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Body Dysmorphia: Have You Got It?

Glowday exists to keep people, particularly women, safe. This goes beyond just ensuring you're seeing someone who isn't going to mess up your face. One of the key reasons we only allow medically-qualified practitioners to partner with Glowday, is because they are far more likely to say no to treatments.

We'll be honest, that's not a choice that serves Glowday or the clinics we work with well from a financial perspective. If we allowed anyone who offers injectables to join Glowday - beauticians, hairdressers, nail technicians, it's likely bookings would treble, and if clinics said yes to everyone, they'd make lots more money! But they do not. Because they are doctors, dentists, and nurses first - and aesthetic practitioners second. They are medically qualified, guided by rules, principles and ethics. They are also accountable to their governing bodies.

It's a decision we believe is right, responsible and we feel passionate about. Saying NO to people who are willing to part with hundreds of pounds for plumper lips or more filler in their face, requires skill and strength.

The clinics you will find on Glowday are trained to spot people who aren't making the right decisions because of body dysmorphia. It's a mental health problem, and one that is serious. We wanted to find out more about this condition so we spoke to Dr Dorota Chudek from Ethical Aesthetics.

Dr Dorota Chudek from Ethical Aesthetics.

So Doctor Dorota, how do you know when there is a problem?

One of the greatest testimonies to the quality of care at my practice are our returning clients. It makes me so happy to see patients come back for more treatments. There are, however, moments when an aesthetician has to look at their regulars from a different angle and consider whether the reason for them coming is not physical but rather psychological - and body dysmorphia could be driving this.

What exactly is body dysmorphia?

When we think about the aesthetic industry, mental health is not the first thing that springs to mind. Although the awareness of the topic is increasing, there are still disorders which affect people’s lives that go undiagnosed. One of them is body dysmorphic disorder ( also known as body dysmorphia/BDD). It is a condition in which a patient has obsessive thoughts about a perceived ( the word perceived being a key in this definition) defect in their looks. A flaw that appears minor to most, is a source of major distress to a patient, to the point where everyday life is affected by it. Patients avoid various social situations, they encounter relationships difficulties, face low mood and anxiety, their work performance declines. A client may come to an aesthetician dissatisfied with their looks while it may not be the looks that need fixing. There are studies which suggest 70% of people with BDD were attempting a cosmetic procedure and 50 % indeed received it.


How do you identify body dysmorphia?

Identifying the condition is extremely difficult as very often a patient will not necessarily speak openly about their insecurities. After-all, it is something they feel embarrassed about: not only the body part itself but also the intrusive thoughts about it! Although the training with regards to diagnosing such issues is minimal, the awareness of the condition is already a good start. There are special screening questionnaires available for identifying it and a good professional will incorporate them in their consultation process. They contain questions about the body image, amount of time spent worrying about perceived flaws, mood swings, avoidance behaviors and effects on social life. If a patient is scoring high it should be investigated further. Similarly, patients who keep coming for treatments more often than advised or asking for fillers which would affect their natural features should also be screened.

Is it hard to say no to clients?

The existence of this condition is yet another argument for choosing a professional with a solid medical background : one who is at least aware of those challenges and who has experienced mental health disorders in their career.

There are great risks that come with accepting a patient who may be suffering from BBD. Firstly, it validates their worries: ‘if they agreed to fix my flaws, the flaws are there, visible to others’. Secondly, it will only strengthen the dissatisfaction of the patient: with their own body as well as with the professional.

While running my own business, I am prepared that in some cases I will have to say no to my clients if it is in their best interest!

Additionally, providing treatments on request of the patient who keeps coming for more and not serving as their reality check seems to me unethical (although lucrative).

The ethos of my practice, Ethical Aesthetics, is about enhancing natural features to make our patients feel good. If the problem is in their head, I will only be able to do so by referring them to a good psychologist, not by deforming their body. I would never agree to recreate an image from an Instagram picture (often photoshopped) if this would not suit the patient. Balance is tricky: you are a master of your own body but I am still a doctor. Feeling confident in my profession here is crucial. Of course communicating the diagnosis is never easy. We ensure the patients that treatments for BDD are available and in most cases CBT is recommended. It is possible that the patient may ignore the referral and instead consult other aesthetic practitioners but by saying no and offering alternative diagnosis we know we have done everything we could have. Ethically!

Thank you to Dr Dorota. We hope this piece has been helpful to you. BBD is a mental health condition. If you are facing the problems described please speak to your doctor or visit https://www.nhs.uk/mental-health/conditions/body-dysmorphia/

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