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Weight concerns more impairing for those with Body dysmorphic disorder

January 11, 2007

Obsession with weight may not be tied to an eating disorder

Providence, RI - In a new study on Body dysmorphic disorder (BDD)-a distressing or impairing preoccupation with an imagined or slight defect in one's appearance-researchers from Bradley Hospital and Brown Medical School found that individuals who are concerned about their weight are more impaired than those whose appearance-concerns are not weight-related. This is particularly important, as weight-related preoccupations have at times not been considered diagnostic of BDD.

Researchers looked at a group of 200 individuals, between the ages of 14 and 64, with BDD. They compared two groups of participants: those who listed weight as "area of concern", and those who did not. The most frequent BDD areas of concern were: skin, hair, nose, stomach, teeth and weight. The study found that individuals with BDD who had weight concerns (29 percent of the sample) also had more overall areas of body image concern, poorer social functioning, more BDD symptoms overall, more frequent suicide attempts, and higher levels of comorbidity than BDD sufferers who did not endorse weight concerns.

In addition, participants who listed weight concerns were significantly younger and more likely to be female. They also more frequently cited the stomach as an area of concern and were more likely to diet, excessively change their clothes and exercise in an attempt to improve their appearance.

The study appears in the January 2007 issue of the journal Eating Behaviors.

"This is important because although we know that it is a serious and disabling condition, in many ways BDD remains poorly understood," says lead author Jennifer Kittler, PhD, a child psychologist at Bradley Hospital and the department of psychiatry and human behavior at Brown Medical School.

In particular, there is controversy within the field as to whether individuals with preoccupations that focus on weight should be considered to have BDD (instead of, for example, an eating disorder). This study indicates that BDD sufferers who have weight concerns may actually be more impaired than other BDD patients, further underscoring the importance of obtaining more information about this population, and of correctly diagnosing and treating those with impairing and preoccupying concerns about their weight, the authors note.

"We know that BDD is a disorder associated with severe symptoms and high levels of comorbidity. This study indicates that the presence of weight-related concerns and preoccupations among individuals with BDD may actually be associated with even higher levels of distress and impairment," says Kittler.

The correct diagnosis and treatment of individuals with weight-related preoccupations, in the absence of eating disorder symptoms, is obviously crucial, as these preoccupations are associated with a high level of psychopathology and distress, the authors write.

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