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Old 10-13-2002, 07:52 PM   #1
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Post Body Dysmorphia?!

Inspired in part by the thread on transsexuals and sex-change operations.... The other night I caught part of a TV program about "Body Dysmorphia". For those who don't know, and I didn't until that night, this is a condition in which a person has a significant dislike for, or detachment from, some aspect of their body, and they wish for "correction" usually via surgery. For example, the two major subjects of this documentary were
1. A woman who wants both of her legs amputated (apparently this is unusual; it's usually only one leg that people have a problem with).
2. A man who wants his right leg amputated. (Not his left, just his right)

In severe cases, where surgery is not available, such people have been known to resort to desperate measures to remove the offending body part.

The theme of the documentary was the journey these people went through, consulting with psychiatrists etc, to gain "approval" for the surgery they wanted. Very much like a gender reassignment - only after extensive counselling etc will surgery be provided.

(BTW at the end of the show, both people had had their requests declined.)

I was amazed to see this show; I had never to my recollection heard of Body Dysmorphia before. It was an eye-opener to me to see someone saying "I want my [perfectly good] leg amputated" and indeed to know that such surgery has been performed in the past. I suppose my first reaction was "Whoa! that's even stranger than transsexualism!"

Does anyone else have any knowledge about this condition? What do you think of the ethics of the situation, and how a surgeon might have to deal with the idea of amputating a perfectly good body part (or two) and essentially disabling a person?

Edited to add: To clarify; Body Dysmorphia Disorder or BDD has many types and degrees; it may range from obsession about a small or imagined flaw ("my nose is too big") through to the most, well, frankly, bizarre types as mentioned above.

Some web links I found, for those interested:

<a href="http://www.yestheyrefake.net/body_dysmorphic_disorder.htm" target="_blank">http://www.yestheyrefake.net/body_dysmorphic_disorder.htm</a>

Quote:
More obscure forms of OCD involve body dysmorphia. Body dysmorphia is a condition wherein persons become excessively focused on some body part, which they perceive to be grossly malformed. Typically, the area that a person with body dysmorphia focuses upon would never be thought of as a defect to others in the person's peer group. Persons with body dysmorphia engage in elaborate checking rituals to try to gain reassurance or assess the severity of their deformity in the mirror or go for repeated plastic surgery or often engage others in the attempt to gain reassurance in the absence of the problem.
<a href="http://www.ocdonline.com/defineocd.htm" target="_blank">http://www.ocdonline.com/defineocd.htm</a>

[ October 13, 2002: Message edited by: Arrowman ]</p>
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Old 10-14-2002, 01:20 AM   #2
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Ihave never heard of this syndrome before. However, looking at it through the lens of OCD makes me feel like I understand it better. I have very mild OCD. When your brain sends nonsense to your body and your body responds stimulating more nonsense from your brain, things get pretty weird. The thing to remember is that it is nonsense coming from a malfunctioning part of the brain. It doesn't make sense not even to the person experiencing it. I am rather shocked that their are doctors out there who would remove healthy tissue in order to deal with this problem but I suppose if they feel that it will avert further injury it might be worth it. It's hard for me to accept none the less. I wonder if it really solves the problem. What's to stop them from obsessing over another body part once the first one is removed? The brain flaw is still there. It's troubling.

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Old 10-14-2002, 04:15 AM   #3
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This is a very interesting topic Arrowman. Thank you for posting it. I have heard of this disorder before only because I have a friend who went through some plastic surgery to correct a perceived defect. I don't believe she was ever diagnosed with it, but because I was curious I did a little checking around. She is definately OCD and had an obsession with one side of her face not being equal to the other side of her face, most specifically her jaw line. She underwent reconstructive surgery for it. I couldn't tell the difference one way or another, but she sure could.

I know another woman who is obsessed like that - specifically about her nose.

I can't imagine wanting to chop off a limb though ... and I can't imagine the doctor who would say OK - I will amputate your leg for you because you don't like the way it looks .... now that is scary!

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Old 10-14-2002, 04:22 AM   #4
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There was a surgeon in Scotland who got crucified in the press a couple of years ago because he was willing to carry out such operations. As I remember it the medical community largely supported him but the management of the hospital got freaked out by the negative publicity and stopped him from further treatment.
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Old 10-14-2002, 07:33 AM   #5
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I wonder if a person would qualify for disability benefits if they got limbs amputated for these reasons. On the other hand, I suppose if you can afford elective surgery of this type, you may not need benefits.
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Old 10-14-2002, 07:59 AM   #6
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'Sir, this nose is false. Its made of polystyrene. And your own hooter is a beaut.'

'I'd still like to have the operation.'

'Well, you've had the operation, you strange silly person.'
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Old 10-14-2002, 10:21 AM   #7
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Any doctor performing such surgery is violating their hippocratic oath and just doing it for the money. This is way beyond "do no harm", the rationale mercenary cosmetic surgeons use.
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Old 10-14-2002, 01:22 PM   #8
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Would Michael Jackson be a prime example of a sufferer of this I wonder?

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Old 10-14-2002, 06:10 PM   #9
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Interesting, it would seem similar in some respects to some anorexia cases where patients asked to draw their body image yield grossly distorted images. There is also a sexual fetish associated with limb amputation I believe, maybe someone can provide a name. I’m too spooked to run an internet search.

Brighid, I remember seeing some research into the science behind beauty & facial symmetry featured very highly, seemingly at a subconscious level. I’m intrigued if this disorder is somehow related to when our possibly innate concept of beauty becomes derailed.

So should the doctor’s perform the surgery ? Depends on how debilitating the mental disorder is I suppose and how treatable it is by other means.
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Old 10-15-2002, 04:02 AM   #10
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echidna,

I remember seeing something along those lines also. I thought it was a bit odd when she came to me and said she was going to have half of her face operated on in order to make it even with the other. She is a beautiful woman, and I could perceive no defect but I didn't feel it would have been right to criticize her choice although I did ask many questions about why she was doing it, etc.

The cosmetic surgeon told her he didn't feel she actually needed this surgery, but she insisted and eventually got it. I guess no one actually NEEDS a face lift ...

She was happy with the surgery and she looks great.

I would be interested to see the research on these sorts of disorders. I definately think Michael Jackson fits the bill as far as having, perhaps a severe form of body dysmorphia. I also wonder if it something that is triggered by abuse.

I always suspected that my friend endured sexual abuse as a child because she had some strange expressions of OCD. She had to bathe when she woke up and before going to bed - 1.5 hrs each time. She was obssessively maticulous about her makeup application - getting ready for anything took approximately 5 hours and that is no exaggeration. She washed her hands so many times that her skin was dried and cracked. Despite some wierd hygiene rituals she is a really wonderful person. She has gotten better over the years and has cut her morning ritual down to 1.5 hours total.

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