Men as likely as women to suffer from body image disorder, study says

A study by psychiatrists at Butler Hospital in Providence, R.I., found a nearly equal sex ratio among patients with body dysmorphic disorder (BDD), as well as similarities in age of onset, course of illness and severity of symptoms between genders. (See also release number 97-021.)

PROVIDENCE, R.I. -- Although women are generally more dissatisfied with their appearance than men in this country, a study of nearly 200 people found that men are as likely as women to seek clinical help for the image obsession known as body dysmorphic disorder (BDD).

The study shows that BDD, a debilitating disorder in which sufferers are preoccupied with imagined flaws in their appearance, afflicts the sexes to a similar degree, though men and women obsess about different parts of the body, said Dr. Katharine A. Phillips, a Brown University psychiatrist and one of the study's two authors.

"Some people assume that because BDD involves the body image it is only seen in women," said Phillips. "Don't assume."

The study, reported in the September issue of The Journal of Nervous and Mental Disease, is the largest ever published on BDD, said Phillips, director of the Body Dysmorphic Disorder and Body Image Program at Butler Hospital in Providence.

In general, it is estimated that as many as one in 50 people have BDD. This study provided an overall picture as to the way the disorder afflicts men and women and found there are more similarities than differences.

The 93 women and 95 men in the study were patients in Phillips' practice. Predominantly unmarried and often unemployed, most of the patients started having symptoms of BDD during adolescence.

Differences between the genders centered mainly on the body part that was of concern to the patient. While men were often concerned with body build, hair loss and the size of genitals, women focused on weight and hips and the condition of their skin. These differences led to variations in the way the patients handled their perceived flaws. Men were likely to use a hat to camouflage the perceived defect whereas women were likely to use makeup.

Unexpectedly, the study found a similar rate of suicide attempts among patients with BDD despite the fact that women are twice as likely as men to attempt suicide in the general population. Also, although more women than men suffer from major depression, panic disorders and anorexia nervosa, the frequency was the same between male and female BDD patients.

Phillips conducted the study with Susan F. Diaz, M.D., of Butler Hospital.

The results are likely to be representative of what a psychiatrist would see in any clinical practice, said Phillips. However, large-scale studies still need to be done to determine the rate of occurrence in the general population. Also, future research will need to investigate whether gender ratio and gender differences are consistent across cultures. As psychiatrists learn more about this little-known disease, they will be better able to recognize sufferers, Phillips said.