Body Dysmorphic Disorder (BDD)
Body Dysmorphic Disorder (BDD) focuses on intrusive appearance concerns, repetitive behaviours (checking, camouflaging), and significant distress or avoidance. This page translates evidence into care: specialized CBT with exposure/response prevention, careful SSRI titration, and strategies to reduce cosmetic procedure seeking. If you’re reviewing an OCD and BDD conference, you’ll find practical protocols for graded mirror exposure, camera/social-media boundaries, and family involvement that avoids reassurance cycles. Because BDD often co-occurs with depression, social anxiety, and suicidality, we link to OCD and Related Disorders for spectrum concepts and implementation detail.
Effective programs prioritize safety, function, and stigma-aware communication. We outline assessment that distinguishes normative appearance concerns from BDD, screens for plastic surgery requests and crisis risk, and sets functional goals (school/work, social participation). Treatment blends ERP with cognitive work on appearance beliefs, perfectionism, and intolerance of uncertainty; SSRIs are titrated to evidence-based doses with adequate duration. Digital hygiene—filters, selfies, and scrolling patterns—is addressed explicitly. Equity matters: culturally sensitive language and access to non-stigmatizing services improve reach and outcomes.
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Differential and severity
- Use structured interviews to confirm BDD and rule out eating disorders.
- Assess suicide risk, insight, and cosmetic-procedure seeking.
CBT with ERP
- Design mirror and social exposure with response prevention.
- Target perfectionism and safety behaviours that maintain the cycle.
Medication strategy
- Titrate SSRIs to evidence-based ranges with adherence support.
- Plan duration and relapse-prevention before tapering.
Digital and social factors
- Set boundaries on filters, selfies, and checking; coach graded re-entry.
- Use values-based goals to counter comparison traps.
Service Models and Supports
Family and partner work
Reduce reassurance and accommodation; teach supportive responses.
Group and brief formats
Offer skills groups and brief protocols to expand access.
Comorbidity pathways
Treat depression/anxiety concurrently without reinforcing avoidance.
School/work reintegration
Plan graded return with accommodations for exposures and breaks.
Equity and culturally sensitive care
Adapt materials to culture and body-image norms; counter stigma.
Measurement and outcomes
Track distress, avoidance, and function; use dashboards for QI.
Risk management
Maintain crisis plans and rapid access during high-risk periods.
Ethics with cosmetic procedures
Coordinate with surgical providers to prevent iatrogenic harm.
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