Body dysmorphic disorder presents in up to 2% of the general population, yet less than half seek psychological support. Some treatment barriers include poor illness insight, low body dysmorphic disorder awareness among mental health professionals and a lack of accessibility to body dysmorphic disorder–specific treatments. Currently available treatments for body dysmorphic disorder, including psychopharmacology and psychotherapy, show modest results in improving body dysmorphic disorder symptoms. With the reduced quality of life and increased risks of suicide among individuals with body dysmorphic disorder, there is a need for new and easily accessible therapeutic approaches specific to body dysmorphic disorder. Emerging research has suggested that mindfulness-based interventions show promise as an addition to available body dysmorphic disorder treatments. Clinical evidence of mindfulness-based interventions demonstrates efficacy in improving symptoms in eating disorders, social anxiety disorder and obsessive-compulsive disorder, conditions that have similar clinical presentations as body dysmorphic disorder. Mindfulness strategies, such as increasing interoceptive awareness, non-judgement and non-reactivity, are also suggested to reduce body image disturbances, anxiety and repetitive thoughts, and cognitive rigidity, clinical characteristics of body dysmorphic disorder. This perspective piece aims to provide evidences for integrating mindfulness into treatment protocols to support mental health professionals better address the challenges faced by individuals with body dysmorphic disorder.
AbedinTGhodsiPTaghilooS, et al. (2022) Causal relationship between coherent self-awareness and basic psychological needs with psychological well-being: Considering the mediating role of mind-awareness in students. Journal of Adolescent and Youth Psychological Studies3: 213–226.
2.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.Washington, DC: American Psychiatric Association.
3.
AnsonMVealeDde SilvaP (2012) Social-evaluative versus self-evaluative appearance concerns in body dysmorphic disorder. Behaviour Research and Therapy50: 753–760.
4.
AtkinsonMJWadeTD (2014) Does mindfulness have potential in eating disorders prevention? A preliminary controlled trial with young adult women. Early Intervention in Psychiatry10: 234–245.
5.
BaerRASmithGTHopkinsJ, et al. (2006) Using self-report assessment methods to explore facets of mindfulness. Assessment13: 27–45.
6.
BahreiniZKahrazeiFNikmaneshZ (2021) Effectiveness of mindfulness-based cognitive therapy on body image anxiety and suicidal ideation of adolescent girls with body dysmorphic disorder. Avicenna Journal of Neuro Psycho Physiology9: 5–10.
7.
BishopSRLauMShapiroS, et al. (2004) Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice11: 230–241.
8.
BondFWHayesSCBaerRA, et al. (2011) Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy42: 676–688.
9.
BrennanSNRossellSLRehmI, et al. (2023) A qualitative exploration of the lived experiences of body dysmorphic disorder. Frontiers in Psychiatry14: 1214803.
10.
BrewerRMurphyJBirdG (2021) Atypical interoception as a common risk factor for psychopathology: A review. Neuroscience and Biobehavioral Reviews130: 470–508.
11.
BrohedeSWingrenGWijmaB, et al. (2015) Prevalence of body dysmorphic disorder among Swedish women: A population-based study. Comprehensive Psychiatry58: 108–115.
12.
BuhlmannU (2011) Treatment barriers for individuals with body dysmorphic disorder: An internet survey. The Journal of Nervous and Mental Disease199: 268–271.
13.
CallaghanGDuenasJNadeauS, et al. (2012) An empirical model of body image disturbance using behavioral principles found in functional analytic psychotherapy and acceptance and commitment therapy. International Journal of Behavioral and Consultation Therapy7: 16–24.
14.
CanseverAUzunODönmezE, et al. (2003) The prevalence and clinical features of body dysmorphic disorder in college students: A study in a Turkish sample. Comprehensive Psychiatry44: 60–64.
15.
CashTFFlemingEC (2002) The impact of body image experiences: Development of the body image quality of life inventory. The International Journal of Eating Disorders31: 455–460.
16.
DekeyserMRaesFLeijssenM, et al. (2008) Mindfulness skills and interpersonal behaviour. Personality and Individual Differences44: 1235–1245.
17.
DidonnaFLanfrediMXodoE, et al. (2019) Mindfulness-based cognitive therapy for obsessive-compulsive disorder: A pilot study. Journal of Psychiatric Practice®25: 156–170.
18.
DijkstraPBareldsDP (2011) Examining a model of dispositional mindfulness, body comparison, and body satisfaction. Body Image8: 419–422.
19.
Falk DahlCAReinertsenKVNesvoldI-L, et al. (2010) A study of body image in long-term breast cancer survivors. Cancer116: 3549–3557.
20.
FangAHofmannSG (2010) Relationship between social anxiety disorder and body dysmorphic disorder. Clinical Psychology Review30: 1040–1048.
