Body Dysmorphic Disorder

        Social media platforms have become widely used in the last decade by teenagers and young adults (Jiotsa et al., 2021). Social Media has exposed body ideals to women and men that start from a young age becoming the determining factor for what their physical appearance should look like. A study conducted by Alsaidan et al., revealed that increased activity use of social media platform is linked to increased prevalence of body dysmorphic disorder (BDD) among adolescents and young adults. Body image is depicted by an individual’s own body perception, thoughts, and emotions. This perception is created by external factors like social constructs, body ideals, family, and friends. Individuals with BDD often present as preoccupied with flaws in their physical appearance.

        The patient population with BDD are usually under the care of Dermatology Clinics and Plastic Surgery (Sun et al., 2022). This population is commonly undiagnosed and untreated during their appointment. Individuals who are underdiagnosed with BDD or untreated will lead to repetitive behavior impairing their day-to-day life (Sun et al., 2022). Sun et al., state that 76% of patients diagnosed with body dysmorphia disorder will undergo surgical and/or minimal invasive cosmetic treatments. Although patients have reported improved body image and self-esteem following the cosmetic treatment, studies have also shown that patient’s body image does not improve following the treatment (Pikoos et al., 2021). Individuals with body dysmorphia disorder can be grouped into non-severe and severe BDD. The group with non-severe BDD will have realistic expectations for postoperative results therefore they are content with their treatment because they are focused on a single concern. While the group with severe BDD will tend to shift their concerns to a different physical feature postoperative treatment result (Sun et al., 2022; Pikoos et al., 2021).

Furthermore, aesthetic medicine should have regular screening of the Body Dysmorphic Disorder Questionnaire and identify if patients meet DSM-5 diagnostic criteria. Aesthetic Medicine commonly practice the bioethical principle of autonomy. Patients seeking cosmetic treatments are deemed to understand the options available for treatments, are free from coercion and can freely choose their treatment option and meet the criteria to provide informed consent (Goodman and Houk, 2022; Sun et al., 2022). However, Sun et al., argue that practitioners should uphold the principle of non-malfeasance in situations such that a patient presents with the diagnosis of BDD and is enabled to provide informed consent due to cognitive deficits.

After learning about the high percentage of patients diagnosed with body dysmorphia disorder who are undergoing cosmetic procedures to “fix” their said problem-- should practitioners within the scope of Dermatology and Plastic Surgery screen for psychiatric disorders such as BDD and refrain from performing cosmetic procedures if the patient screens positive for the disorder?

References

Alsaidan, M. S., Altayar, N. S., Alshmmari, S. H., Alshammari , M. M., Alqahtani , F. T., & Mohajer, K. A.     (2020). The prevalence and determinants of body dysmorphic disorder among young social media             users: A cross-sectional study. Dermatology Reports, 12(3).

Goodman, C., & Houk, T. (2022). Misapplying autonomy: why patient wishes cannot settle treatment             decisions. Theoretical Medicine and Bioethics: Philosophy of Medical Research and Practice, 1–17.

Jiotsa, B., Naccache, B., Duval, M., Rocher, B., & Grall-Bronnec, M. (2021). Social Media Use and Body     Image Disorders: Association between Frequency of Comparing One’s Own Physical Appearance to        That of People Being Followed on Social Media and Body Dissatisfaction and Drive for Thinness.            International Journal of Environmental Research and Public Health, 18(6), 2880.

Pikoos, T. D., Rossell, S. L., Tzimas, N., & Buzwell, S. (2021). Is the needle as risky as the knife? The         prevalence and risks of body dysmorphic disorder in women undertaking minor cosmetic procedures.         Australian & New Zealand Journal of Psychiatry, 55(12), 1191–1201.

Sun, M. D., & Rieder, E. A. (2022). Psychosocial issues and body dysmorphic disorder in aesthetics:             Review and debate. Clinics in Dermatology, 40(1), 4–10.