The Relationship Between Body Dysmorphic Disorder and Eating Disorders

This chapter discusses research findings regarding body dysmorphic disorder (BDD) and eating disorders, and it provides guidelines for distinguishing between them. BDD and eating disorders show many similarities, including negative and distorted body image, decreased quality of life, compensatory behaviors such as dieting, and abnormalities in visual processing. Patients with BDD express specific concerns with different parts of their bodies and physical appearance; common examples are complexion, nose, breasts/genitals, and hair. In patients who have prominent concerns about weight and body fat and shape, however, the diagnosis of BDD can be complicated because such concerns can occur as a symptom of BDD but also overlap with those in eating disorders such as anorexia nervosa and bulimia nervosa. BDD and eating disorders are often comorbid, which is accompanied by notably higher rates of suicidality and psychiatric hospitalization than occur in patients with either disorder alone. BDD and eating disorders represent distinct pathologies, and it is important to distinguish between them, particularly given the increased risk of suicidality when the disorders are comorbid.