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Other names: Endep

WHY BDD IS UNDERDIAGNOSED: NOSE CONCERS AND OTHER SYMPTOMS
Nose concerns are also very common. About 60% of people with nose concerns worry that their nose is too large. More than a quarter worry it’s bumpy or misshapen. Less commonly?sometimes after nose surgery?they think it’s too small. One woman thought her nose was “bumpy and swollen”; a middle-aged man thought his was “puffy.” People with nose concerns are especially likely to have surgery?often repeated surgeries. One woman I treated first thought her nose was too large, and then, after surgery, felt it was too small. A college student first believed his nose was too long, but then, after surgery, thought his nostrils were too wide.
I once had an interesting conversation with a psychiatrist from Japan who was familiar with BDD. He was surprised to learn that I’d found that people in the U.S. usually worry that the nose is too large; in his experience, in Japan the concern is often that the nose is too small. In addition, he said that concerns with hair loss are uncommon in Japan. These observations raise the interesting question of whether cultural factors may influence the exact worry that people have.
BDD can also involve larger body areas. Many men are preoccupied with their overall body build, thinking they look too small or inadequately muscular. This form of BDD is called “muscle dvsmorphia.” Thev may wear many layers of clothing to enhance their size, excessively lift weights, or use potentially dangerous anabolic steroids to bulk up. Others?often women?are concerned that they’re too large or overweight. Of the people in my studies, 22% were excessively concerned with their weight.
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