BACKGROUND: To others they look perfectly normal, but to a person suffering from body dysmorphic disorder (BDD) their body is repulsive and disfigured. BDD is a mental disorder that's characterized by excessive preoccupation with a real or imagined defect in ones personal appearance. It's a type of somatoform disorder, meaning physical symptoms are present that suggest a mental condition. BDD sufferers may be obsessed with certain perceived flaws, like a certain facial feature or skin appearance and can have problems controlling negative thoughts about these perceived defects despite positive reinforcement from others.

SYMPTOMS: Frequent comparison of ones own appearance to others is a primary symptom of BDD. One of the most common symptoms is habitually and compulsively looking into mirrors or other reflective surfaces. Another symptom: going to great lengths to cover or hide the perceived flaw whether it is by wearing excessive clothing or makeup or using hands and posture to cover the area.

CAUSES: The cause of BDD is somewhat unclear. However, researchers believe a number of factors may contribute to and happen along with BDD. The first possibility is a chemical imbalance in the brain. Lower than normal levels of serotonin, a mood and pain-regulating chemical, may contribute to BDD. Obsessive-compulsive disorder may be partly to blame as well. It's not uncommon for BDD to occur simultaneously with obsessive-compulsive disorder, during which a patient may experience uncontrollable urges to practice ritualistic behavior related to his or her physical appearance. Other disorders that may cause or accompany BDD are generalized anxiety, eating disorders and other psychological disorders.

TREATMENT: Before treatment can begin, patients usually go through a BDD screening process. The process usually starts with a questionnaire used by psychiatrists and psychologists to determine if a patient is suffering from BDD. An examination may also be done to further determine the extent of the disease. Once diagnosed, doctors often recommend combination treatments for BDD. Antidepressants are often prescribed to lessen or alleviate symptoms of BDD. Selective serotonin reuptake inhibitors seem to be the most effective type of antidepressant when treating BDD. Cognitive behavior therapy is also used for treatment. During therapy patients use talking to help identify unhealthy, negative thoughts and behaviors and try to replace them with healthy ones.

WHERE THE PROBLEM LIES: In a study done looking at more than 500 patients with BDD, the most common areas of concern were: Skin (73%)
Hair (56%)
Nose (37%)
Weight (22%)
Stomach (22%)
Breasts/nipples (21%)
Teeth (20%)
Thighs (20%)
Eyes (20%)
Legs (overall) (18%)
Body Build (16%)
Ugly Face (14%)
Lips (12%)
Buttocks (12%)
Chin (11%)
Fingers (11%)

To enroll in ongoing research: UCLA Body Dysmorphic Disorder Program or (310) 206-4951