21.
FisslerMWinnebeckESchroeterT, et al. (2016) An investigation of the effects of brief mindfulness training on self-reported interoceptive awareness, the ability to decenter, and their role in the reduction of depressive symptoms. Mindfulness7: 1170–1181.
22.
GivehkiRAfsharHGoliF, et al. (2018) Effect of acceptance and commitment therapy on body image flexibility and body awareness in patients with psychosomatic disorders: A randomized clinical trial. Electronic Physician10: 7008–7016.
23.
GodseyJ (2013) The role of mindfulness based interventions in the treatment of obesity and eating disorders: An integrative review. Complementary Therapies in Medicine21: 430–439.
24.
GoldinPRGrossJJ (2010) Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion (Washington, D.C.)10: 83–91.
25.
GopanHRajkumarEGopiA, et al. (2024) Mindfulness-based interventions for body image dissatisfaction among clinical population: A systematic review and meta-analysis. British Journal of Health Psychology29: 488–509.
26.
GrunewaldWFogelbergSFergusonW, et al. (2023) Longitudinal relationships between specific domains of interoception and muscle dysmorphia symptoms. Eating Behaviors48: 101686.
27.
GuYQZhuY (2023) A randomized controlled trial of mindfulness-based cognitive therapy for body dysmorphic disorder: Impact on core symptoms, emotion dysregulation, and executive functioning. Journal of Behavior Therapy and Experimental Psychiatry81: 101869.
28.
HaleLStraussCTaylorBL (2013) The effectiveness and acceptability of mindfulness-based therapy for obsessive compulsive disorder: A review of the literature. Mindfulness4: 375–382.
29.
HawleyLLLisiDMRichterMA, et al. (2024) The relationship of rumination, worry and OCD symptoms during technology supported mindfulness therapy for OCD. Clinical Psychology & Psychotherapy31: e3018.
30.
HongKNezgovorovaVHollanderE (2018) New perspectives in the treatment of body dysmorphic disorder. F1000Research7: 361.
31.
Jefferies-SewellKChamberlainSRFinebergNA, et al. (2017) Cognitive dysfunction in body dysmorphic disorder: New implications for nosological systems and neurobiological models. CNS Spectrums22: 51–60.
32.
JenkinsonPMTaylorLLawsKR (2018) Self-reported interoceptive deficits in eating disorders: A meta-analysis of studies using the eating disorder inventory. Journal of Psychosomatic Research110: 38–45.
33.
Kabat-ZinnJ (1990) Full Catastrophe Living: Using the Wisdom of Your Mind to Face Stress, Pain and Illness. New York: Dell.
34.
Kabat-ZinnJ (1994) Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New York: Hyperion.
35.
KellyMMWaltersCPhillipsKA (2010) Social anxiety and its relationship to functional impairment in body dysmorphic disorder. Behavior Therapy41: 143–153.
36.
KerrCESacchetMDLazarSW, et al. (2013) Mindfulness starts with the body: Somatosensory attention and top-down modulation of cortical alpha rhythms in mindfulness meditation. Frontiers in Human Neuroscience7: 12.
37.
KeyBLRowaKBielingP, et al. (2017) Mindfulness-based cognitive therapy as an augmentation treatment for obsessive–compulsive disorder. Clinical Psychology & Psychotherapy24: 1109–1120.
38.
KhoshkerdarPRaeisiZ (2020) The effect of mindfulness-based stress reduction on body image concerns of adolescent girls with dysfunctional eating attitudes. Australian Journal of Psychology72: 11–19.
39.
KocovskiNLFlemingJERectorNA (2009) Mindfulness and acceptance-based group therapy for social anxiety disorder: An open trial. Cognitive and Behavioral Practice16: 276–289.
40.
KozlovEBantumEPaganoI, et al. (2020) The reach, use, and impact of a free mHealth mindfulness app in the general population: Mobile data analysis. JMIR Mental Health7: e23377.
41.
LandmannSCludiusBTuschen-CaffierB, et al. (2019) Mindfulness predicts insight in obsessive-compulsive disorder over and above OC symptoms: An experience-sampling study. Behaviour Research and Therapy121: 103449.
42.
LavellCHWebbHJZimmer-GembeckMJ, et al. (2018) A prospective study of adolescents’ body dysmorphic symptoms: Peer victimization and the direct and protective roles of emotion regulation and mindfulness. Body Image24: 17–25.
43.
LillisJHayesSCLevinME (2011) Binge eating and weight control: The role of experiential avoidance. Behavior Modification35: 252–264.
44.
LinardonJGleesonJYapK, et al. (2019) Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: Implications for eating disorder prevention. Cognitive Behaviour Therapy48: 15–38.
45.
