Treatment for body dysmorphia

If you're having body image problems that affect your everyday life, seek support. There are treatments available to help. 

I started to believe in myself and ‘live in the moment’. I finally started to feel good about how I looked.

Support from your GP for body dysmorphia

Talking to your GP is a good place to start. They can refer you for an assessment and help you access treatment.

If you're diagnosed with body dysmorphic disorder (BDD), your GP should offer you treatment. These should include cognitive behavioural therapy (CBT) and medication.

These treatments are recommended by the National Institute of Health and Care Excellence (NICE) in its OCD and BDD: treatment guidelines.

If you're worried about speaking to your GP, see our tips for talking to your GP.

Professionals can sometimes miss the signs of body dysmorphia.

You might feel your GP doesn't recognise your symptoms. Or perhaps you're not getting the treatment you need. You could get an advocate to support you. Our pages on advocacy and mental health have more information.

Cognitive behavioural therapy (CBT)

CBT is a form of talking therapy. It aims to show connections between your thoughts, feelings and behaviours. It can also help you develop practical skills to manage them. Sometimes this involves using self-help materials such as books or computer programmes.

The treatment your doctor offers may depend on how severe your symptoms are. But ideally they should offer you CBT before prescribing any medication.

CBT can be delivered via telephone, video, or face-to-face with a therapist. And it's either one-to-one or in a group.

The aim of CBT for body dysmorphia is to help you feel less anxious about your body by:

• Helping you change your attitude to body image and physical appearance
• Exploring your worries about your perceived physical flaw(s)
• Reducing your need to carry out compulsive behaviours

Our page on CBT has more information on CBT.

Exposure and response prevention in CBT

A type of CBT – known as exposure and response prevention (ERP) – is recommended for BDD. This technique helps you confront your obsessions so you get used to dealing with them.

This involves:

• Facing situations where you'd normally think obsessively about part of your appearance. This is to help you cope better with these situations over time.
• Developing techniques to help you avoid doing compulsive behaviours when you'd normally want to. Like mirror checking.

ERP needs to be carefully managed to avoid causing more anxiety and distress. So it's important that you understand the treatment fully. And that you feel comfortable with your therapist.

Medication

Your doctor might offer to prescribe antidepressants.

This could be on its own, or in combination with CBT. For example, if:

• CBT isn't successful in treating your BDD
• Your BDD is moderately to severely affecting how you live your day-to-day life

The type of antidepressant is usually a selective serotonin reuptake inhibitor (SSRI). These can help reduce obsessive thoughts and behaviours.

SSRIs can cause unpleasant side effects for some people. It's a good idea to discuss this with your GP before starting.

If a first course of SSRIs and more intensive CBT isn't effective, the next step is usually to try a different SSRI. Or another antidepressant called clomipramine.

Our information on antidepressants includes more about SSRIs and side effects of antidepressants. You can also take a look at our information on what you should do before starting medication.

Specialist services for BDD

If other treatments aren't helpful, your GP may refer you for specialist help.

This could be through community-based mental health and social care. You'll be given a more thorough assessment by the community mental health team (CMHT). Your CMHT will develop a potential care plan with you. This may include support from a service that specialises in BDD.

Access to specialist services is limited across the UK. You may need to travel outside your local area. Waiting times for specialist services can also be very long.

Find out more in our pages on health and social care rights.

What other treatments are there for body dysmorphia?

Everyone is different. So the treatments recommended by the NICE guidelines don't always work for everyone.

You may find different treatments or self-care techniques helpful. This could be on their own or alongside other treatments. Some of our tips for improving your body image may help.

The Body Dysmorphic Disorder Foundation has further information about treatments for BDD.

Can cosmetic surgery help with body dysmorphia?

Doctors do not recommend cosmetic surgery if you have body dysmorphia.

This is because:

• The focus of your worry could shift to another part of your body after surgery
• Surgery has health risks

If you go for a cosmetic or skin procedure and the provider thinks you might have body dysmorphia, they may refer you to a specialist. This should be a mental health professional who specialises in body dysmorphia. 

They should assess you. They may ask you to give yourself time first. They could suggest you try treatment for body dysmorphia before any cosmetic surgery.