Most people are conscious about their appearance, but a new study has found that an excessive concern about one’s weight may indicate a mental health condition outside the realm of eating disorders. The study is focused on body dysmorphic disorder (BDD), a condition where people have a distressed or impaired preoccupation of an imagined or slight defect in their appearance.

Researchers discovered that individuals who are concerned about their weight are more impaired than those whose appearance-related concerns are not associated with their weight. BDD can cause extreme stress or behavioral impairment in the work or personal lives of sufferers. The disorder is also associated with more suicide attempts and comorbidities.

Investigators at Bradley Hospital and Brown Medical School believe the study findings are salient as weight-related preoccupations have at times not been diagnostic characteristics of BDD.

Researchers looked at 200 individuals between the ages of 14 and 64 with BDD. They compared two groups of subjects: those who listed weight as “area of concern”, and those who did not.

The most frequent BDD areas of concern were skin, nose, hair, stomach, teeth and weight. The study found that people with BDD who had weight concerns (29%) also had more overall areas of body image concern, poorer social functioning, more BDD symptoms overall, more frequent suicide attempts, and higher levels of comorbidity than BDD sufferers without weight concerns.

As well, subjects who listed weight concerns were significantly younger and more likely to be female.

They also more often cited the stomach as an area of concern and were more likely to diet, excessively change their clothes and exercise in an attempt to improve their appearance.

Lead author Jennifer Kittler, PhD, called the findings “important because although we know that it is a serious and disabling condition, in many ways BDD remains poorly understood.”

There is controversy especially within the field as to whether individuals with preoccupations that focus on weight should be considered to have BDD and not an eating disorder.

The study indicates that BDD sufferers who have weight concerns might actually be more impaired than other BDD patients, further underscoring the importance of obtaining more information about this population, and of correctly diagnosing and treating them, the authors note.

“We know that BDD is a disorder associated with severe symptoms and high levels of comorbidity. This study indicates that the presence of weight-related concerns and preoccupations among individuals with BDD may actually be associated with even higher levels of distress and impairment,” Kittler said.

The study appears in the January 2007 issue of the journal Eating Behaviors.

SOURCES: Kittler J, Brown Medical School, Brown University, Providence, RI, USA. Bradley Hospital, Providence, RI, USA.

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