In the United States, greater than one-third of all women between the ages of 15 and 39 have a condition called body dysmorphic disorder (BDD). This disorder is made evident when preoccupations with body appear and especially when the preoccupations focus on one area. Body dysmorphic disorder interferes with social, career, sexual and personal relations and activities. However, there is no one cause or even one set of symptoms, which makes the issue even more pressing, especially in teen girls.

What is BDD?
According to Abigail Natenshon, psychotherapist and author of When Your Child Has an Eating Disorder, BDD is about self loathing, body intolerance and body image disturbance. "It's one thing to be aware of your body; it is another to be over-aware," says Natenshon. "Those who suffer from BDD are preoccupied – or even overly obsessed – with their body, their shape, their size and their weight. It goes without saying that all of these conditions put a person at high risk to develop eating disorders."

But why? "Reasons why BDD develops come together in the context of genetic susceptibilities and temperament," says Natenshon. "In these cases, the whole can be greater and more devastating than the sum of its parts. The question why is far less significant than what to do to alleviate the emotional pain that BDD carries with it."

Take Note
While BDD is a dominant disorder, teens do not wear a sign on their neck to let you know it's there. Parents need to learn what it is, what it does and what to look for.

"When a young woman is worried more about what she ate than anything else, it is a warning sign," says Jessica Weiner, a motivational speaker and author of A Very Hungry Girl. "Other important signs to watch for related to BDD are: a withdrawal from friends; severe mood swings; a determined preoccupation with exercise, losing weight and with dieting; preoccupation with body size (both their own and others, often comparing). Basically if your body and your food is all you think about from the moment you wake up to the moment you go to sleep, all of your 'worth' is based on body image and weight, your life has become unmanageable – there is a problem or warning sign there to pay attention to."

Fuel for the Fire
It is important to remember that all teens – especially preteen and teen girls – have some natural preoccupation with their bodies, as they are changing, growing and developing in many ways. "Being aware of your body as it changes with the onset of the teen years and puberty is healthy," says Weiner. "However, a person struggling with BDD will begin to put their preoccupation ahead of all other things, although secretly at times. The presence of BDD usually develops after some type of dramatic or tragic events but can also be a learned behavior. In addition, events at home can also trigger BDD."

Effects of BDD
According to Weiner, the effects of BDD do not just limit themselves to one area of a teen's life; it spans to each and every area, creating difficulty and sometimes totally preventing any type of "regular" activity. Below are the most common effects of BDD on various areas, according to Weiner:

Social – Preteen and teen times are already awkward, but those with BDD will feel especially inhibited and isolated from the group.

Self-esteem – The development of BDD robs you of self-esteem because it can make you feel as though you are alone with this problem, and no one else will understand you. While friends are progressing nicely with their esteem, a girl with BDD may feel like she is many steps behind her friends

Body/System growth and development – By starving, overeating or purging food, and abuse of laxatives, etc., a preteen or teen will severely harm the body, especially the brain, liver, heart, kidneys, stomach and throat. In addition, the onset of puberty, menstruation and naturally growing up may be slowed down.

Personal relations – You don't want to feel close to anyone when you have BDD – everyone seems to be perfect while you're stuck battling the demons in your head.

Family relations – Oftentimes a family member will want to fix or "heal" the teen. However, a teen suffering from BDD won't get better until they want to get to better and ask for help. Families can be severely affected by BDD because they do not always understand it is a legitimate problem, and their attempts to help may push the teen away even further.

Activities of interest – A teen with BDD will not always feel up to pursuing activities and interests outside of the disorder. This is one reason why the disorder is so serious, so disturbing and so urgent – it can literally rob a preteen or teen of these years.

What Can a Parent Do to Help?
Parents see their teens every day and know what's "normal" for them. Needless to say, if something develops, parents should be the first to notice – and help. "I think parents need to always listen to their guts," says Weiner. "If you think your child needs help, get help. It is that simple. It is better to make a mistake and overreact than to under-react, because someone with severe depression and BDD may be likely to try drugs, sex or suicide. When you see a major change in your child and you notice habits and preoccupations that you think are 'weird,' then talk to them. Get educated! Don't judge, and go seek some professional help."

The best – and most important – thing to remember is that BDD is a legitimate mental and physical health problem affecting both younger and older women every single day. Knowledge is power. "Once we can look beyond the behaviors and symptoms and recognize that BDD is born from other circumstances and experiences, then we can truly uncover a way to help each other heal," says Weiner. "Education, knowledge and knowing when to seek professional help are the best steps in helping someone – or yourself – deal with and overcome BDD."

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