Meet Robyn Stern: She is a licensed clinical social worker in the United States specializing in treating BDD. She was formally diagnosed with BDD when she was 22 years old after several years of not knowing what was wrong with her, misdiagnosed with depression and anxiety and struggling to maintain day to day tasks and functioning.
“Life as a I knew it failed to exist, as my thoughts about my appearance consumed me and took away all the joy in my life; (family, friends, and school). The thoughts of my appearance being faulty, led me to feel defective, different, and just not sure how to navigate the world on a day-to-day basis.”
Robyn accessed evidence-based treatment and utilized Cognitive Behavioural Therapy (CBT), Exposure Response Prevention (ERP) and Acceptance Commitment Therapy as well as more intensive psychotherapy with a licensed therapist:
“I have learned that BDD and my physical appearance do not need to define me and how I choose to live each day. The work while challenging has given me a place in recovery, which has allowed me to give to other people. I am extremely enthusiastic about understanding the complexities of this disorder because it took so much life from me, but most importantly, I want to help others.”
Learn more about the report that was released by the Health and Social Care Committee this week.
Our Ambassador Charlie King, media volunteer Kim Booker and others associated with the BDD Foundation have been talking with the media this week about the importance of this report into body image, in particular highlighting the issues surrounding Body Dysmorphic Disorder and how the government can help.
Here are some highlights:
Kim Booker who gave evidence to the Parliamentary inquiry into the impact of Body Image has also been interviewed in recent days on her experience of BDD which fuelled her use of aesthetics. She calls for better regulation of the industry and support for those suffering from Body Dysmorphic Disorder
Her powerful testimony can be found on Sky News and Channel 4 news.
The BDD Foundation has been campaigning hard for changes in policy and legislation to protect vulnerable individuals such as those with BDD. This has included our campaign with Monki and Change.org petition calling for transparency on altered images online, signing up to Dr Luke Evans ‘Body Image Pledge‘ calling for the same legislation and more recently submitting evidence to the Health and Social Care Committee’s inquiry into the impact of body image.
Video evidence that was given can be found here.
The BDD Foundation also submitted written evidence with the help of Dr Georgina Krebs.
The final report was released on Tuesday 2nd August and we are very pleased to say that Body Dysmorphic Disorder has it’s own section as well as specific recommendations to the Government.
“We received much evidence detailing one of the conditions that can directly develop because of poor body image: Body Dysmorphic Disorder (BDD). The Body Dysmorphic Disorder Foundation described this disorder as: a mental health condition characterised by excessive preoccupation with perceived flaws in physical appearance. These flaws appear as very minimal or completely unobservable to others, but are a source of great distress to the BDD sufferer. People with BDD can be preoccupied with any aspect of their appearance, but the most common focus is facial features, such as eyes, teeth, nose, skin and hair. BDD differs from body image issues seen in other conditions such as eating disorders, which focus primarily on weight and shape.
Dr Georgina Krebs, a specialist in BDD, highlighted that BDD was previously thought to be rare, but recent studies have shown that about 2% of the general population experience BDD at any one point in time. She said that it is not known if BDD is becoming increasingly common over time, but this is plausible in the context of rising sociocultural pressures relating to appearance. It is known, however, that the prevalence of BDD is much higher in certain groups. For example, the Mental Health in Young People 2017 survey, commissioned by NHS Digital and conducted by the Office for National Statistics, found that more than one in 20 (5.6%) 17- to 19-year-old girls experience BDD.
We heard that the impact of BDD can be profound and that the disorder often leads to other mental health conditions, such as depression and substance misuse. Concerningly, rates of suicidality are also very high. Approximately one in four people with BDD attempt suicide, making it one of the highest risk of all mental health disorders.
We were told of the significant impact that BDD can have on how people function. Evidence shows that, among young people attending mental health services for BDD, one in three are out of school because of their appearance concerns. It is also common for young people with BDD to completely withdraw from social activities because of their appearance concerns, and even become housebound.
This echoes the experience of Kim Booker, one of our lived experience witnesses. She described how it felt to live with BDD:
“Rather than see myself as a whole, I see myself as fractured pieces. I home
in and zoom in on certain parts of myself and heavily criticise parts that
I see as flaws. When I have really bad flare-ups, it can take up about 80%
of my mind capacity. It is all I can think about. For instance, when I want
to change certain features of my face, I am constantly thinking about how
I am going to change it. I feel ugly. I do not like people looking at certain
sides of my face. Sometimes I do not want to leave the house. It is in the
category of OCD; it is a compulsive disorder. We ruminate and cannot stop
seeing the flaws, even though other people probably cannot see them.”
As with Kim, we were told that BDD typically emerges during adolescence and that it is essential that the disorder is recognised and treated early to avert the potentially devastating impact that it can have at this crucial developmental period.
