Body Dysmorphic Disorder – Do You See What I See?

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Body Dysmorphic Disorder – Do You See What I See?

This skewed view of our own perception used to be reserved for adults and teenagers but thanks to media, beauty pageants and society, in general, it is striking girls even as young as elementary school.  Body Dysmorphic disorder does not discriminate between male and female though it is predominately thought of as a woman’s issue. It is a psychological disorder in which the person is excessively concerned about and preoccupied with a defect, real or perceived in their physical features.

The majority of the time when an outside perspective is taken on the person, no defect at all is noticed. In fact, many of the people who feel ugly, fat, unattractive and so forth are seen by the outside world as perfectly attractive if not even beautiful or near perfect.

What makes someone see themselves in such a warped and off-balance way? There are numerous factors that play into this often-destructive point of view. One’s upbringing can have a lot to do with self-view and self-esteem. Kids can be cruel. Mocking one another for fun, or on a deeper level to distract attention from them in order to make themselves feel better. This can be incredibly hurtful if not scarring emotionally sometimes for a lifetime. It helps tremendously to have loving supportive parents, but not everyone is lucky enough to have this family support structure.

When most of us look in the mirror we see an accurate reflection of what we look like. People with Body Dysmorphic Disorder see something akin to looking at a reflection of themselves in a funhouse mirror. Only for them, it’s not a game and it’s not fun. It causes a range of symptoms from panic to fear to self-loathing, hatred, disgust, and major depression and can even be linked to suicidal tendencies.

It’s easy from the outside to look at them and scoff, telling them they look fine, even beautiful but to them, it’s a lie. You are just trying to make them feel better. It’s truly not what they see. The onset of this disorder usually occurs between adolescence and early adulthood.

In recent years plastic surgery has become a more than viable option for these sufferers, the only problem is that when the issue is indeed not physical, fixing the physical doesn’t always help. Often once the perceived problem has been corrected it just gives flight to the next one arising. Yes, your nose is now straight but now you see that your lips are too thin or your eyes are starting to sag or so on and so forth. Often these people spend thousands upon thousands of dollars to continue down the painful road of repeated surgery only to find one problem after another, never to be satisfied because the problem doesn’t lie in the physical but in the mental and emotional perception of the physical. This is often very difficult for the surgeon to pinpoint and so the surgeries continue.

With all of the pressure to be beautiful in today’s society, how do we tell the difference between someone who is going after their idea of their perfect self in a healthy way and one who is coming from the angle of self-loathing and mental illness? It may be at times tough to distinguish, even for the most trained and skilled professionals.

Some common symptoms of BDD include:

Obsessive thoughts about perceived physical defects

Obsessive-compulsive behaviors related to appearance

Major depressive symptoms

Delusional thoughts or beliefs related to appearance

Social withdrawal

Suicidal thoughts

Anxiety attacks

Low self-esteem



Avoiding leaving the house

Dependent on others

Inability to work because they are too focused on appearance

Decreased academic or work performance


Perfectionism (undergoing numerous surgeries)

Compulsive Behaviors:

Always checking appearance in mirrors or windows

Or an inability to look in mirrors at one’s own reflection

Camouflage – Baggy clothes, lots of makeup

Excessive grooming

Becoming hostile towards people

Excessive dieting or exercising


Comparing self to models

In extreme cases doing plastic surgery on one’s self with disastrous results

Excessive enema use (if weight is a concern)

Most commonly perceived defects:

Skin (73%)

Hair (56%)

Weight (55%)

Nose (37%)

Toes (36%)

Abdomen (22%)

Breasts/chest/nipples (21%)

Eyes (20%)

Thighs (20%)

Teeth (20%)

Legs (overall) (18%)

Body build/bone structure (16%)

Facial features (general) (14%)

Face size/shape (12%)

Lips (12%)

Buttocks (12%)

Chin (11%)

Eyebrows (11%)

Hips (11%)

Ears (9%)

Arms/wrists (9%)

Waist (9%)

Genitals (8%)

Cheeks/cheekbones (8%)

Calves (8%)

Height (7%)

Head size/shape (6%)

Forehead (6%)

Feet (6%)

Hands (6%)

Jaw (6%)

Mouth (6%)

Back (6%)

Fingers (5%)

Neck (5%)

Shoulders (3%)

Knees (3%)

Ankles (2%)

Facial muscles (1%)

Once you realize it is BDD that you have, what do you do about it?

It is easy from an outside perspective to say that you just need to take a clear look in the mirror, but for these people that mirror is not the same as ours. It is clouded and tainted.

Studies have found that Cognitive Behavior Therapy (CBT) has proven effective. In a study of 54 BDD patients who were randomly assigned to Cognitive Behavior Therapy or no treatment, BDD symptoms decreased significantly in those patients undergoing CBT.

BDD was eliminated in 82% of cases at post-treatment and 77% at follow-up.[27]

Due to believed low levels of serotonin in the brain, another commonly used treatment is SSRI drugs (Selective Serotonin Reuptake Inhibitor). 74 subjects were enrolled in a placebo-controlled study group to evaluate the efficiency of fluoxetine hydrochloride (Prozac); patients were enrolled in a 12-weeks, double-blind, randomized study. At the end of treatment, 53% of patients responded to the fluoxetine.[28]

A combined approach of Cognitive Behavior Therapy (CBT) and anti-depressants is more effective than either alone. The dose of a given anti-depressant is usually more effective when it exceeds the maximum recommended doses that are given for Obsessive Compulsive Disorder (OCD) or a major Depressive episode.

Are there alternatives to medication?

There appear to be, yes.

According to Charles Gant, N.M.D., Ph.D., M.D., Author of End your Addiction Now and ADD and ADHD Complementary Medicine Solutions as well as Mary Reed, Herbalist they recommend:

1. Quit caffeine drinks completely. If one is a regular tea or coffee drinker he may need to do this gradually to avoid withdrawal symptoms

2. If your cholesterol is below 170, get it up. Lower than 170 the body cannot repair the myelin.    

3. Ensure you are getting the daily minimum requirement of vitamin B-complex.

4. 1 tbs. Flaxseed oil daily (fatty acids help nourish the nerve sheathing)

5. Spirulina capsules, 8-10 capsules per day

6. Valerian 1-2 capsules a day in combination with skullcap, hops, and passionflower. *Valerian alone is not recommended.

If you suffer from this condition please take heart. You are not crazy. You are lacking the nutrients that your body needs to get over this. There is much hope.

If you live in Fort Myers, Cape Coral, Bonita Springs, Estero, Lehigh, or Naples, Florida come see Dr. Jason Kaster, D.C. and form a plan to work on proper supplementation, diet, and alignment body dysmorphic disorder doesn’t have to take over your life.

Additionally, positive self-talk can also be beneficial. Done in a mirror for even greater effect. Even if you do not believe it at first look at yourself in the mirror and state out loud “I am beautiful just as I am.” “I love and accept myself.” Your subconscious hears you and does not distinguish between believed truth and a lie. Done repeatedly, you will begin to believe it yourself and your self-esteem will increase.

Chiropractor & Nutritionist in Fort Myers, FL.

Fort Myers Chiropractor, Dr. Jason B. KasterChiropractic care is a safe, alternative treatment when applied appropriately. Chiropractic treatments help in dealing with the symptoms of many conditions. Are you going to wait for your symptoms to be felt, or are you going to prevent them before they start?

Dr. Jason B. Kaster, a chiropractor, and nutritionist in Fort Myers can help you and your family achieve their optimal health.

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