The Body Image Program at Rhode Island Hospital

Welcome to the Body Image Program

Body Image Program

Listen to Katherine Phillips, MD, discuss
olfactory reference syndrome in this podcast.
ORS is a disorder that causes a person
to believe they are emitting a foul odor
when they really are not.

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The Body Dysmorphic Disorder and Body Image Program is one of the few specialty programs in the country for body dysmorphic disorder (BDD). The program is directed by Katharine Phillips, MD, professor of psychiatry and human behavior at Rhode Island Hospital and The Warren Alpert Medical School of Brown University in Providence, Rhode Island. Phillips is internationally known for her pioneering clinical and research work on BDD.

This website is periodically updated to bring you current information about BDD. We welcome you to browse through our pages for more in-depth information on body dysmorphic disorder and our program, which is located at Rhode Island Hospital and affiliated with The Warren Alpert Medical School of Brown University. Our program is dedicated to helping people with BDD. We do this by spreading the word about BDD, educating students and trainees, and doing clinical research on BDD in order to increase knowledge about BDD and develop new and better treatments for this disorder.

Because BDD causes so much suffering yet is still unfamiliar to many people, a major part of our mission is to spread the word about BDD to both professionals and the public. To accomplish this, Phillips has written the most comprehensive book on BDD and its treatment: The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder, published by Oxford University Press. She recently revised and updated this book (2009): Body Dysmorphic Disorder: An Essential Guide, which was also published by Oxford University Press. This more recent update reflects new knowledge about BDD. It’s also geared more toward BDD sufferers, their family, and their friends. However, professionals and anyone else interested in learning about BDD should find it helpful. Phillips is also co-author of The Adonis Complex: How to Identify, Treat, and Prevent Body Obsession in Men and Boys, published by the Free Press in 2002.

Phillips speaks widely and has done many media interviews on BDD. For example, she has appeared on the "Oprah Winfrey Show," "Dateline NBC," the "Today" show, ABC’s "20/20," MSNBC and CNN, and she has been interviewed by the New York Times, Time magazine, the Boston Globe, and many other media outlets. We also do clinical research to increase understanding of BDD and develop more effective treatments for this emotionally painful and sometimes disabling problem. Research enables us to learn critically important things, such as how to identify BDD, who gets it, how it affects people, what causes it, and what treatments work. Our ongoing treatment studies offer study treatment for people who qualify.

What Is Body Dysmorphic Disorder?

Body dysmorphic disorder (or BDD) is a relatively common, often severe, and under-recognized body image disorder. People with BDD experience distressing or impairing preoccupations with perceived flaws in their appearance. People with BDD are obsessed with the belief that something’s wrong with how they look. They may describe themselves as looking ugly, unattractive, “not right,” deformed, or even “hideous” or “monstrous.” This preoccupation frequently focuses on the face or head, often the skin (for example, acne, scarring, skin color, lines, wrinkles), hair (for example, thinning or too much or too little body hair), or nose (for example, size or shape). However, people with BDD can dislike any part of their body.

People with BDD think about their perceived appearance flaws for at least an hour a day, and typically for many hours a day. When other people say they look fine, people with BDD find it hard to believe this reassurance. Read In Our Own Words, stories of people with BDD.

These appearance concerns cause significant emotional distress or problems in daily functioning (usually both). For example, the appearance worries can lead to low self-esteem, avoidance of family and friends, and problems with work or school. They often fuel anxiety, depression, and even thoughts about suicide. Some people experience manageable distress and are able to function well, although not up to their potential. Others find that this disorder ruins their life.

BDD is an underrecognized and serious mental illness. It isn’t vanity. It’s important to recognize the symptoms of BDD and get the right treatment.

Recognizing BDD: Common Appearance Concerns and Behaviors

A person with BDD can be preoccupied with the appearance of any body area. Common body areas of concern are:

• Skin • Stomach • Body Build • Buttocks
• Hair • Eyes • Hips • Chin
• Nose • Thighs • Lips • Eyebrows
• Weight • Teeth • Face size or shape

People with BDD may frequently:

  • Try to hide the perceived appearance flaws with clothes, makeup, a hat, sunglasses, or other types of cover
  • Frequently check or avoid mirrors or other reflecting surfaces
  • Compare their appearance with that of other people
  • Frequently change their clothes
  • Excessively groom (e.g., excessively perform skin routines, hair styling, makeup application, shaving)
  • Pick their skin
  • Ask others for reassurance about their appearance
  • Exercise excessively
  • Diet

Effective Treatments Are Available for BDD

The good news is there are effective treatments for BDD. BDD isn’t vanity. It is a bona fide medical disorder that often gets better with the right treatment. Elsewhere on this website, we provide more detail about these treatments. We also describe study treatment that we offer through our research program for people who qualify.

Certain medications called serotonin-reuptake inhibitors (also known as SRIs or SSRIs) are often very helpful for BDD. They are not habit forming and are usually well tolerated. A certain type of therapy, called cognitive-behavioral therapy (or CBT), is also often helpful for BDD. These two types of treatment often diminish appearance preoccupations and compulsive behaviors (such as mirror checking), alleviate emotional distress and suffering, and improve depression in people with BDD. They also often help people with BDD feel better about how they look, function better, and lead a happier and more productive life. There is hope for people with BDD!

Here is more information about BDD and treatment options.

How Our Program Can Help

We are dedicated to doing research to increase understanding of BDD and to develop new—and more effective—treatments for BDD. Research provides extremely valuable information about BDD. It’s the best way to better understand BDD and how to overcome it. We regularly publish our research findings in scientific journals so they are available to both professionals and the public. We also disseminate our research findings through presentations and media interviews. 

We can do research and learn what treatments are effective only if people volunteer to participate in our studies. We are very grateful to everyone who participates! Their participation is an invaluable contribution toward our ultimate goal: to diminish suffering and improve quality of life for people with BDD.

Study Treatment for Those Who Qualify

We offer study treatment for those who are within driving distance (about an hour) of Providence, RI, and who further qualify for our studies. Some of our studies are also offered in Boston in collaboration with other researchers.

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