Body Dysmorphic Disorder Treatment

What is Body Dysmorphic Disorder/IOCD Foundation

Anxiety and Depression Association of America

Dr. Steven Pence is an anxiety specialist in the treatment of body dysmorphic disorder (BDD) for both adolescents and adults in Oakland County, Michigan. Dr. Pence treats social phobia with evidenced-based cognitive behavior therapy with emphasis on exposure response prevention (ERP) and cognitive restructuring for both weekly therapy and intensive outpatient treatment programs. Body Dysmorphic Disorder (BDD) is a mental disorder characterized by a preoccupation with one or more flaws in appearance in which a person intensely obsesses over his or her body image and affects about 2% of the population. These feelings are consuming and cause harmful beliefs and attitudes that affect emotions and behavior. Individuals may seek out cosmetic procedures and are never satisfied. Many people are unhappy about something with the way they look, however these individuals are preoccupied with the thought and suffer from emotional distress through anxiety, shame, depression, and disgust. Body image concerns most commonly begin in late adolescence between the ages of 16-18 when teenagers begin to compare themselves with their peers. BDD often precedes at the age of 12-14, however, it may take up to 15 years for presentation to mental health professionals. BDD can get worse as the person ages and become unhappier as they struggle with physical changes of age. The quality of life can become significantly impaired based on severity and individuals with severe BDD can become homebound causing significant relationship issues.

Symptoms of this disorder may include:
Fixation with physical appearance
Frequently obsessing in the mirror or avoiding mirrors altogether
Repeatedly asking others for assurance that they look okay
Frequent cosmetic procedures or unnecessary plastic surgery
Excessive grooming
Refusing to be photographed
Camouflaging their appearance
Compulsive skin picking
Avoiding social situations
Emotional problems, such as feelings of disgust, low self-esteem, anxiety, or depression
Keeping obsessions and compulsions secret due to feelings of shame
Avoiding social situations, public places, work, school, etc.

Parts of the body that may be involved:
Face including skin, nose, hair, eyes, chin, and lips
Body build including muscle size, shape, & leanness
Breasts & genitals

Many individuals struggle with symmetry or proportion of their body.

A clinical assessment and psychoeducation is very important in the process of treatment. BDD is treated using a combination of medicine and cognitive-behavioral therapy with exposure response prevention techniques and cognitive restructuring to challenge the beliefs that appearance can be perfect. Serotonin reuptake inhibitors (SRIs) is considered the first-line medication treatment for body dysmorphic disorder. Psychoeducation is important in the treatment process. Cognitive strategies also include identifying maladaptive thoughts, assessing them, and replacing new alternative thoughts.