LindeJRückCBjurebergJ, et al. (2015) Acceptance-based exposure therapy for body dysmorphic disorder: A pilot study. Behavior Therapy46: 423–431.
46.
MacrynikolaNMirZGopalT, et al. (2024) The impact of mindfulness apps on psychological processes of change: A systematic review. npj Mental Health Research3: 1–16.
47.
MalcolmALabuschagneICastleD, et al. (2018) The relationship between body dysmorphic disorder and obsessive-compulsive disorder: A systematic review of direct comparative studies. Australian and New Zealand Journal of Psychiatry52: 1030–1049.
48.
MalcolmABrennanSNGraceSA, et al. (2021) Empirical evidence for cognitive subgroups in body dysmorphic disorder. Australian and New Zealand Journal of Psychiatry55: 381–390.
49.
MancusoSG (2016) Body image inflexibility mediates the relationship between body image evaluation and maladaptive body image coping strategies. Body Image16: 28–31.
50.
McCauslandJPaparoJWoottonBM (2021) Treatment barriers, preferences and histories of individuals with symptoms of body dysmorphic disorder. Behavioural and Cognitive Psychotherapy49: 582–595.
51.
PaulusMPFeinsteinJSKhalsaSS (2019) An active inference approach to interoceptive psychopathology. Annual Review of Clinical Psychology15: 97–122.
52.
PearsonANHeffnerMFoletteVM (2011) Acceptance and commitment therapy for body image dissatisfaction: A practitioner’s guide to using mindfulness, acceptance and values-based behavior change strategies. Eating Disorders19: 369–371.
53.
PhillipouARossellSLWildingHE, et al. (2016) Randomised controlled trials of psychological & pharmacological treatments for body dysmorphic disorder: A systematic review. Psychiatry Research245: 179–185.
54.
PhillipsKAMenardW (2006) Suicidality in body dysmorphic disorder: A prospective study. The American Journal of Psychiatry163: 1280–1282.
55.
PhillipsKASiniscalchiJMMcElroySL (2004) Depression, anxiety, anger, and somatic symptoms in patients with body dysmorphic disorder. The Psychiatric Quarterly75: 309–320.
56.
PintoAPhillipsKA (2005) Social anxiety in body dysmorphic disorder. Body Image2: 401–405.
57.
ProwseEBoreMDyerS (2013) Eating disorder symptomatology, body image, and mindfulness: Findings in a non-clinical sample. Clinical Psychologist17: 77–87.
58.
ReindlSM (2001) Sensing the Self: Women’s Recovery from Bulimia. Cambridge, MA: Harvard University Press.
59.
Riquelme-MarínARosa-AlcázarAIOrtigosa-QuilesJM (2022) Mindfulness-based psychotherapy in patients with obsessive-compulsive disorder: A meta-analytical study. International Journal of Clinical and Health Psychology22: 100321.
60.
RossellSLCastleDJPikoosT, et al. (2023) Body dysmorphic disorder and the ugly truth of Australian healthcare. Australian and New Zealand Journal of Psychiatry57: 1407–1409.
61.
SandozEKWilsonKGMerwinRM, et al. (2013) Assessment of body image flexibility: The Body Image-Acceptance and Action Questionnaire. Journal of Contextual Behavioral Science2: 39–48.
62.
SchulteJSchulzCWilhelmS, et al. (2020) Treatment utilization and treatment barriers in individuals with body dysmorphic disorder. BMC Psychiatry20: 69.
63.
SchwartzKGansterFMTranUS (2023) Mindfulness-based mobile apps and their impact on well-being in nonclinical populations: Systematic review of randomized controlled trials. Journal of Medical Internet Research25: e44638.
64.
StewartTM (2004) Light on body image treatment: Acceptance through mindfulness. Behavior Modification28: 783–811.
65.
TeperRSegalZVInzlichtM (2013) Inside the mindful mind: How mindfulness enhances emotion regulation through improvements in executive control. Current Directions in Psychological Science22: 449–454.
66.
WahlKHuelleJOZurowskiB, et al. (2013) Managing obsessive thoughts during brief exposure: An experimental study comparing mindfulness-based strategies and distraction in obsessive–compulsive disorder. Cognitive Therapy and Research37: 752–761.
67.
WebbJBWood-BarcalowNLTylkaTL (2015) Assessing positive body image: Contemporary approaches and future directions. Body Image14: 130–145.
68.
ZhangNYangHX (2024) A network analysis of body image concern, interoceptive sensibility, self-consciousness, and self-objectification. Journal of Clinical Psychology80: 2247–2267.
69.
ZhaoFGuoZBoY, et al. (2024) Is cognitive behavioral therapy an efficacious treatment for psychological interventions in body dysmorphic disorders? A meta-analysis based on current evidence from randomized controlled trials. Journal of Affective Disorders352: 237–249.
