deemed to have a diagnosis of Body Dysmorphic Disorder (BDD). In my practice I have only seen a small proportion of BDD cases, as low as 2%; however, these cases share common characteristics. BDD patients are constantly preoccupied with an imagined physical defect in appearance or a grossly exaggerated worry about a minimal defect.
BDD is a psychiatric disorder characterized by excessive preoccupation with imagined defects in physical appearance. People with the disorder are obsessed by the idea that some part of their body -- their hair, nose, skin, hips, whatever -- is ugly or deformed, when in truth it looks normal. People with BDD may focus on moles, freckles, acne, minor scars, facial or body hair, or the size and shape of their breasts or genitalia. And they may spend an excess of time looking in the mirror, may be forever fixing their hair, or wear heavy makeup or sunglasses inside as a form of camouflage. They may make multiple medical visits or have surgical procedures to correct the imagined defect.
There are distinct criteria to diagnose a potentially BDD patient.
• Camouflages some aspect of her appearance with her hand, clothing, a hat, or makeup.
• Fears ridicule in social situations, has a limited social life, and experiences social anxiety.
• Consults many dermatologists or plastic surgeons.
• Undergoes repeated surgical procedures to change perceived defects.
• Undergoes medical solutions but they do not provide relief.
• Constantly looks in reflective surfaces or avoids mirrors altogether.
• Performs excessive grooming rituals.
• Repeatedly measures or touches the perceived defect.
• Thinks about the perceived defect for several hours each day.
• Obsessing over appearance causes failure in school and work.
The saddest aspect of BDD is that the preoccupation with the purported defect causes
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