Difference Between Body Dysmorphic Disorder and Anorexia

Body Dysmorphic Disorder (BDD) and Anorexia are two disorders that are often confused with each other due to their similar features. However, there are some key differences between these disorders, which are important to understand in order to provide effective treatment.

What is Body Dysmorphic Disorder?

Body Dysmorphic Disorder (BDD) is a mental disorder characterized by an obsessive preoccupation with perceived flaws or defects in one's appearance. These flaws may be minor or imagined, but they can have a significant impact on the individual's self-esteem and quality of life. People with BDD may spend hours each day checking and comparing their appearance, seeking reassurance from others, or engaging in repetitive behaviors like picking at their skin or trying to cover up their perceived flaws.

It usually occurs in early adolescence, but it can also occur in older people who are too concerned about the aging process.

Body dysmorphic disorder affects men and women relatively equally. Women tend to develop eating disorders, while men, especially those who engage in bodybuilding, fitness, and other sports, are more likely to develop so-called muscular dysmorphia.

Body dysmorphic disorder is common in people with eating disorders. The course of the disorder usually persists over time, with symptoms alternating with periods of exacerbation and fading. The part of the body that is in the patient’s focus may be the same or may change over time.

The main symptoms of body dysmorphic disorder are −

• Increased concern about a defect in appearance;

• Suicidal thoughts and suicide attempts;

• Problems with social skills and professional development.

Many patients have concomitant diseases such as obsessive-compulsive disorder, depression, social phobia, etc

Body dysmorphic disorder may occur as a result of −

• Mental illness − Schizophrenia, bipolar disorder, hypomania, cyclothymia, hallucinatory disorder, etc.;

• Emotional instability − Low self-esteem, high anxiety, post-traumatic stress, depression, etc.;

• Genetic factors − In people with a family burden, the chance of developing the disease is 4-8 times higher

Diagnosis of body dysmorphic disorder is based on −

• Analysis of the symptoms;

• Personal, family, and social history;

• Psychological evaluation of the behavior, feelings, and thoughts related to the negative self-image.

With appropriate treatment, both with medication and with psychotherapy, body dysmorphic disorder usually has a good prognosis. The probability of complete recovery is relatively high and the likelihood of recurrence of the disease after remission is low.

What is Anorexia?

Anorexia Nervosa is a serious eating disorder characterized by a persistent restriction of food intake leading to significantly low body weight, intense fear of gaining weight or becoming fat, and a distorted body image. People with Anorexia may engage in extreme measures to lose weight, such as limiting their food intake, excessive exercise, and sometimes even purging behaviors like vomiting or using laxatives.

Symptoms of anorexia are −

• Weight loss: A reduction of more than 15% of the normal for the age and height;

• Body mass index (BMI) below 17.5;

• Adolescent developmental disorders: Secondary amenorrhea, etc.;

• Constipation: Caused by the reduced amount of food;

• Cachexia, dry skin, hypotension, decreased body temperature, decreased heartbeat, disorders of the body’s water-balance, osteoporosis, etc.

• Patients often lie about their feeding and weight.

The disease is caused by the interaction of mental, family, social and cultural factors. The causative factors include −

• Genetic factors − In patients with family history the development of anorexia is 10 times more likely;

• Psychiatric factors − Depression, panic disorder, abuse, and abnormality in sexual behavior often precede anorexia;

• Personal characteristics − In patients with anorexia, tendencies towards perfectionism, decreased initiative, and social fear are often observed.

• Socio-cultural factors − Cult to perfect appearance;

• Biological factors − Perinatal hypoxia, premature birth, etc.

Diagnosis is based on −

• Physical examination;

• Psychological evaluation

• Laboratory tests – complete blood count, analysis of the electrolytes and protein, etc.

The therapy of the disease includes three main directions −

• Rehabilitation and diet therapy;

• Psychotherapy;

• Work with the family to build an appropriate and supportive environment for the patient.

Complete remission occurs in 50% of the patients, in 30% occurs improvement in the symptom.

Differences: Body Dysmorphic Disorder and Anorexia

One of the key differences between BDD and Anorexia is the focus of the obsession. In BDD, the focus is on a perceived flaw or defect in one's appearance, while in Anorexia, the focus is on weight and body shape. While both disorders involve a distorted body image, the specific focus is different.

Another difference between the two disorders is the severity of weight loss. While individuals with BDD may also engage in behaviors that affect their weight, such as excessive exercise, their primary concern is not with weight loss. In contrast, individuals with Anorexia will typically have a significantly low body weight and may even be dangerously underweight.

Additionally, the age of onset may differ between the two disorders. BDD often begins in adolescence, while Anorexia typically develops in late adolescence or early adulthood. The gender distribution is also different, with BDD affecting both men and women equally, while Anorexia is more commonly diagnosed in women.

Lastly, the treatment approaches for BDD and Anorexia are different. In BDD, treatment typically involves a combination of medication and therapy, with cognitive-behavioral therapy (CBT) being the most effective. In Anorexia, treatment usually involves a team approach with medical and psychological professionals, and may include behavioral therapy, nutritional counseling, and medication if necessary.

The following table highlights the major differences between Body Dysmorphic Disorder and Anorexia −

Characteristics	Body Dysmorphic Disorder	Anorexia
Definition	Body dysmorphic disorder is a mental disorder in which a person is obsessed with an imaginary or insignificant defect in his/her body that others do not notice.	Anorexia is a disorder of eating behavior whereby the patients deliberately and without objectively apparent reasons drastically reduce their weight.
Occurrence	Body dysmorphic disorder usually occurs in early adolescence, but it can also occur in older people who are too concerned about the aging process. It affects men and women relatively equally.	Anorexia mainly affects girls in puberty and young women. Less than 5% of the patients are male.
Symptoms	The main symptoms of body dysmorphic disorder are increased concern about a defect in appearance, suicidal behavior, problems with social skills and professional development.	Symptoms of anorexia are significant weight loss, BMI below 17.5, adolescent developmental disorders, constipation, cachexia, dry skin, hypotension, decreased body temperature, decreased heartbeat, disorders of the body’s water-balance, osteoporosis, etc.
Etiology	Body dysmorphic disorder may occur as a result of mental illness, emotional instability, and genetic factors.	Anorexia is caused by mental, family, social and cultural factors. The causative factors include genetic factors, psychiatric factors, personal characteristics, socio- cultural factors, biological factors, etc.
Diagnosis	Diagnosis of body dysmorphic disorder is based on an analysis of the symptoms; personal, family, social history; psychological evaluation of the behavior, feelings, and thoughts related to the negative self-image.	Diagnosis of anorexia is based on physical examination, psychological evaluation, laboratory tests.
Treatment	Body dysmorphic disorder is treated with medications and with psychotherapy.	The therapy of anorexia includes rehabilitation and diet therapy, psychotherapy, work with the family to build an appropriate and supportive environment for the patient.

Conclusion

In conclusion, while BDD and Anorexia share some similarities in terms of body image distortion, there are important differences between the two disorders.

BDD is primarily characterized by an obsessive preoccupation with perceived flaws in one's appearance, while Anorexia is characterized by a persistent restriction of food intake leading to significantly low body weight and a distorted body image focused on weight and shape.

Understanding these differences is crucial in order to provide appropriate treatment and support to individuals struggling with these disorders.