Why Are Patients With Body Dysmorphic Disorder So Self-critical?

Anxiety or Eating Disorder?

Body dysmorphic disorder (BDD) is actually a type of anxiety disorder, not a type of eating disorder. The affected individual focuses on physical flaws that other people may not notice. The cause of BDD is still unknown. But most likely it results from an inborn biology plus environmental factors.

Brain studies have confirmed that brain imaging results differ between subjects diagnosed with BDD and others who have not been diagnosed with this disorder. For example, BDD individuals are more likely to report feelings of disgust or repulsed when viewing images of their own faces versus control groups. Similarly, brain-imaging studies show alterations in two areas of the brain of persons with BDD: the visual processing center in the orbitofrontal cortex, and the frontostriatal system, which affects emotional reactions and behaviors. Theses studies suggest that brains of people with BDD are processing visual information differently in their brain, and this finding might explain why their perceptions differ from those of other people.

Exposure Therapy

A good majority of persons affected by this type of anxiety disorder might mistakenly resort to restricting their caloric intake in an effort to lose weight and therefore look better (in their own eyes). Clinicians might even mistakenly look at this issue as an eating disorder. Unfortunately, no amount of weight loss, or plastic surgery, or covering the body with make up, clothes, jewelry, etc. will present relief.

Just like many other anxiety disorders, the most effective treatment is exposure therapy (read more). The idea is to desensitize the brain at the site or image or thought of the dreaded object, in this case the part(s) of the body that brings out the most disgust in the mind of the person until such time that the brain will no longer react by the same emotional intensity as it did before. It is as if we have over charged the circuitry to the point of disconnecting the relationship between emotional disgust and the site of the dreaded body part.

I am Dr. Dashtban and in my practice I treat anxiety and depressive disorders associated with medical conditions. If you have any questions regarding successful treatment of BDD, give me a call at 408-458-8222, 831-621-1150 or write to me at drdashtban@medicalpsychologyservice.com.

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