BDD Subtypes and Muscle Dysmorphia: Assessment Led Guidance

Specialist CBT therapy for anxiety, OCD, depression and more in West London

Appearance related distress can involve checking, camouflage, comparison, avoidance, rigid exercise or diet rules, skin focused behaviours or a sense that a particular feature is unacceptable. A guide cannot diagnose body dysmorphic disorder, muscle dysmorphia, an eating disorder, a skin condition or another explanation for an individual's concerns. Diagnostic manuals include a muscle dysmorphia specifier within body dysmorphic disorder. Some people use other informal terms to describe dissatisfaction with muscularity, skin, hair or other features. These descriptions can help a person explain their experience, but they cannot establish a diagnosis, cause or treatment plan. Context, distress, repetitive behaviours, physical health, substance use, eating patterns, daily functioning and safety all matter. Skin damage, infection, severe changes in eating, injury from exercise, use of anabolic substances, medication questions or cosmetic procedure decisions may need medical, dermatological, substance use, dietetic or specialist assessment. Those concerns should not automatically be treated as an anxiety or body image problem. A therapist cannot advise on stopping medication or substances, prescribe a diet or exercise plan, or decide whether a cosmetic procedure is medically appropriate. CBT based support may explore appearance related thoughts, checking, avoidance, comparison, shame or compulsive patterns where clinically appropriate. Exposure based or behavioural work should be planned collaboratively with an appropriately trained clinician, not treated as a self directed challenge. The pace and focus depend on assessment, risk, health and the person's goals. For related information, see BDD therapy at https://lyceumclinic.co.uk/therapy/body dysmorphic disorder/, BDD and cosmetic procedures at https://lyceumclinic.co.uk/guides/bdd cosmetic procedures west london/, mental health and movement at https://lyceumclinic.co.uk/guides/mental health weight diet movement/ and BDD neuroscience at https://lyceumclinic.co.uk/guides/bdd neuroscience/. If appearance concerns are accompanied by inability to stay safe, thoughts of harming yourself, severe restriction, purging, serious physical deterioration, psychosis, confusion or a sudden marked change in mental state, seek urgent help. In immediate danger, call 999 or attend A&E.