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What is Body Dysmorphia?

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Imagine being disgusted every time you glance at a mirror but at the same time, you cannot look away. How you look preoccupies your mind, and every thought is negative. No makeup is good enough, no clothes are pretty enough to distract from what you so firmly believe are inexcusable flaws in your appearance. This is the daily plight of people with Body Dysmorphic Disorder.

These people suffer persistent, disturbing obsessions about their physical appearance. Depending on the severity of the disorder, patients may think they are unattractive, ugly, and even grotesque. The three most common subjects of patients’ attention are the skin (73% of patients), the hair (56%), and the nose (37%). Most patients report multiple areas of concern, with the average being 5-7 different ones.

It takes over

These preoccupations consume 3-8 hours a day on average.  The most severely affected quarter of patients spent over 8 hours a day on them. They engage in multiple compulsive behaviors that are unwanted and increase anxiety. Patients spend this time examining their reflections and adjusting their appearance via excessive personal grooming.

They frequently seek emotional support from others. They attempt to hide their perceived defects by applying extra makeup, tanning excessively, or wearing clothes and hats to hide themselves. Patients frequently touch worrisome areas and often pick their skin, hair, and nails, frequently causing additional damage and scarring.

About 48% of these patients end up receiving cosmetic surgery or dermatologic treatments, but very few patients (2.3%) have any long term emotional benefit from these procedures. Even though patients with muscle dysmorphia usually have normal sized or large muscles, they spend inordinate amounts of time regulating their diet and working out. Additionally, 21% of men with muscle dysmorphia use anabolic steroids to boost gains from exercise. These patients have higher social anxiety in general, and severe symptoms lead patients to avoid social situations.

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References
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  2. Didie, E. R., Kelly, M. M., & Phillips, K. A. (2010). Clinical features of body dysmorphic disorder. Psychiatric Annals, 40(7), 310-316. [Citation is on p.3, Table 1 and paragraph 1]
  3. Phillips, K. A., Wilhelm, S., Koran, L. M., Didie, E. R., Fallon, B. A., Feusner, J., & Stein, D. J. (2010). Body dysmorphic disorder: some key issues for DSM‐V. Depression and anxiety, 27(6), 573-591. [Citation is on p.5, paragraph 3]
  4. Crerand, C. E., & Sarwer, D. B. (2010). Cosmetic treatments and body dysmorphic disorder. Psychiatric Annals, 40(7), 344-348. [Citation is on p.3, section the use of cosmetic treatments in people with BDD, paragraph 2]
  5. Phillips, K. A., Wilhelm, S., Koran, L. M., Didie, E. R., Fallon, B. A., Feusner, J., & Stein, D. J. (2010). Body dysmorphic disorder: some key issues for DSM‐V. Depression and anxiety, 27(6), 573-591. [Citation is on p.21, paragraph 5]
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