Archive for Body Dysmorphic Disorder (BDD)
Orthorexia: Where Eating Disorders Meet OCD
Orthorexia – The Not-So-Healthy Obsession with “Healthy” Eating

Individuals suffering with Orthorexia exhibit symptoms similar to those of OCD and Eating Disorders.
Orthorexia Nervosa (also simply known as Orthorexia) is a relatively new term within the psychological and medical fields. Simply defined, Orthorexia is an eating disorder in which an individual has an excessive and ultimately unhealthy obsession about maintaining a diet that is totally “healthy” and “pure”. Because of their extremely restrictive eating, individuals with Orthorexia are often severely underweight, and frequently lack the proper nourishment to perform basic daily activities. Like most cases involving an eating disorder, the outcome of Orthorexia can be severe malnutrition and a significant reduction of one’s quality of life.
Orthorexia has not yet been accepted as a formal diagnosis by the psychiatric community, and has not been defined within the Diagnostic and Statistical Manual (DSM-IV). However, since first being described by Dr. Steven Bratman in 1996, many health professionals have observed the often debilitating results of this condition. › Continue reading
Social Anxiety / Social Phobia: Alone With Witnesses – Part 2
In part one of this two-part series, we discussed the experience of the Social Anxiety sufferer. In part two, we examine how to treat this condition with Cognitive Behavioral Therapy (CBT), and how Social Anxiety relates to other Obsessive Compulsive Spectrum Disorders.
Treatment of Social Anxiety

Social Anxiety can be successfully treated with Cognitive Behavioral Therapy (CBT)
The most effective form of treatment for Social Anxiety is the same as in other Obsessive Compulsive Spectrum Disorders – Cognitive Behavioral Therapy (CBT). This is because, like the other disorders in the spectrum, Social Anxiety involves an obsession and a series of compulsions which form a cycle.
The fundamental obsession in Social Anxiety is the fear of being evaluated negatively. This generally includes fears of being rejected, as well as the fear of being singled out for humiliation and traumatized by emotional abuse from others. The primary compulsion in Social Anxiety is the phobic avoidance of social situations in which one fears rejection and/or humiliation (thus its synonym, Social Phobia).
It is tempting to look at avoidance as the absence of engaging in social behavior. However, avoidance is an overt physical and mental behavior, the primary goal of which is to reduce or eliminate anxiety. For the individual with Social Anxiety, the act of choosing not to go to the party thus serves the same function as the act of choosing to wash one’s hands serves for the individual with OCD. Further, those with Social Anxiety who are able to commit to a social interaction may find themselves escaping mentally in the process by spending their energy focusing on things other than the present situation. › Continue reading
Body Dysmorphic Disorder (BDD) Research – Year in Review
Body Dysmorphic Disorder (BDD) is a condition in which one has an obsessive preoccupation with his or her physical appearance. We recently posted two articles about the condition, one on BDD in the media, and the other on BDD in teenagers. In the final installment of our three part series, we look at recent research related to this condition.
Body Dysmorphic Disorder and How We See Ourselves

