Men with body dysmorphic disorder are most commonly preoccupied with their skin (for example, with acne or scarring), hair (thinning), nose (size or shape), or genitals. A recently recognised form of body dysmorphic disorder that occurs almost exclusively in men is muscle dysmorphia, a preoccupation that one’s body is too small, “puny”, and inadequately muscular, which may lead to potentially dangerous abuse of anabolic steroids.
Patients with body dysmorphic disorder can be challenging to treat, say the authors. Many require admission to hospital, become housebound, and attempt suicide. However, recent research suggests that drug treatment and cognitive behavioural therapy are effective. Surgical or other non-psychiatric treatments appear to usually be ineffective.
Body image isn’t just a women’s problem, say the authors. The challenge is to enhance both physicians’ and the public’s awareness of body dysmorphic disorder so that effective treatments can be offered and unnecessary suffering and morbidity avoided, they conclude.