PIPRAMS

LESSON PLAN ON
TOPIC: BODY DYSMORPHIC DISORDER
SUBJECT: MENTAL HEALTH NURSING
 IDENTIFICATION DATA:
 NAME OF THE TEACHER: MS GARIMA PANT (ASSISTANT PROFESSOR)
 NAME OF THE SUBJECT: MENTAL HEALTH NURSING
 NAME OF THE TOPIC: BODY DYSMORPHIC DISORDER
 GROUP OF THE STUDENTS: 45
 SIZE OF THE GROUP:45
 DATE AND TIME OF PRESENTATION:
 VENUE/PLACE OF PRESENTATION: CLASSROOM
 DURATION OF TEACHING:31 minutes
 AV AIDS: Black board, Flash cards, Charts.
 PREVIOUS KNOWLEDGE ABOUT THE TOPIC: The students may have some previous
knowledge about the topic “BODY DYSMORPHIC DISORDER”
 GENERAL OBJECTIVES: At the end of the teaching session the group will be able to gain
*knowledge about the topic BODY DYSMORPHIC DISORDER.
*Develop and improve professional efficiency.

 SPECIFIC OBJECTIVES: At the end of the teaching the group will be able to discuss the
topic
S NO TIME SPECIFIC CONTENT TEACHING LEARNING ACTIVITY/ EVALUATION
OBJECTIVE AV AIDs
Lecture cum discussion
1.) 1 min. To introduce
INTRODUCTION What is BDD?
Body Dysmorphic disorder
the topic BDD.
(BDD), or body dysmorphia is,
a mental condition where a
person spends a lot of time
worrying about flaws in their
appearance. These flaws are
often unnoticeable to others

People of any age can have

BDD, but it’s most common in
teenagers and young adults. It
affects both men and women.

DEFINITION
2.) 2 min. To define the ● It is a somatoform disorder, Define the
topic BDD. wherein the afflicted Lecture cum discussion term BDD.
individuals is concerned with
body image manifested as
 excessive concern about and
preoccupation with a
perceived defect of their
physical appearance.

● A fear of being evaluated

Negatively by others.
S NO TIME SPECIFIC CONTENT TEACHING LEARNING ACTIVITY/ EVALUATION
OBJECTIVE AV AIDs
Lecture cum discussion
3.) EPIDEMIOLOGY
Epidemiologic
studies have
reported a point prevalence of
0.7 % to 2.4 % in the general
population. These studies
suggest that BDD is more
common than disorders such
as schizophrenia or anorexia
S NO TIME SPECIFIC CONTENT TEACHING LEARNING ACTIVITY/ EVALUATION
OBJECTIVE AV AIDs
CAUSES /ETIOLOGY
●Biological: deficiency of
4.) 3 min. To explain the Black board Explain the
Serotonin .
causes of BDD. causes of
BDD.
●Genetic: 20% patients; 1st
degree relatives such as
parents , child or siblings.

●personality: Neuroticism,
perfectionism, introversion,
sensitivity to rejection.
Environmental: Media
pressure, eg.
-desire to look
like glamor models lead to
unrealistic expectations
 .
●Testing and criticism:
contributory role in
individuals- genetically/
environmentally predisposed.

●parenting style: parents who

either place excessive
emphasis on aesthetic
appearance or disregard it.

●Sexual trauma , insecurity or

Rejection.

S NO TIME SPECIFIC CONTENT TEACHING LEARNING ACTIVITY/ EVALUATION

OBJECTIVE AV AIDs

5.) 2 min. To List down ONSET List down the

the onset of ●Late adolescence. onset of body
body ●Average age=16.4 years Lecture cum discussion dysmorphic
dysmorphic ●M=F disorder.
disorder. ●Course of illness –
continuous
●Unusual for symptoms to
show periods of remission.
●Comorbidity
 ● Commonly associated with
psychiatric disorders
(depression, anxiety, social
phobia and obsessive
compulsive disorder)

S NO TIME SPECIFIC CONTENT TEACHING LEARNING ACTIVITY/ EVALUATION

OBJECTIVE AV AIDs

6.) 5min. To Enumerate

CLINICAL FEATURES Enumerate
the clinical Flash cards the clinical
Obsession occurs usually with
features of features of
one part of the body such as
BDD. BDD.
facial features, hips, thighs,
feet, etc. but in some cases
patients have multiple issues
with various body parts.
• A constant need to ‘fix’ the
flaw(s) by adopting certain
behaviors such as wearing
only certain kinds of clothing,
modifying eating habits,
constantly re-applying
makeup, or in extreme cases,
cosmetic surgery. Due to this,
BDD is often classified as a
variation of OCD.

• Depressive behaviors such as

lack of interest in getting ready
for parties, formal occasions,
etc.

• Constant comparison of
their own bodies with other
people, either friends,
random strangers, or
celebrities.

• Catching sight of
one’s appearance in mirrors
or other reflective surfaces,
 thus earning the name ‘mirror
syndrome’.

• Self-injury
• Attribution of one’s ‘flaws’ to
other problems in daily life
• Overachieving nature
• Selfesteem issue
S NO TIME SPECIFIC CONTENT TEACHING LEARNING ACTIVITY/ EVALUATION
OBJECTIVE AV AIDs

7.) 10 min. To describe the TYPES OF BDD Chart paper Describe the
types of body • Classification of BDD has only types of body
dysmorphic been done loosely because the dysmorphic
symptoms do not have a clear
disorder. distinction between one another disorderin
and tend to overlap. Usually, the detail.
type of BDD one has depends on
what coping mechanism is evolved
to deal with it. Based on this, types
include:

1.)BDD with eating disorder.

