Not just a case of extreme vanity: What is Body Dysmorphic Disorder, and why you need to know

Body Dysmorphic

A while back, singer-actress Miley Cyrus, in a soul-baring interview, made a casual reference to the term ‘body dysmorphia’. The Internet erupted as the interview created a lot of social media buzz. It brought into focus a much-poorer cousin of the infamous eating disorders — Body Dysmorphic Disorder (BDD). Though, at first much of this may sound like describing a person who is vane, but the problem lies much deeper – and it’s one that needs to be addressed.

So, what is body dysmorphic disorder and why should you care?

BDD Foundation describes body dysmorphic disorder as ‘a disabling preoccupation with perceived defects or flaws in appearance’. Don’t dismiss it as a pathetic case of vanity just yet. Dr Bhavna Barmi, clinical psychologist at Fortis Escorts Heart Hospital, New Delhi, explains, “It is a kind of somatoform disorder in psychiatry — usually the person has symptoms of a medical illness or a medical disorder, but the symptoms cannot be fully explained as actual physical disorders. It is basically an exaggeration in the mind of a small defect that a person has.” Common obsessions tend to be facial features — such as the nose, eyes, hair, chin, skin or lips — or particular areas of the body — such as the breasts or genitals, apart from general preoccupation with being too fat or skinny. Giving an example, Dr Barmi says, “I might feel that there is a mole — in actuality a small mole on my cheek — but I have exaggerated it and I have perceived it as a very big defect. I think that those who are seeing me are seeing such a big, black blotch on my face and I must be looking really ugly with it.”

“May be the defect can be ignored, but the person puts too much emphasis on it. It can start by just being a mild concern of body image or a body part. What is important is that it is causing clinically significant distress. So, that means the preoccupation with the imagined defect and the distress or the stress or the depression that it causes is of clinical significance — to the extent that sometimes it also reduces the social and occupational functioning.”

What does potentially distressing preoccupation with appearance look like? Dr Barmi cites a case, “I have a case in which the person came to me saying that, ‘my nose is completely deformed — completely deformed. Because my nose is deformed, I am not going to go to college now because people make fun of me. I will not go to social gatherings. I think my family also makes fun of me now, so I’m not very happy on the family front’. Then, in her house, she started becoming very very aloof. She started removing all the mirrors from the house. Her parents eventually took her for plastic surgery. She came back and again she looked into the mirror and found another small defect. She went back to the cosmetic surgeon to confront him, and even went to the extent of filing a lawsuit against that doctor.

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