Are you worried about your weight?


How many people reading this will be conscious of putting on a few extra pounds over the festive period. I know I am. Yet, for some, such self- consciousness is a daily battle and goes far beyond feeling a bit fat.

Often beginning at school, perhaps as a result of teasing or being bullied, preoccupation with body image may take over and become an obsession. In adolescence when girls are most sensitive about their looks and body shape, media images can fuel insecurity, often with pictures depicting models airbrushed to portray an idealised but unrealistic image. Other possible causes includes genetic predisposition and hormonal or chemical imbalances.

For the self-conscious teen,hiding away, indulging in excessive grooming or over reliance on make-up or, constantly looking in mirrors examining every little imperfection can become a daily torture, a nightmare relived over and over again. These days it is not just girls who suffer with BDD but an increasing number of boys are becoming obsessed with perceived defects or flaws in their appearance.

Body Dysmorphic Disorder (BDD) is an anxiety related condition associated with distorted body image. In many ways it is similar to Obsessive Compulsive Disorder (OCD) where the compulsion to look in mirrors, check and often pick at the skin can be overwhelming. To the person experiencing it, no matter how much reassurance they may receive, this will afford little comfort. You see, it is a pervasive psychological condition where rather like looking into a fairground mirror, the mind distorts reality. It affects between 0.5% ( OCD-UK) and 1% (NHS Choices) of the population.

BDD is a serious condition and can lead to depression and even suicide. It is common in those who suffer with anxiety, in particular those with a history of OCD, social phobia. It frequently exists alongside eating disorders such as anorexia and bulimia.

What signs might indicate that BDD may be a problem?

  • Becoming pre-occupied with looking at others, comparing yourself to others.
  • Having feelings of disgust or revulsion about your body.
  • Seeing yourself as abnormal, odd or different.
  • Feeling that others are judging you (and your body) in a negative way.
  • Avoiding or obsessing over mirrors, constantly checking your appearance.
  • Using make up, clothing or hair to hide supposed defects, imperfections or flaws.
  • Becoming overwhelmed or upset over your appearance (commonly focusing on facial features such as the nose or perhaps complexion).
  • Feeling uncomfortable and anxious when in company.
  • Becoming secretive and not wanting to seek help.
  • Contemplating plastic surgery to correct perceived bodily defects.
  • Obsessing over food, diet and exercise.

What help is available?

The start point with regard to getting help should ideally be your family doctor. It is likely that they will recommend Cognitive Behavioural Therapy, a form of talking therapy that focuses on the way our perception affects our thoughts, emotions and behaviours. This type of therapy has proved to be very effective with BDD and is recognised by the National Institute for Clinical Excellence (NICE). Medication may also be extremely helpful, in particular SSRI antidepressants. Sometimes there also may be a role for antipsychotic medication.

The key thing is to recognise that you have a problem and that you need help

Until next time, Steve Clifford, Cognitive Behavioural Psychotherapist.

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