The Psychology of Dieting Series: Body Dysmorphic Disorder

21 March, 2021

            The Psychology of Dieting Series: Body Dysmorphic Disorder

As the second overview in Remedy Kitchen's Psychology of Dieting Series, we're bringing awareness to another form of psychological health issue linked to the development of eating disorders. Last week, we covered the topic of Binge Eating Disorder. In the upcoming weeks we'll be delving deeper into some more topics that link in with our ongoing dedication in supporting Eating Disorder Awareness Week. So, this week, we're going over Body Dysmorphic Disorder (BDD).

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What is Body Dysmorphic Disorder?

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Body Dysmorphic Disorder - abbreviated as 'BDD' both in medical terms and for the purposes of this article - is where a patient suffers extreme misperceptions regarding their physical appearance. We all feel some kind of pressure to look our best, what with the abundance of appearance improving cosmetics, baseless rituals and even dieting pills that are relentlessly promoted on social media. However, BDD is an intense form of almost self-loathing, whereby the patient is consumed by the urge to improve their looks; or hide them away.

The disorder is a psychiatric disorder, and so sufferers of BDD are often unable to overcome their torment without adequate mental health support and treatment. BDD is sometimes referred to as dysmorphophobia, and essentially; the clue as to what the disorder entails lies within the name.

The Psychology of Body Dysmorphic Disorder Delusions

Those with BDD find they exhibit physical defects that are then obsessed over, scrutinised in the mirror for hours on end. Even resulting in cosmetic surgery to fix their 'defect'. While some BDD patients acknowledge and recognise that their defects are not, in fact, disastrous portrayals of who they are as a person, every case varies in severity. Some patients understand that others see them as a usual person, since peers generally do not fixate themselves on the barely noticeable imperfections of others.

Other forms of BDD can be more severe, with roots in psychological delusions. Delusional Body Dysmorphic Disorder is a deeper psychiatry issue, whereby patients become fixated on body image 'defects' that may not actually be there.

Body Dysmorphic Disorder: the Endless Pursuit for Perfection

The methods people with BDD use to diminish the visual impact of their 'defects' can be extremely damaging to their physical and mental health. It doesn't matter whether the defect is actually there (but only a minor one that is fixated upon by the patient), or whether the defect materialises as a result of delusional symptoms. The purposed solutions that patients will resort to are often damaging.

These pursuits result in drastic efforts to alter appearances, often at any cost. The patient believes this will reduce the psychological distress they experience concerning their defects, however the result can lead to further damage and mental anguish. Harmful procedures or habits include cosmetic surgery, extreme dieting, excessive 'grooming' and even attempting self-surgery.

Since the core cause of BDD may lie within neurological explanations, it is concerning to know that BDD is a relatively understudied form of psychological illness. With a growing number of scientific studies into BDD, as well as increased awareness surrounding the disorder, there are hopes that treatment options for the future will become more effective.

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Body Dysmorphic Disorder and Eating Disorders

The visual perceptions experienced by those with BDD as they gaze upon themselves in the mirror can cause intense feelings of emotional distress. Suicidal ideation, becoming reclusive and avoiding social situations due to debilitating anxiety; these are just a few of the symptoms of Body Dysmorphic Disorder. As such, patients resort to extreme measures in order to overcome what they perceive to be a vulgar defect. Many of these measures involve fasting, calorie restrictions or intense weight loss regimes.

Body Dysmorphic Disorder and Eating Disorders are separate conditions. BDD is not an Eating Disorder, and Eating Disorders aren't a Body Dysmorphic Disorder or Delusion. Developing an eating disorder is considered a symptom of BDD, while BDD is cited as an underlying symptom of Eating Disorder diagnoses. It seems like a chicken and egg situation*. Complex for now, but we have the scientific research underway that will hopefully reveal some insights, eventually prompting structured treatment plans.
(*the egg?)

Complexity arises as people with eating disorders report concurrent symptoms parallel to those associated with BDD. The links between the psychological disorders overlap closely. The intricacies regarding the correlations and comorbidity of Obsessive Compulsive Disorder, Body Dysmorphic Disorder and Eating Disorders continue.

