Body Dysmorphic Disorder and Cosmetic Treatments

The spotlight is rightly increasing on the link between psychological health and cosmetic procedures. As both a Cosmetic Doctor and Psychiatrist, Dr Azoo is uniquely placed to offer expert insight into the relationship between these 2 fields of medicine.

Body Dysmorphic Disorder (BDD), or dysmorphophobia, is the preoccupation with an imagined defect in appearance that leads to significant distress and impairment in daily functioning.

Due to their lack of insight, individuals with BDD believe that cosmetic procedures will be the solution to their insecurities, even though they rarely get satisfaction from them. Cosmetic procedures can then become an addiction, as patients never reach full satisfaction.

People with body dysmorphic disorder think about their real or perceived physical flaws for hours each day. Their obsessive thoughts may lead to severe emotional distress and can interfere with everyday life.

Who does it affect?

BDD affects about 1 in every 50 people and effects men and women almost equally.

BDD often begins to occur in adolescents 12-13 years of age.

Young women’s self-esteem is worryingly low and professional aesthetic doctors are becoming increasingly concerned at a spike in girls as young as 13 getting Botox. Mental health problems and, of course, “celebrity culture” play an important and connected role in this phenomenon. There are also still no legal age restrictions on Botox (although no responsible practitioner should administer Botox to children without clear medical necessity) and the industry remains woefully unregulated which is a major concern for both patients and professionals.

Many people with BDD do not seek help because they are worried that people will judge them or think they are vain. This means that many people with BDD are likely to experience it for a long time before seeking support.

It is more of a psychological issue than a physical addiction.

An individual suffering from BDD can dislike any part of their body, but most often they find fault with:






Someone with body dysmorphic disorder can see their flaws as significant and prominent, even if they are barely minor imperfections. It is a condition that can drive people to have cosmetic procedures again and again. The desire to fix the perceived ‘defect’ can ultimately lead to an addiction.

A combination of problems

Another important aspect is that people who have body dysmorphic disorder are more likely to have another psychiatric disorder such as:



•Substance use disorder including alcohol and drugs

•Eating disorders

•Obsessive Compulsive Disorder (OCD)

Someone showing signs of cosmetic procedure addiction may also be suffering from another issue that is causing them to abuse drugs and alcohol as well as putting themselves through repeated procedures.

Cosmetic procedures are not the only way that people suffering from body dysmorphic disorder try to ‘fix’ their flaws. Some will turn to very dangerous drugs in hopes of improving their bodies. This self-medicating can also lead to substance use disorder.

This is why dual diagnosis treatment is so important for people who struggle with co-occurring disorders, having a comprehensive and holistic program with dual diagnosis resources can make all the difference.

Aesthetic Doctors and Cosmetic Treatment Addiction

While aesthetic doctors are trained to perform cosmetic procedures, they should also have the ability to identify patients who may develop a cosmetic treatment addiction. So what are some warning signs doctors could be watching for? A few examples may be:

1. Patients are often unhappy with the results of their cosmetic procedures and take their frustrations out on their treating doctor in extreme cases.

2. The individual may have very unrealistic expectations about the treatment, thinking it will gain them a better job or a better relationship.

3. They may be satisfied with the requested treatment, but then “suddenly realize” another feature is unacceptable and desire more procedures.

In response to this issue, aesthetic practitioners need to have the required skills and knowledge to correctly identify those presenting with BDD like symptoms. Administering a questionnaire such as the one available at Dr Azoo Cosmetic Clinic (Here) to screen for associated symptoms can be helpful. Those who show signs of BDD can then have a further discussion with Dr Azoo and be referred to mental health professionals for specialised treatments, such as cognitive behavioural therapy, exposure and response prevention, family support and medication as required.

Medical practitioners have an ethical responsibility to weigh the risks and potential benefits of any treatment. Dr Azoo puts the health and overall wellbeing of his patients at the forefront of any decision he makes. He will not perform a cosmetic procedure on anyone who I believe is having it unnecessarily, whether that's through addiction or coercion. Dr Azoo believes that everyone is beautiful just the way they are, and that cosmetic treatments should be used to complement a person's individual and natural beauty.

Further information and support on BDD can be found through the MIND website via this link:

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