Abstract
Body dysmorphic disorder is characterized by a preoccupation with an imagined defect in appearance that causes clinically significant distress or impairment in important areas of functioning. If a slight physical anomaly is actually present, the person concerned with the anomaly is excessive and bothersome. Conventional treatment involves monoamine oxidase inhibitors and serotonin specific drugs that reduce symptoms in at least 50% of patients but these have their own side effects. Homeopathy has been useful in such cases by understanding patients’ complete state of mind with least side effects[1].
Keywords: Body Dysmorphic Disorder, Genetics, Hormonal Influences, Brain, Homoeopathy, Repertory, Materia Medica
Introduction
Body dysmorphic disorder is characterized by a preoccupation with an imagined defect in appearance that causes clinically significant distress or impairment in important areas of functioning. This disorder was reorganized and named dysmorphophobia more than 100 years ago by Emil Kraepelin, who considered it a compulsive neurosis.[1]
Body dysmorphic disorder is a poorly studied condition partly because patients are more likely to go to a dermatologist, internists, or plastic surgeon than to a psychiatrist for this condition. The most common age of onset is 15-30 years, women are more affected. Comorbidity include major depressive episode, anxiety disorder (70%) and psychotic disorder (30%).[7]
The exact cause of Body dysmorphic disorder is unknown however the stereotype concept of beauty emphasized in certain families affects patients thinking about their body. The defense mechanism associated are repression, dissociation, distortion, and symbolization.[1]
According to ICD-11, Body dysmorphic disorder is characterized by persistent preoccupation with one or more defects or flaws in appearance that are either unnoticeable or slightly noticeable to others. Individuals experience excessive self-consciousness and perform repetitive behavior. Example: -Mirror checking, Excessive grooming, skin picking and reassurance seeking, comparing his or her appearance with that of others which results in painful emotions.[5]
The international prevalence of Body dysmorphic disorder is about 1.9 to 2.2% out of which females were found to have more suffering than man. In India prevalence of Body dysmorphic disorder in adults in the community was estimated to be 1.9%.[6]
BDD is a complex condition with multiple etiological factors, here are some possible causes and contributing factors;
- Genetics:- Family history and Genetics predisposition play a role in BDD development
- Brain structure and function: -Brain region responsible for processing emotions, perception and body image may contribute to BDD.
- OCCIPITOTEMPORAL CORTEX: – Process visual information related to body shape and appearance.
- AMYGDALA- Process emotions such as anxiety and fear which are often associated with BDD.
- PARIETAL LOBE: – Involved in spatial processing and body awareness
- FUSIFORM GYRUS: -Involved in face and body perception, recognition and processing. These brain regions interact and communicate with each other to create our body image and perception.
- Hormonal Influences: –
- Serotonin– Decreased serotonin levels have been linked to BDD causing depression and anxiety.
- Dopamine: – Imbalances may contribute to obsessive behaviors and body image disturbances.
- Testosterone: – Fluctuations during puberty menopause or pregnancy may also impact body image and self-perception.[8][9]
It’s essential to note that Hormonal imbalances are just one potential contributing factor to BDD. Other biological, psychological, and environmental factors also play a role.
- Sociocultural factors – Media society beauty standards, social comparison and peer pressure.
- Psychological factors: – Low self-esteem and perfectionism and high expectations
- Environmental factors:- Childhood experiences -Bullying, teasing Parenting styles -Critical or perfectionism. It’s essential to note that BDD is a multifaceted condition, and individual factors may vary.
- Person feeling :- People with Body dysmorphic disorder after feal distressed due to preoccupied thoughts of flaws.in their appearance that are either non noticeable or only slightly observable to others. This can make a person anxious, scared, depressed about there is something wrong in his body.[8][9]
Homoeopathic Part:-
Homeopathy on the other hand gives a safe way of treatment of such cases. Homeopathy has the least side effect and takes an individualistic approach in solving such cases.
REPERTORIAL PART[2]
- MIND-DELUSION-BODY-BLACK,It is
- MIND-DELUSION-BODY-Brittle is
- MIND-DELUSION-BODY-Broad
- MIND-DELUSION-BODY-Brown, Spotted
- MIND-DELUSION-BODY-Diminished; is
- MIND-DELUSION-BODY-Enlarged; Body is
- MIND-DELUSION-BODY-Forehead was pulled
- MIND-DELUSION-BODY-Absent is
- MIND-DELUSION-BODY-Brittle is -Break in two, will
- MIND-DELUSION-BODY-Cut through; he is
- MIND-DELUSION-BODY-Disintegrating
- MIND-DELUSION-BODY-Elongated
- MIND-DELUSION-BODY-Enlarged body expanded
- MIND-DELUSION-BODY-Left part body is small
- MIND-DELUSION-BODY-THICK
- MIND-BODY-DELUSION-BODY-Left half does not belong to her
Materia Medica[3][4]: –
1) Calcarea Carbonica:- For individuals with excessive concern about appearance, social anxiety, and a tendency to be overly critical.
