preoccupation with body image is a recurring theme of the digital age. Some claim that the popularity of selfies and posting photos onto social media has created a generation obsessed with their looks.  Whether or not this is true, preoccupation with physical appearance is normal, especially during puberty.

But, when taking care over appearance tips over into the realms of obsession, it could be a sign that your child has BDD. Here, the charity BODY, explains more about this upsetting condition.

How does BDD differ from negative body image?

Body hang-ups are common. You'd be hard pressed to find many people 100% happy with their body. But for people with body dysmorphic disorder (or BDD), a hang up can develop into an all-encompassing obsession which can make them deeply unhappy and put them at risk of other mental health problems, such as depression and self-harm.

BDD is a serious mental health condition characterised by a preoccupation with one or more flaws in appearance. These flaws are often minor or even non-existent, leading some to call BDD 'imagined ugliness'.

People with BDD become so hung up over their body image that it starts to have a negative effect on their entire life. This can range from continual extreme thoughts about corrective surgery to being completely housebound. They may avoid seeing friends or family, quit a job or start skipping school. People with BDD may also be at risk of self-destructive behaviour. 

BDD isn’t vanity

BDD is sometimes confused with vanity or attention-seeking behaviour, but it’s important to remember that it’s a serious mental health condition. People with BDD genuinely feel flawed or ugly and tend to be socially isolated, in part because they believe others will think they are vain. This often makes it harder to get help.

‘The most common areas to become preoccupied with are the skin, nose and hair’

Sufferers of BDD usually focus on what they see as their flaws for up to 8 hours a day, affecting one or all aspects of their life. People can concentrate their negative thoughts on any part of their body, but the most common areas to become preoccupied with are the skin, nose and hair.

People may focus on small features or on larger areas, like their muscles. For example, muscle dysmorphia sufferers believe they’re small and weak even when they’re large and muscular. This disorder is common in boys and men and has recently been reported on mainstream media, referred to as ‘bigorexia’.

What are the symptoms of BDD?

The following behaviours are often warning signs of BDD. Some of these things can be warning signs for other issues, and some, like self-consciousness, are a normal part of growing up. But if your child is displaying multiple signs, it’s probably worth looking into more closely [See what to do if you think your child may have BDD, below].

  • Highly self-conscious.
  • Checking appearance in a mirror or reflective surface obsessively.
  • Distracted - struggling to concentrate on anything other than their appearance.
  • Increased self-isolation - not wanting to leave the house or go out and see friends.
  • Continually seeking reassurance about their appearance.
  • Picking at their skin to make it perfect.
  • Comparing themselves with other people, including celebrities in magazines or online.
  • Avoiding certain situations such as having their photograph taken, close-up interactions or being under bright lights/ surrounded by lots of mirrors.
  • Depressive thoughts and comments in relation to body image.

Research and findings on the condition

At the moment, there isn’t enough information on BDD, though research has shown that it’s more common in people with a family history of BDD, suggesting a possible genetic link. Similarly, a study showed that 80% of anorexics have family members who have also suffered from the disorder. BDD has also been linked to eating disorders. Unlike many eating disorders, though, BDD affects men and women equally.

What to do if you think your child may have BDD

Like many mental health conditions, BDD can sometimes come with a stigma attached, but people suffering from this isolating condition need help. The usual line of treatment is Cognitive Behavioural therapy (CBT) but BODY, a charity focusing on helping those with BDD and other body image related mental health problems, offers a variety of other therapies that can help too:

  • Support groups for loved ones and carers.
  • Self-help classes.
  • One on one therapy.
  • Creative expressive therapy workshops.
  • Occupational therapy.
  • Integrative psychotherapy.
  • The BODY Buddy national be-friending system.

If you think your child might have BDD, tell them that you love them and are worried about them, and try to find out if there’s something else that could be contributing to the issues you’ve noticed. It’s important that you book an appointment with your GP. They’ll be able to refer you onto a specialist who will be able to help your child.

Online resources to help people with BDD

Body Dysmorphic Disorder Foundation:

OCD UK’s section on BDD:

Further reading

The Body Dysmorphic Disorder Foundation has produced a list of books on the subject written by professionals aimed at the general public.

The advice published on Parent Info is provided by independent experts in their field and not necessarily the views of Parent Zone or NCA-CEOP.

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