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Body dysmorphic disorder (BDD) involves excessive concern and shame over a minor or even imagined defect in their appearance. The problem in this disorder is not vanity, where someone is overly preoccupied with personal beauty. It is a disorder that causes the child or adolescent to experience shame and despair about the way that they look.  Often children with this disorder begin by trying to cover up their perceived flaw with makeup or clothing. As it progresses, they might even express a desire to fix the problem through cosmetic surgery.  However, the real issue is not a true flaw, but a distorted perception of self. They continue to believe that they are severely deformed or distracting to others despite being told otherwise by friends and loved ones.  


Treatment of body dysmorphic disorder involves both cognitive behavioral therapy and pharmacotherapy.  It begins with helping the patient to recognize that the disorder itself causes them to misperceive and misplace focus on certain aspects of their appearance.  They are then supported as they gradually stop attempting to scrutinize or cover their appearance.  Exposure is used to guide the patient in returning to engaging in normal life activities that they have been avoiding out of fear of people noticing their physical appearance.  It is important for those with body dysmorphic disorder to be taught how to view their body for what it truly is - beautiful - and to learn how to develop meaningful relationships in-spite of their fears.

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