an obsessive disorder that increasingly affects children

Rocío, 16 years old, showed up at her psychologist’s office recounting different situations that caused her discomfort. He especially highlighted the dislike for some parts of his body: he rejected his hair, face, legs, hips and arms.

When the therapist asked her what she liked about her body, Rocío found it very difficult to mention anything, which It revealed the degree of daily suffering he experienced. Precisely, this dislike prevented him from interacting with other people and caused him to isolate himself. That is to say, a variety of negative consequences that produced a cycle of increasingly greater discomfort.

Paz, 17 years old, I was terrified of taking exams. He made a psychological consultation and, through a thorough examination, a high level of distaste for his body emerged. She felt ugly. She had already had a nose job and was looking to have another to reduce her breasts. She never ended up “friending” her image, which put her on the edge of a vicious circle of aesthetic treatments and surgeries, always insufficient.

The cases of Rocío and Paz are examples of the same pathology: body dysmorphia disorder (BDD), which is characterized by severe concern about one or more physical defects that the affected person believes they see in themselves.

“The initial consultation could also be due to weakness or lack of motivation, but exploring the source of the discomfort appears what is known as the dysmorphic condition,” explains Diana Kirszman, doctor in psychology, creator of the AIGLE Foundation and coordinator of the Pauta program ( Unified Assistance Program for Eating Disorders).

Kirszman expands Paz’s case: “The initial reason for his consultation had to do with an exaggerated fear of taking exams. In the evaluation with professionals, a very significant social withdrawal and a level of dissatisfaction with their body was evident.. Reason why she became isolated: she avoided all types of interpersonal ties since she felt rejected and not accepted. There was clearly a body discomfort and that is why the nose surgeries, breast reduction surgeries and the desire to have other operations on the body.

Body dysmorphic disorder affects 2 out of every 100 adolescents and occurs six times more in girls than in boys, according to a study published in the Journal of the American Academy of Child and Adolescent Psychiatry.

“BDD manifests itself as an excessive concern about appearance, derived from a distortion of body image, which generates great suffering in the individual, which prevents him from functioning functionally in his life,” says Kirszman, author of the book The Enemy in the Mirror.

And he adds: “Some of the signs are: that the person is convinced that they have a defect that makes them ugly or deformed, extreme concern about a self-perceived defect or constantly comparing their own appearance with that of others. “It happens to those who have adopted a model of physical ‘perfection’ where the value of a certain aesthetic takes on a fundamental place, which reinforces the symptoms.”

Ana, 8 years old, came to the office because I had no friends and was depressed. I was bullied. Her mother also received messages on her cell phone: the other mothers wrote to her that her daughter was “a toad.” The girl had panic attacks. I didn’t want to go to school. They didn’t invite her to birthdays either. Depressed and socially withdrawn, Ana experienced dysmorphia.

It is no exception: BDD is increasingly seen in more children. It can also start in kindergarten.

Tania Borda, doctor in psychology and specialist in Obsessive Compulsive Disorders (OCD), states that “40% of adolescents with depression meet criteria for dysmorphia,” but searches for professional help usually begin elsewhere.

“The first thing they do is go to plastic surgeons, dermatologists or a nutritionist to somehow fix the disturbing defect, which may or may not be perceptible to the eye of another,” adds Borda. “It is believed that around 13% of the population that undergoes cosmetic surgery has dysmorphia. Most people with dysmorphia were abused, bullied, or experienced what we call lack of emotional attachment during childhood. The worry is so severe that it causes discomfort that can range from anxiety and depression to even thoughts of suicide. It can also generate dysfunction socially, academically and occupationally. The two symptoms, then, for which we should see if there is dysmorphia are depression and social phobia.“, summarizes Dr. Borda, author of the book Body obsessions and also, Body dysmorphic disorder: a complex disorder.

Julieta had always felt insecure about the size of her breasts. She underwent augmentation surgery convinced that this change would make her feel more confident. At first, she was happy, but then she started to look “bigger” in the mirror.. He felt that his proportions had changed and that he had to “compensate” for it somehow. This led her to intensify her physical exercise routine, trying to lose weight to achieve that balance that she never seemed to achieve.

What began as an intervention to improve his self-esteem ended up becoming an endless search.

“The case of Juliet rreflects how complicated it can be when the desire to change your body turns into a spiral of perfectionism, fueled by external pressures and unrealistic personal expectations.”says Daniela Ciccioli, specialist in Eating Disorders, member of the Libertador interdisciplinary team. And he continues: “The factors that can also predispose the appearance of this type of disorder – always taking into account that there is a characteristic of psychological vulnerability – have to do with social pressure and beauty standards. That is why they are problems that appear in childhood and adolescence. There is the obsession with having a beauty style, often unrealistic. The media, social networks and applications allow us to have a lot of accessibility to this and therefore greater appearance of comparisons and pressure to have to be a certain way.. Psychological vulnerability has to do with low self-esteem, anxiety, depression, and the need to be in control of things. A perfectionist tendency. This can occur both in terms of eating disorders and also in regards to this dysmorphia disorder,” explains Ms. Ciccioli.

Cognitive behavioral therapy is one of the ways to treat dysmorphia. In some cases medication is required. And the role of the nutritionist is also important.. “It helps improve the relationship that a person has with food and with their body. Although BDD focuses on the distorted perception of body image, this concern often affects the way the person eats and takes care of themselves,” says Carolina Masi, a nutrition graduate.

“The main objective is to help people develop healthy eating habits, which are not guided by physical appearance but by nutrition and general well-being. The idea is not to reinforce obsessive behaviors towards the body, but to educate about nutrition from a perspective of self-care and comprehensive health.“adds the specialist, who works in coordinating the training and prevention of eating disorders area of ​​the Libertador team.

“The treatment of body dysmorphia disorder is complex and requires a comprehensive approach to achieve complete and sustained recovery,” he concludes.