Body dysmorphic disorder (BDD) causes your child to dislike something about the way he looks and thinks about it all the time. Your child may get to the point where it is very hard to go outside or even talk to others without thinking about things that he thinks of as flaws. For example, your child may worry all the time that his skin is too pale, his chest is too small, or his nose is too long. These thoughts about a seeming flaw are distorted. Often the flaw that your child worries about is not real, or is something that others do not notice.
BDD is different from eating disorders. Children and teens with BDD may not be concerned about weight or body size. Instead, they feel that they have extremely ugly flaws of the face, hair, skin, or some other body part.
What is the cause?
The exact cause of the disorder is not known. Possible causes include:
The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way your child thinks, feels, or acts. People with this disorder may have too little or too much of some of these chemicals.
Someone whose family has a history of obsessive-compulsive, depression, or anxiety disorders is more likely to develop BDD. Families with very high expectations may be at higher risk for BDD.
Being a perfectionist.
BDD affects mostly teens and young adults. It may start gradually or suddenly.
What are the symptoms?
Symptoms may include:
Always comparing his body to how other people look
Constantly trying to cover or hide the area that he thinks is flawed
Feeling nervous and self-conscious or avoiding other people
Often touching, measuring, or looking at the area that he thinks is flawed, or completely avoiding mirrors or touching the area
Checking with other people to see if they think the flaw is as ugly as he thinks it is
Constantly doing research about the area he thinks is flawed
Wanting surgery or treatment that isn’t needed
Children and teens with BDD may also be anxious, depressed, or even suicidal because of always focusing on the area that he thinks is flawed
How is it diagnosed?
Your healthcare provider or therapist will ask about your child’s symptoms. He will make sure your child does not have a medical illness or drug or alcohol problem that could cause the symptoms.
How is it treated?
Cognitive behavior therapy (CBT) is a way to help your child identify and change views she has of herself, the world, and the future. CBT can make your child aware of unhealthy ways of thinking. It can also help her learn new thought and behavior patterns. The therapist also helps your child resist compulsive behaviors, such as mirror checking. Other types of therapy do not appear to be very effective in treating BDD.
If your child has severe symptoms, medicines may be prescribed. These medicines can help your child feel less anxious, depressed, and preoccupied with his or her seeming flaws.
What can I do to help my child?
Support your child. Encourage her to talk about whatever she wants to talk about. Be a good listener. This helps your child realize that her feelings and thoughts really do matter, that you truly care about her, and that you never stopped caring. If your child shuts you out, don’t walk away. Let your child know that you are there for her whenever she needs you. Remind your child of this over and over again. Even children raised in a loving and nurturing home need to hear it a lot because they may feel unworthy of love and attention for other reasons.
Donâ€™t criticize or tease your child about the way she looks. Praise your child for her efforts. Also, point out to your child that you appreciate other people for what they do rather than how they look.
Help your child learn to manage stress. Teach children to practice deep breathing or other relaxation techniques when feeling stressed. Help your child find ways to relax, for example take up a hobby, listen to music, watch movies, or take walks.
Take care of your childâ€™s physical health. Make sure your child eats a healthy diet and gets the right amount of sleep and exercise every day. Teach children to avoid alcohol, caffeine, nicotine, and drugs.
Help your child avoid TV programs, movies, magazines, or websites that emphasize being thin instead of being healthy. Teach your older child to question advertisements or articles that make her feel bad about her body shape or size. Are they are trying to sell something? Is what they say and show true? Or, have the pictures been air-brushed or computer generated to make the person look so perfect?
Understand that plastic surgery usually does not help. Your child may get addicted to plastic surgery because he can never be satisfied with the way he looks.
Check your childâ€™s medicines. Tell all healthcare providers who treat your child about all medicines the child takes.
Contact your healthcare provider or therapist if you have any questions or your childâ€™s symptoms seem to be getting worse.
Ask your child if she is feeling suicidal or has done anything to hurt herself. Get emergency care if your child has ideas of suicide or harming others or harming herself.
Developed by RelayHealth.
Pediatric Advisor 2015.1 published by RelayHealth. Last modified: 2013-09-11 Last reviewed: 2013-09-11
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Body Dysmorphic Disorder: References
Kaplan and Sadockâ€™s Comprehensive Textbook of Psychiatry. Sadock (Ed) and Sadock (Ed) 2008
Dulcan’s Textbook of Child and Adolescent Psychiatry. Mina K. Dulcan. 2009
Child and Adolescent Pyschopharmacology Made Simple. John D. Preston Psy D ABPP,Â John O’Neal,Â Mary C. Talaga, 2010
Cochrane Database Syst Rev.Â 2009 Jan 21;(1):CD005332. Pharmacotherapy and psychotherapy for body dysmorphic disorder. Ipser JC,Â Sander C,Â Stein DJ.
Clinical Obsessive-Compulsive Disorders in Adults and Children By Robert Hudak, Darin Dougherty Cambridge University Press, 2011