BODY DYSMORPHIC DISORDER (BDD)

Dr Benny Monzani (Clinical Psychologist)

National Specialist CAMHS for OCD, BDD
and Related Disorders
Sky news BDD video

Imperfect Me: The impact of Body Dysmorphia

What is BDD?

1. Preoccupation with a
2. Repetitive behaviours to
perceived flaw/s
fix/hide flaw/s
(any body part)

3. Not about weight

4. Distress/Impairment
(i.e. eating disorder)
BDD Statistics
• Affects 2% of adolescents
• BDD is often undetected without direct screening

• Female > Male

• Onset during adolescents

• Depression & anxiety disorders are common with BDD

Causes of BDD
• Biological factors (genes, chemicals, brain systems)

• Environmental factors also important

• Negative stressful events (e.g. teasing/bullying, family stress,
abuse, etc)
• Perfectionism
• Aestheticality
BDD Treatment
• NICE guidelines recommend:
• Cognitive Behaviour Therapy (CBT)
• Selective Serotonin Re-uptake Inhibitors (SSRIs)

• Cosmetic treatment is not recommended

Signs of BDD in School
Warning Signs
Late/inconsistence attendance or not attending at all
Avoiding certain lessons e.g. P.E.
Leaving class to check mirrors/ reflective surfaces
Excessive make-up or not adhering to uniform rules at school to hide appearance
Seeking reassurance about appearance
Difficulty focusing due to appearance worries
Avoiding being around peers
Decline in academic performance
What can schools do?

Ask about appearance Share useful

anxiety/BDD! resources

Give useful contacts Give a hopeful

(CAMHS, GP) message for the future
How can schools help?
Tips on how school can help
Awareness of BDD
School adjustments
Things to avoid
Peer relationships
Work together
Ask about appearance anxiety, validate feeling and
show understanding, share BDD resources
Breaks, extra time, strategies to support them in
school (e.g. clothes, time table, signals)
Discussing appearance, involvement in BDD
behaviours/rituals
Look out for teasing/bullying
Liaise with family and other professionals
Resources
• Charities (incl resources & support groups):
• BDD Foundation: www.bddfoundation.org
• OCD Action: www.ocdaction.org.uk

• Online resources:
• https://m.youtube.com/watch?v=ZrjmeBZUeb8
• https://www.bbc.co.uk/programmes/p067bnvw

• Books
• ‘Appearance anxiety’ (first book on adolescent BDD) coming out
soon (March 2019)
• Treatment books by Veale & Neziroglu; and by S. Wilhelm
WHAT DO PEOPLE
THINK OF BDD AS A
DIAGNOSIS?
It’s just vanity
It’s because of
social media

It’s normal to worry

about appearance
Our service
• N&S outpatient CAMHS
• Mild to Severe BDD
• < 18 years old

• We offer
• Assessment
• Treatment
• Consultation
• Workshop & Teaching
Contact us
• Contact details
• Telephone: 020 3228 5222
• Email: ocdbdd.camhs@slam.nhs.uk
• https://www.national.slam.nhs.uk/services/camhs/body-
dysmorphic-disorder-service/

• How to refer:
• Written referrals from CAMHS incl. background information &
presenting problem
Take home message
• BDD is a common and debilitating condition

• BDD can affect school in different ways

• Don’t be shy to ask about BDD!

• There are different ways students with BDD can be

supported in school
THANK YOU!
Dr Angela Lewis & Dr Benny Monzani
National Specialist CAMHS for OCD, BDD
and Related Disorders