Despite this, researchers are rightly intrigued by the links between BDD and Eating Disorder phenomenology specifically. Links need to be connected, and we're slowly (but surely) getting there. A 2006 study by Grant & Phillips set out to determine whether Anorexia Nervosa was a 'subtype' of Body Dysmorphic Disorder.

Their findings reported that no, Anorexia Nervosa is not a subtype of Body Dysmorphic Disorder. By 'subtype,' they mean that Anorexia Nervosa would be a secondary condition linked to BDD, implying the BDD comes first and the onset of the eating disorder is then triggered as a result. The study shows the disorders are entirely separate, however they are closely linked with correlating symptoms. The researchers concluded that the disorders should be regarded entirely separate in a clinical sense.

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Research into Body Dysmorphic Disorder

Studies into delusional BDD are breaking into some previously untapped areas of the psyche, uncovering why such delusions happen.

UCLA scientists studied the neuropathology in BDD patients using fMRI scans of the brain to determine the severity of any noticeable psychological activity. Aptly named "Why the Mirror Lies," the hypothesis of the study was that body dysmorphic tendencies would correlate with . Patients had to look at an original photo of their face, alongside an edited version that highlighted high-spatial frequency information.

Patients were found to have diminished visual input processing capabilities, since the frontostratial systems portrayed peculiar reactions to the images. The lower the self-image of the participant, the more intense this unusual activity became. Conversely, the control group had no significant issues. The researchers also concluded that the neurological areas that become overwhelmed with stimuli in BDD patients correlate with the areas of overstimulation found to cause problems in Obsessive Compulsive Disorder (OCD).

This link between similar neural pathways supports the obsessive symptoms that those with BDD experience. The participants subconsciously focused on details that others would barely notice when looking at them. Researcher Fausner explained how their obsessive regard for detail means they cannot ascertain between the minor 'defects' they see and the entire image of their face as a holistic entity.

This research shows the BDD experience of psychological distress and delusional effects. This determines the pathological nature of symptoms, discerning that dedicated psychiatric support and therapy should be regarded as a potential treatment. Relating this to how those with eating disorders experience BDD, we could assume that the same neurological patterns show abnormal activity upon scrutinising their bodies - rather than their face. Of course, further studies are sure to come.

Body Dysmorphic Disorder Delusions BDD Psychology of Eating and Dieting Eating Disorders and BDD Links

If you want to lose weight, do it healthily.

In raising awareness about Eating Disorders, we are committed to sourcing factual scientific data that helps us portray the message to our readers. Eating disorders always have been, and still are, a debilitating struggle for many women and men out there.

While there are many causative speculations regarding how these disorders begin, it's difficult to ignore the potential impact of the toxic dieting culture that we've cultivated here in the Western world.

Societal pressures do have an impact on us, even on a subconscious level. Remedy's mission set out to change these ideologies, one customer (or reader) at a time. On the whole, humans seem blindly disoriented by the external effects of expectations and the ever-changing definition of 'beauty'. We're here to challenge this. Nutritional health comes first for us, and it should for you too. The issue with eating disorders and endless weight loss attempts is clear. It doesn't work. Of course, if you are suffering from BDD, any form of eating disorder or psychological delusions, you need to seek help from a medical professional.

For those simply wanting to get their diet in check... Simple lifestyle transformations have the ability to evoke balance every day, uplifting the spirits and informing your overall physical health. Let's start with nutrition. Remedy have developed a nourishing range of meal prep plans specifically for this reason. With thoughtfully combined ingredients and nutritive benefits, each plan offers something unique for everyone.

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Thanks For Reading...

The Remedy Kitchen concept and ethos was created by Katie McIntosh, Remedy Kitchen’s co-founder and Managing Director.
Katie is a specialist in Nutritional Interventions for Eating Disorders & Obesity, and has completed an expanding range of wellbeing-centric qualifications to date, including Detox Specialist, Advanced Sports & Exercise Nutrition, Performance Enhancement Specialist with the National Academy of Sports Medicine, Precision Nutrition Level 1 Coach and BSc Psychology. Katie is also a member of the British Psychological Society.
Having first launched her career as a fitness professional back in 2015, Katie realised her passion for helping others use nutrition to elevate their health could be put to better use. It was this realisation, along with the identification of a stark gap in the market , that inspired the Remedy Kitchen concept into what it is today.