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Home / Body Image and Eating Disorders


Body image refers to how people see themselves. People with negative or distorted body image or BDD have a persistent and intrusive preoccupation with real or perceived flaws in their appearance. They think for hours everyday about their perceived flaws. Their thoughts cause them severe emotional distress and interfere with their work, daily life and relations. They may even undergo unnecessary plastic surgeries to correct perceived malformations, spend hours before mirrors, camouflage their perceived defects, exercise or groom excessively, compare body parts to others, avoid people, but are never satisfied with the results and are difficult to convince. The intrusive thoughts and compulsive behaviours in BDD are similar to obsessions in OCD.

BDD most often develops in adolescents and teens

Diagnosis and treatment

If your child is preoccupied with appearance to the extent that it interferes with academics, school and social life, causes significant emotional disturbance, negative self image and dysfunctional behaviour then talk to a mental health expert.

The usual treatment for BDD is an anti depressant with CBT.

ACT with CBT : ACT teaches methods to tolerate anxiety provoking thoughts and symptoms rather than trying to change them. It uses the core concepts of mindfulness, acceptance and value based living. It teaches client to increase acceptance and motivation to stay in treatment.CBT approach of exposure and response prevention teaches clients to recognise irrational thoughts and to chan negative thinking patterns and adopt healthy ways.

Treatment is tailored to the individual client’s needs. Therapy is usually done in weekly sessions over several weeks, mostly 12 to15 sessions are needed, some cases may need upto 20 sessions.

Anti Depressant medication SSRI’s can relieve the obsessions and compulsions associated with BDD.


Eating disorders– such as Anorexia nervosa, Bulimia, Binge eating disorders, Psychogenic vomiting– occurs most commonly in adolescent girls and young women, but adolescent boys and young men may be affected, as may children approaching puberty and older women upto the menopause.

Signs and symptoms of an eating disorder

Anorexia nervosa

  • Body weight is maintained at least 15% below that expected
  • The weight loss is self-induced by avoidance of “fattening foods”, self-induced vomiting; self-induced, purging; excessive exercise; use of appetite suppressants and/or diuretics.
  • There is body-image distortion in the form of a specific psychopathology whereby a dread of fatness persists as an intrusive, overvalued idea.
  • A widespread endocrine disorder involving the hypothalamic – pituitary -gonadal axis is manifest in women as amenorrhoea and in men as a loss of sexual interest and potency.

Bulimia Nervosa

  • There is a persistent preoccupation with eating, and an irresistible craving for food; the patient succumbs to episodes of overeating in which large amounts of food are consumed in short periods of time.
  • The patient attempts to counteract the “fattening” effects of food by one or more of the following: self-induced vomiting; purgative abuse, alternating periods of starvation; use of drugs such as appetite suppressants, thyroid preparations or diuretics.

Psychotherapy that works for Eating Disorders

It is important to recognise that recovery from an eating disorder is a long and arduous process. Recovery involves not only improvement in the disordered thought processes about food and body image but a recovery of one’s full identity and self image. Psychotherapy for eating disorders can be long specially if you also have other issues like depression, substance abuse, relationship problems.

CBT Cognitive Behavior Therapy teaches skills that allow participants to identify and change negative patterns of thinking and beliefs and learn healthy ways to coping strong emotions.

DBT Dialectic Behavior Therapy teaches skills that allow participants to apply mindfulness and emotional regulation.

ACT Acceptance and Commitment Therapy teaches skills that allow participants to become aware of and accept their emotions and experiences.

Family therapy is specially useful in younger clients to help family understand their role in supporting disordered eating and ways the family can  help the client.

Medication may be added for comorbid depression or anxiety.

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