The 411 on Body Dysmorphic Disorder by Brian S. Glatt, MD, FACS

Board Certified Plastic Surgeon Brian S. Glatt, MD, FACS, was recently quoted in an article about Body Dysmorphic Disorder on


Read Dr. Glatt’s answers to frequently asked questions about BDD below.

~ What is Body Dysmorphic Disorder?

Body Dysmorphic Disorder (BDD) is a disease that causes a person to be excessively concerned about and overly preoccupied with a perceived defect in his or her physical appearance (body image).  This is a perception which is either out of proportion with the reality of the defect or is completely perceived by the patient and cannot be appreciated by someone else. 

~ What are the warning signs that someone has Body Dysmorphic Disorder?

Warning signs include obsessing over a particular feature or body part excessively, to the point that it may cause true psychological distress, changes or impairment in social relationships and functioning, development of depression or anxiety,  and withdrawal from social activities.  Classic symptoms include obsessive and/or delusional thoughts and behavior relating to a perceived appearance and/or defect, major depression, social withdrawal, suicidal or self-mutilating idealization, anxiety, feelings of shame, low self-esteem, overwhelming self-conscious feelings, or the total inability to work or function secondary to concerns about a perceived appearance.  

~ What causes Body Dysmorphic Disorder? 

BDD commonly develops in adolescence, but usually presents in adulthood as people suffer for years before seeking treatment.  There is no known cause.  BDD has some links with obsessive-compulsive disorder and anxiety disorders.  Teasing or excessive criticism or other life experiences may act as a trigger for susceptible people, but these are not thought to be causes. 

~ Why do some patients go too far?

Some people go so far as having surgery to “correct” the perceived defect, however this is never the answer and will frequently lead to never-ending requests for more surgery (e.g. Michael Jackson), and can also lead to psychosis and even suicidal tendencies.  

~ Is there a treatment/cure for this disease? 

Surgery, especially cosmetic surgery, is NEVER the answer and can actually make the condition worse.  Treatment is generally quite complex, and it is very difficult to persuade BDD sufferers to seek help since their insight concerning their psychological condition is very poor, and they remain very focused on the perceived physical aspect.  Treatment should be guided by a psychiatrist experienced with Body Dysmorphic Disorder and usually consists of a combination of psychotherapy and medication. 

~How often do you see this condition appearing in your own practice? 

This condition is more common than most practitioners realize and it is very easy to overlook the symptoms and perform surgery on a patient if you are not keenly aware of BDD and look out for it.  I see patients who clearly meet the criteria come through my practice at least monthly, and sometimes more commonly than that. 

~ How do you handle patients who you suspect may have the disorder? 

These patients are very difficult to manage and need to be treated carefully.  They generally get upset and angry when refused surgical treatment, and the conversation must be handled very gently.  I explain that they are not “crazy”, but I just cannot see what they see.  I encourage them to seek treatment with a therapist who specializes in BDD patients.  The unfortunate reality, though, is that most patients will eventually find another plastic surgeon willing to perform surgery despite the possibility of worsening the patient’s condition.

Contact Board Certified Plastic Surgeon Brian S. Glatt, MD, FACS at Premier Plastic Surgery Center of New Jersey by calling 973-889-9300, or visit his website

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