Sometimes people are so ashamed how they look, they avoid social situations. At the extreme, some people think they have physical defects that are actually not visible to anyone else.
This is called, Body Dysmorphic Disorder (BDD). The Mayo Clinic defines it as “a mental health condition in which you can’t stop thinking about one or more perceived defects or flaws in your appearance – a flaw that appears minor or can’t be seen by others. But you may feel so embarrassed, ashamed and anxious that you may avoid many social situations.”
An example would be a 14-year-old girl who is certain that her nose is too large and misshapen that she begs her parents to let her get a “nose job.” However, her parents can see that her nose is normal, even attractive.
To help her feel better, her parents take her to a plastic surgeon. He tells her and her parents that her nose is 100% normal, and he will not operate on it.
A study in England of children and adolescents age 5-19, showed that body dysmorphic disorder (BDD) and preoccupation with appearance were more common than realized.
BDD was more common in adolescents and girls than children and boys. Preoccupation with appearance was more common than full-blown BDD.
However, preoccupation with appearance had the same rate and type of negative effects and associated impairment seen with BDD (Krebs G and colleagues Journal of Child and Adolescent Psychiatry, March 17, 2024).
The most common associated mental health conditions were anxiety and depression. Also, the children & adolescents and their parents reported “psychosocial impairment, self-harm and suicide attempts.”
Clearly, BDD and appearance preoccupation in children and adolescents are worrisome and warrent an evaluation by a mental health professional.
Peter M. Hartmann, MD
Family Medicine & Psychiatry
Health and Culture 