Most worryingly, the BDD Foundation estimated that 85% of individuals with BDD do not receive an accurate diagnosis, due both to sufferers being reluctant to seek help and to healthcare professionals lacking adequate knowledge about the condition. We are concerned at the lack of resource being directed toward the treatment of those suffering, many unknowingly, with BDD.“
“We urge the Department to ensure more is done to make the diagnosis and treatment of Body Dysmorphic Disorder (BDD) a priority. From a diagnostic perspective, we recommend that Health Education England update the IAPT (Improving Access to Psychological Therapies) and EMHP (Educational Mental Health Practitioner) curricula to make training in BDD compulsory for all mental health practitioners. The Government should ensure BDD is included in the PSHE (personal, social, health and economic) education curricula within the section on body image, to promote early detection and early intervention within schools. As well as improved diagnosis rates, suitable care for those living with BDD must be available. We recommend that BDD specialist practitioners are eventually embedded into the multidisciplinary teams in every new community model for adults severely affected by mental illness.
We call on the Government to better equip future generations and their families with the skills and resources required to tackle body image issues. These skills and resources include critical thinking, particularly when it comes to appraising images, and self-worth. We recommend that the Government explores the use of family hubs as a route to educate parents and young people about body image, self-worth, and body positivity.
We commend the Government’s work to date to introduce Education Mental Health Practitioners within school-based Mental Health Support Teams across the country, as well as the commitment to have a Mental Health Lead teacher in schools. We recommend that the Government review the training of these practitioners to ensure it includes spotting early signs of conditions related to body image issues. We ask the Government to provide us with a further update on their progress in introducing these roles and to set out the timeframe for establishing them in every school in England.”
“Another condition that has serious physical health implications is muscle dysmorphia, a subtype of BDD characterised by the preoccupation with the idea that one’s body is not sufficiently lean and muscular. Chris Bell and Dr Charlotte Kerner from Brunel University told us that what can appear to be simply a high drive for muscularity in men and women can result in several potentially deleterious health consequences such as dietary restraint and binge eating practices, depression, anxiety, low self-esteem, perfectionism and steroid/supplement use.
We recommend that the Department commissions a national review of the growing use of anabolic steroids in England as it relates to body image. We further recommend that the Department introduces a national awareness campaign around safe anabolic steroid use. This ought to be coordinated through existing steroid user support groups and targeted at areas of highest risk, such as gyms with a high proportion of body builders.”
“We call on the Government to work with advertisers to feature a wider variety of body aesthetics, and work with industry and the ASA to encourage advertisers and influencers not to doctor their images. We believe the Government should introduce legislation that ensures commercial images are labelled with a logo where any part of the body, including its proportions and skin tone, are digitally altered.”
“We urge the Department to ensure more is done to make the diagnosis and treatment of Body Dysmorphic Disorder (BDD) a priority. From a diagnostic perspective, we recommend that Health Education England update the IAPT (Improving Access to Psychological Therapies) and EMHP (Educational Mental Health Practitioner) curricula to make training in BDD compulsory for all mental health practitioners. The Government should ensure BDD is included in the PSHE (personal, social, health and economic) education curricula within the section on body image, to promote early detection and early intervention within schools. As well as improved diagnosis rates, suitable care for those living with BDD must be available. We recommend that BDD specialist practitioners are eventually embedded into the multidisciplinary teams in every new community model for adults severely affected by mental illness.”
Eva has been recovered from BDD for 20 years, so brings loads of wisdom and experience to this episode. (Which is number 27, not 26, as I say in the intro!)
It’s a little different from the others in that Eva tells us her story directly, in four parts.
You can download the transcript for this episode here:
https://bddfoundation.org/wp-content/uploads/2022/08/Eva-Fisher-show-notes.pdf
Victoria Macdonald interviews a young woman with BDD and her mother about the experience of developing BDD through to diagnosis and then specialist treatment at the Maudsley Michael Rutter Centre.
The show also highlights the recent parliamentary inquiry and report into the impact of body image on physical and mental health.
Our wonderful trustee, Dr Amita Jassi, who is a Consultant Clinical Psychologist at the Maudsley Michael Rutter treatment centre, was also featured. She explains what Body Dysmorphic Disorder is, some common symptoms and how treatment can help.
To find out more about how you can access treatment on the NHS follow this link.
For more advice and support you can contact our e-helpline: support@bddfoundation.org
Dr Rob Willson from the Body Dysmorphic Foundation said: “There’s lots of pressure from social media to try to conform to certain stereotypes of an idealised beauty and particularly in men.
George Mycock discusses the impact that social media had on his muscle dysmorphia: “I think it does play a huge part – it’s very easy to get engrossed in an echo chamber, you follow the people who agree with your extreme thoughts and they show you more extreme thoughts and it starts spiralling out of control,” he said.
