Body Image Program

We’re very pleased to announce that Dr. Katharine Phillips has published a new book on BDD! This book: Understanding Body Dysmorphic Disorder: An Essential Guide was published in January 2009 by Oxford University Press.

Welcome to Our Program
The Body Dysmorphic Disorder and Body Image Program is one of the few specialty programs in the country for body dysmorphic disorder (BDD). The program is directed by Katharine A. Phillips, M.D., Professor of Psychiatry and Human Behavior at Butler Hospital and The Warren Alpert Medical School of Brown University in Providence, Rhode Island. Dr. Phillips is internationally known for her pioneering clinical and research work on BDD.

This website is periodically updated to bring you current information about BDD. We welcome you to browse through our pages for more in-depth information on body dysmorphic disorder and our program, which is located at Butler Hospital and affiliated with The Warren Alpert Medical School of Brown University. Our program is dedicated to helping people with BDD. We do this by spreading the word about BDD, educating students and trainees, and doing clinical research on BDD in order to increase knowledge about BDD and develop new and better treatments for this disorder.

Because BDD causes so much suffering yet is still unfamiliar to many people, a major part of our mission is to spread the word about BDD to both professionals and the public. To accomplish this, Dr. Phillips has written the most comprehensive book on BDD and its treatment: “The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder”, published by Oxford University Press. She recently revised and updated this book (2009): “Body Dysmorphic Disorder: An Essential Guide”, which was also published by Oxford University Press. This more recent update reflects new knowledge about BDD. It’s also geared more toward BDD sufferers, their family, and their friends. However, professionals and anyone else interested in learning about BDD should find it helpful. Dr. Phillips is also co-author of “The Adonis Complex: How to Identify, Treat, and Prevent Body Obsession in Men and Boys”, published by the Free Press in 2002.

Dr. Phillips speaks widely and has done many media interviews on BDD. For example, she has appeared on the Oprah Winfrey Show, Dateline NBC, The Today Show, ABC’s 20-20, MSNBC, and CNN, and she has been interviewed by the New York Times, Time Magazine, the Boston Globe, and many other media outlets. We also do clinical research to increase understanding of BDD and develop more effective treatments for this emotionally painful and sometimes disabling problem. Research enables us to learn critically important things, such as how to identify BDD, who gets it, how it affects people, what causes it, and what treatments work. Our ongoing treatment studies offer free study treatment for people who qualify.

What is Body Dysmorphic Disorder?
This section provides a brief overview of Body Dysmorphic Disorder. More detailed information is provided in other sections of our website.

Body dysmorphic disorder (or BDD) is a relatively common, often severe, and under-recognized body image disorder. People with BDD experience distressing or impairing preoccupations with perceived flaws in their appearance. People with BDD are obsessed with the belief that something’s wrong with how they look. They may describe themselves as looking ugly, unattractive, “not right,” deformed -- or even “hideous” or “monstrous.” This preoccupation frequently focuses on the face or head, often the skin (for example, acne, scarring, skin color, lines, wrinkles), hair (for example, thinning or too much or too little body hair), or nose (for example, size or shape). However, people with BDD can dislike any part of their body.

People with BDD think about their perceived appearance flaws for at least an hour a day, and typically for many hours a day. When other people say they look fine, people with BDD find it hard to believe this reassurance. Click here to read In Our Own Words, stories of people with BDD.

These appearance concerns cause significant emotional distress or problems in daily functioning (usually both). For example, the appearance worries can lead to low self-esteem, avoidance of family and friends, and problems with work or school. They often fuel anxiety, depression, and even thoughts about suicide. Some people experience manageable distress and are able to function well, although not up to their potential. Others find that this disorder ruins their life.

BDD is an underrecognized and serious mental illness. It isn’t vanity. It’s important to recognize the symptoms of BDD and get the right treatment.

Recognizing BDD: Common Appearance Concerns and Behaviors
A person with BDD can be preoccupied with the appearance of any body area. Common body areas of concern are:

People with BDD may frequently:

• Try to hide the perceived appearance flaws with clothes, makeup, a hat, sunglasses, or other types of cover
• Frequently check or avoid mirrors or other reflecting surfaces
• Compare their appearance with that of other people
• Frequently change their clothes
• Excessively groom (e.g., excessively perform skin routines, hair styling, makeup application, shaving)
• Pick their skin
• Ask others for reassurance about their appearance
• Exercise excessively
• Diet

Effective Treatments Are Available for BDD
The good news is there are effective treatments for BDD. BDD isn’t vanity. It is a bona fide medical disorder that often gets better with the right treatment. Elsewhere on this website, we provide more detail about these treatments. We also describe free study treatment that we offer through our research program for people who qualify.

Certain medications called serotonin-reuptake inhibitors (also known as SRIs or SSRIs) are often very helpful for BDD. They are not habit forming and are usually well tolerated. A certain type of therapy, called cognitive-behavioral therapy (or CBT), is also often helpful for BDD. These two types of treatment often diminish appearance preoccupations and compulsive behaviors (such as mirror checking), alleviate emotional distress and suffering, and improve depression in people with BDD. They also often help people with BDD feel better about how they look, function better, and lead a happier and more productive life. There is hope for people with BDD!

Here is more information about BDD and treatment options.

How Our Program Can Help
We are dedicated to doing research to increase understanding of BDD and to develop new -- and more effective -- treatments for BDD. Research provides extremely valuable information about BDD. It’s the best way to better understand BDD and how to overcome it. We regularly publish our research findings in scientific journals so they are available to both professionals and the public. We also disseminate our research findings through presentations and media interviews. 

We can do research and learn what treatments are effective only if people volunteer to participate in our studies. We are very grateful to everyone who participates! Their participation is an invaluable contribution toward our ultimate goal: to diminish suffering and improve quality of life for people with BDD.

Free Study Treatment for Those Who Qualify
We offer free study treatment for those who are within driving distance (about an hour) of Providence, RI, and who further qualify for our studies. Some of our studies are also offered in Boston, Massachusetts and New York City in collaboration with other researchers.

To read more about our treatment research, please visit our page, Free Treatment Studies and Other Studies of BDD.

Suggested Reading on BDD
On this website we offer suggested reading on BDD. This includes books and articles written for the public and professionals (psychologists, psychiatrists, other physicians, social workers, etc.) Reading these articles is a good way to stay abreast of recent developments in the field, including treatment recommendations. We update this listing periodically. Please click on the following link for a list of publications about Body Dysmorphic Disorder.

Where to Find Treatment for BDD
Finally, it’s important for BDD sufferers to see licensed professionals who are familiar with BDD and its treatment. We periodically update our list of referrals, which includes professionals around the world who have experience treating BDD. Although this list isn’t comprehensive (there are professionals qualified to treat BDD whom we don’t necessarily know), we do our best to provide information on where to find treatment for this disorder.