2.)BDD with self injury.

3.)Passive BDD.
S NO TIME SPECIFIC CONTENT TEACHING LEARNING ACTIVITY/ EVALUATION
OBJECTIVE AV AIDs

BDD WITH
EATING
Lecture cum discussion
DISORDER
BDD With Eating Disorders

• Here a person tries to control their

physical appearance by losing weight.

• This leads to 2 common eating

disorders, Anorexia nervosa and
Bulimia.

• In addition to decreasing the food

intake, a person may also exercise
constantly.

• Typical symptoms of this form include:

1. Dehydration

2. Inflammation of the esophagus (in

Bulimic patients)

3 Frequent fainting

4. Chapped lips and poor hair and skin

condition

5. Tendency to skip meals and food or

eating as little as possible in a day

6. Fatigue

BDD WITH SELF

INJURY
1.) The highlighting symptoms of
this form involves the person Lecture cum discussion
purposefully inducing harm
onto themselves ,in particular
,on the body that is causing
the grief.

2.) This includes cutting onself,

pinching one’s skin or
scratching oneself with the
nails , or other objects.

3.) In severe cases, the patient

inflicts dangerous bruises onto
 themselves using tools such as
hammers and scissors. There
are also chances the wounds
might become septic if the
patient cuts very frequently
over the same spot.

4.) The patient usually uses

clothing to cover up signs of
harm, such as wearing long
sleeves or turtleneck shorts
and full length pants.

PASSIVE BDD
1.) In this form, the patient
does not make any effort
to hide the flaw or find an
alternate coping Lecture cum discussion
mechanism.
2.) Instead, they keep their
insecurities contained
within themselves and
usually become
withdrawn from others.
3.) This type of BDD usually
results in depression.
PSYCHOLOGICAL
 IMPACTS Enlist the
8.) 2 min To enlist the Black board psychological
1.) A person feels unworthy or
psychological impacts of
unloved.
impacts of BDD.
2.) They feel that their flaws are
BDD.
the only aspect to them and
they have no other
perceivable talents.
3.) Other talents or skills are
often left unexplored or the
person feels it is useless to
pursue them because of the
way they are.
4.) They find it difficult to
maintain normal social
relationships, especially with
members of the opposite
sex.
5.) Secondary mental illnesses
may develop including type 2
OCD, bipolarity, depression

S NO TIME SPECIFIC CONTENT TEACHING LEARNING ACTIVITY / EVALUATION

OBJECTIVE AV AIDS
And eating disorders.
6.) Constant requests for
 cosmetic surgeries such as
liposuction, implants,
reshaping and re-sculpting
procedures because they feel
that’s the only solution for
them to appear normal.
7.) They might develop
attachments onto objects
such as dolls or pets,
believing they won’t judge
them by their appearance.

S NO TIME SPECIFIC CONTENT TEACHING LEARNING ACTIVITY/ EVALUATION

OBJECTIVE AV AIDs
9.) 2 min. To Discuss
TREATMENT Discuss about the treatment of BDD.
about the Pharmacological
treatment treatment
BDD. 1.) Use of selective serotonin
reuptake inhibitors
(fluoxetine, paroxetine,
clomipramine,
fluvoxamine)
2.) Cognitive behavioural
therapy Patient
constructing a hierarchy
of these symptoms and
keeping a body image
diary during treatment,
which is exposure therapy
to overcome self-
consciousness and
response to decrease
checking behaviour. 3.)
Surgery: Patient rarely
satisfied with surgery:
defect is mostly imagined;
is emotional, rather
physical
 Recent study: reported
32 of 41 patients who did
undergo were highly
satisfied with the
outcome.

SUMMARY
Body dysmorphic disorder is a mental health condition in which you can't stop thinking about one or more perceived defects or flaws in
your appearance — a flaw that appears minor or can't be seen by others. But you may feel so embarrassed, ashamed and anxious that appears
minor or can’t be seen by others. But you may avoid many social situations.

CONCLUSION
• Patients with BDD are likely to present for aesthetic or cosmetic dental treatment. • This is potentially problematic since aesthetic dental treatment has
little benefit for people with BDD and has potentially negative consequences for patient and the treating clinician. • Clinicians should be aware of this
possibility and be familiar with specific strategies to recognize and assess people with suspected BDD and appropriately manage them by referral to specialist
services

BIBLIOGRAPHY
• James M, Clarke P, Darcey R Body dysmorphic disorder and facial aesthetic treatments in dental practice BDJ 2019; 227 (10) 929-933

• Patricia Tatiana Soler, Cristina Michiko Harada Ferreira, Jefferson da Silva Novaes and Helder Miguel Fernandes Body Dysmorphic Disorder: Characteristics,
Psychopathology, Clinical Associations, and Influencing Factors Intech Open 2018

• Ahluwalia R, Bhatia NK, Kumar PS, Kaur P. Body dysmorphic disorder: Diagnosis, clinical aspects and treatment strategies. Indian J Dent Res 2017;28:193-7

• Suzanne E Scott and J Tim Newton, Body Dysmorphic Disorder and Aesthetic Dentistry Dent Update 2011; 38: 112–118