Researchers are learning more about Body Dysmorphic Disorder (BDD)
This past year saw a number of interesting research studies on the topic of body image and Body Dysmorphic Disorder (BDD). One study surveyed over 2200 men and women of various body types regarding their self-perceptions related to weight and body image. Those who completed the survey were evaluated for their body-mass index (BMI), a ratio of height to weight that provides a range of numerical values for what could be described as a “healthy weight”. Participants were also instructed to describe how they perceived their bodies, using a range of terms such as “slim” and “fat”.
The study found that only 13% of the women participants who were evaluated as having a “healthy” weight for their height (BMI) were satisfied with their overall appearance. More disturbing was the finding that only 6% of these women saw themselves as being “slim”. Conversely, only 6% of the male participants who were evaluated as having a healthy BMI saw themselves as “fat”. Furthermore, of the study participants who were actually overweight, twice as many women as men described themselves as being “ashamed” of their bodies. The most obvious conclusion we can draw from these data is that men and women see themselves in startlingly different ways, and have very different emotional reactions to their weight. › Continue reading
Body Dysmorphic Disorder (BDD) and Teens
Increasing numbers of teens are having elective cosmetic surgeries to address body image issues, without fully considering the physical and psychological risks involved. Part two of our three-part series on Body Dysmorphic Disorder (BDD).
Our last post focused on Body Dysmorphic Disorder (BDD), body image issues, and cosmetic surgery in the entertainment industry. While I can appreciate that movie stars and models to some extent depend on their appearance for their livelihoods, I worry about the message that stars’ cosmetic surgeries send to the public, particularly young women who see these stars as role models. One recent news story focused on the increasing numbers of teens seeking cosmetic surgeries. The article noted three problematic issues specifically related to this growing trend of teens looking to surgically enhance their bodies: › Continue reading
Body Dysmorphic Disorder (BDD) and Body Image in the News
Recently there have been a number of stories in the media that have touched upon the topic of Body Dysmorphic Disorder (BDD). These stories suggest the unfortunate extent to which women (and a growing number of men) appear to be internalizing extremely distorted ideas of beauty.
Will BDD become known as Heidi Montag Syndrome?
Perhaps the most public illustration of this growing problem is the case of Heidi Montag. Until a year ago, I had never heard of Heidi Montag, and I still have no idea why she is famous. Apparently, she is on a reality TV show called “The Hills”, which Stylite blogger Linda Ripoll describes as an “amazing exploration into self-hatred, body dysmorphic disorder, and addiction to plastic surgery”. › Continue reading
Treatment of OCD and OC Spectrum Disorders in Children
“If I knew then what I know now.”
Chances are, if you’re reading this, you’ve found yourself saying the same thing at some point in your adult life. Nowhere is this more relevant than from the perspective of someone looking back on a childhood with Obsessive Compulsive Disorder (OCD) or an Obsessive Compulsive Spectrum Disorder. When I meet a new client under 18, there is a powerful sense of traveling through time. I think, “If only I had someone like me to go back and talk to me when I was someone like this.” How much time might I have saved being able to resist repetitive, unnecessary rituals? How many more events, relationships, and simple moments of peace might I have been able to enjoy if only I had known what was really happening to me? › Continue reading
Latisse and Body Dysmorphic Disorder (BDD)
In late 2008, the drug Lumigan, originally developed to treat glaucoma, was approved by the Food and Drug Administration (FDA) to be prescribed as an eyelash enhancer. It seems that one of the side effects of the glaucoma drug, now called Latisse when marketed for eyelash enhancement, is eyelash growth. According to a recent article in the Los Angeles Times, Latisse is being prescribed by dermatologists, plastic surgeons, and day spa physicians to women who want to increase the length and fullness of their lashes.
Is this a good thing? One of the most common issues we see in our clients with Body Dysmorphic Disorder (BDD) is excessive focus on the appearance of their eyes, including their eyelashes. Latisse plays right into this common BDD concern. › Continue reading
Proposed DSM-5 Changes for OCD and Anxiety Disorders
There have long been rumblings that the American Psychiatric Association (APA) was undertaking a thorough review of its Diagnostic and Statistical Manual, Fourth Edition (DSM-IV). The ostensible goal of such a review would be to create a more accurate and in-depth edition of the DSM, which was last updated in 1994.
After ten years of ongoing debate, the numerous APA work groups investigating potential revisions to various diagnoses and categories to be included in a planned fifth edition have presented their suggestions to the APA. Some of these changes are likely to be as controversial as current classifications in the DSM-IV, while others will pass barely noticed into the new DSM-5 (for example, the switch away from Roman numerals in the title). A number of these proposed changes directly impact conditions treated here at the OCD Center of Los Angeles. To wit: › Continue reading
Reassurance Seeking in OCD and Related Conditions
People with Obsessive Compulsive Disorder (OCD) who experience the pain and terror brought on by unwanted intrusive thoughts will use whatever means necessary to alleviate their discomfort. If they can’t make themselves feel sure about something internally, they reach out to the nearest person who they think can do it for them. If they are unavailable, the person with OCD will often reach out to the cold, unforgiving internet where the answers they hope not to find will always be waiting. › Continue reading
Body Dysmorphic Disorder (BDD) and Cosmetic Surgery
Recently, a friend suggested I read Bodies, the most recent book by Susie Orbach. I had not previously heard of this book, but even a casual reading of the synopsis on Amazon confirms what we see every day at the OCD Center of Los Angeles. Between our clients with Body Dysmorphic Disorder (BDD), and the thousands (millions?) of cosmetic procedures that are basically the norm here in Los Angeles, it is painfully obvious that many people not only dislike their bodies, but are willing to undergo painful, expensive surgeries in an effort to reduce their insecurities. › Continue reading
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