2) Graphites:- For those with body image issues, feeling self-conscious, and a fear of being judged.
3) Kalium Bromatum:- For symptoms like excessive preoccupation with appearance, anxiety and depression.
4) Lycopodium: – For individuals with low self-esteem, fear of criticism, and tendency to hide their perceived flaws.
5) Natrum Muriaticum: – For those with a critical attitude towards them, self and others and a tendency to hide their true feelings.
6) Pulsatilla: – For individuals with a fear of being alone, a need for reassurance and a tendency to be overly concerned with appearance.
7) Silicea: – For those with a fear of being judged, a need for control and a tendency to be overly critical.
Repertory with Materia Medica[2][3][4]: –
1) MIND-DELUSION-body -brittle is: THUJA OCCIDENTALIS
2) MIND- DELUSION- body- delicate is: THUJA OCCIDENTALIS
- As if something were alive in abdomen -as if body were made up of glass
3)MIND-DELUSION-BODY-Covers-bed, covers the whole: PYROGEN
- Feels she was crowded with arms and legs, a sense of duality.
- Sensation as if she covered the whole bed; or knows that the head is on the pillow but knows not where the rest of body is.
4) MIND- DELUSION- body- scattered about; body was- tossed- about to get the pieces together; he: BAPTISIA TINCTORIA
5) MIND- DELUSION- separated- body- arms are separated from the body: BAPTISIA TINCTORIA
- Lifeless body but restless mind. The body feels separated/ scattered and tries to bring all pieces together.
6) MIND- DELUSIONS- body- shrunken, like a dead; body is: SABADILLA
Delusions as to the state of his body. Has erroneous notions about himself. Imagine he is very sick; that parts are shrunken; that she is pregnant.
Body dysmorphic disorder has a very significant Impact on the society where 25% suicide rate is seen. People with this disorder often have depression, social rate is seen. People with this disorder often have depression, social isolation, or social anxiety. They also abuse drugs as they tend to self-medicate themselves. They are preoccupied with the thoughts of flaws in their appearance that are either non-noticeable or slightly observable to others. This can make a person anxious, scared, depressed about the fact that something is wrong in his body. Body dysmorphic disorder also leads to problems act work and school as people are not able to concentrate well on their works.[9]
Psychiatrists play a major role in treating this disorder along with psychologists who with the help of correct therapies would develop insight in the patients. Thus, Body Dysmorphic Disorder can be tackled with efficient therapies and therapeutics.
References
- Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 12th ed. Philadelphia: Wolters Kluwer; 2022.
- Schroyens F. Synthesis: Repertorium Homoeopathicum Syntheticum. 9.1 ed. London: Homeopathic Book Publishers; 2001.
- Boericke W. Pocket manual of homoeopathic materia medica & repertory. 9th ed. New Delhi: B. Jain Publishers; 2000.
- Bailey PM. Homeopathic psychology: Personality profiles of the major constitutional remedies. Berkeley (CA): North Atlantic Books; 1995.
- World Health Organization. International classification of diseases for mortality and morbidity statistics (11th Revision). Geneva: World Health Organization; 2019. Available from: https://icd.who.int/
- Singh AR, Veale D. Understanding and treating body dysmorphic disorder. Indian journal of psychiatry. 2019 Jan 1;61(Suppl 1):S131-5.
- Sathyanarayana HP, Padmanabhan S, Balakrishnan R, Chitharanjan AB. Prevalence of Body Dysmorphic Disorder among patients seeking orthodontic treatment. Progress in orthodontics. 2020 Dec;21:1-5.
- International OCD Foundation. Impact of BDD [Internet]. Boston (MA): International OCD Foundation; [cited 2025 Apr 24]. Available from: https://bdd.iocdf.org/expert-opinions/impact-of-bdd/
- Johns Hopkins Medicine. Body dysmorphic disorder [Internet]. Baltimore (MD): Johns Hopkins Medicine; [cited 2025 Apr 24]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/body-dysmorphic-disorder
Author:
Dr. Premwati Yadav, MD Scholar, Department of Psychiatry, Government Homoeopathic Medical College and Hospital, Bhopal, Madhya Pradesh
Dr. Santosh Hande, Head of Department, Department of Psychiatry, Government Homoeopathic Medical College and Hospital, Bhopal, Madhya Pradesh.
