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. 2025 Jun 24:7:ojaf070.
doi: 10.1093/asjof/ojaf070. eCollection 2025.

Body Dysmorphic Disorder in Aesthetic Practitioners: A Cross-Sectional Study of Prevalence, Awareness, and Psychological Implications

Patricia Barrera, Fernando Felice, Madara Orlovska, Steven Harris

Body Dysmorphic Disorder in Aesthetic Practitioners: A Cross-Sectional Study of Prevalence, Awareness, and Psychological Implications

Patricia Barrera et al. Aesthet Surg J Open Forum. .

Abstract

Background: Body dysmorphic disorder (BDD) is a mental health condition characterized by an obsessive focus on perceived physical flaws, causing significant psychological distress. Aesthetic practitioners often interact with appearance-focused patients, increasing their potential exposure to BDD and its psychological effects. Understanding BDD prevalence and awareness among practitioners is crucial for their professional and personal well-being.

Objectives: The authors of this study aim to assess the prevalence of BDD among aesthetic practitioners (physicians and surgeons) and evaluate their awareness of the disorder.

Methods: A cross-sectional study was conducted with 199 participants, including 98 aesthetic practitioners and 101 lawyers (control group). Participants completed the Depression, Anxiety, and Stress Scale (DASS-10) and the Cosmetic Procedure Screening (COPS) questionnaires, along with questions assessing BDD knowledge. Statistical analyses included Pearson's correlations, χ 2 tests, analysis of covariance, and logistic regression.

Results: Possible BDD was identified in 8.2% of aesthetic practitioners vs 2% of controls (P = .056). Aesthetic practitioners showed a significant association with self-reported physical-aesthetic disorders (χ 2(2) = 11.25, P = .004). Total COPS scores correlated significantly with distress, anxiety, and depression levels (all P < .001). Regression analysis revealed that aesthetic practitioners were 7 times more likely to exhibit BDD symptoms compared with controls (b = 2.03, P = .03, odds ratio = 7.59), even after controlling for anxiety and depression.

Conclusions: In this study, the authors underscore the need for enhanced BDD awareness and mental health training among aesthetic practitioners. Addressing mental health within the aesthetic field is essential to improve professional practices and safeguard psychological well-being.

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Figures

Figure 1.
Figure 1.
Total adjusted Cosmetic Procedure Screening scores by group.
Figure 2.
Figure 2.
Bar chart of association between group (study vs control) and self-reported physical-aesthetic disorder.
See this image and copyright information in PMC

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