Health officials have issued new draft guidance recommending that individuals seeking cosmetic surgery undergo mental health assessments, particularly for body dysmorphic disorder (BDD). The National Institute for Health and Care Excellence (NICE) advises that healthcare professionals should not proceed with cosmetic procedures if they suspect a patient may have BDD, but instead refer them to a specialist for further evaluation.
The guidance also highlights the importance of assessing patients with depression, anxiety, autism, or ADHD for obsessive-compulsive disorder (OCD) and BDD. OCD is characterised by intrusive thoughts and compulsive behaviours, while BDD involves persistent concern over perceived flaws in one’s appearance.
NICE notes that healthcare professionals often do not routinely inquire about intrusive thoughts or worries relating to appearance, which may lead to under-recognition of these conditions. The draft guidelines encourage clinicians to ask structured questions regarding appearance-related concerns prior to cosmetic procedures.
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If a patient’s responses suggest BDD, the guidance advises postponing any cosmetic interventions, as such procedures can exacerbate BDD symptoms and distress. NICE emphasises the need to normalise discussions around these mental health issues to reduce stigma, shame, and fear of judgement.
By improving early identification and referral, the new guidelines aim to ensure patients receive appropriate support and treatment before symptoms worsen. It is estimated that OCD affects approximately 1.2% of the population, while BDD impacts around 2%.
Eric Power, interim director of the Centre for Guidelines at NICE, commented: “People with obsessive compulsive disorder and body dysmorphic disorder can experience symptoms for a long time before they receive the right diagnosis and support. These conditions are often misunderstood, and many people find them difficult to talk about because of embarrassment, shame or fear of being judged. Our draft recommendations aim to help healthcare professionals recognise symptoms earlier, ask the right questions and support people to access appropriate treatment sooner. Earlier identification can help ensure people receive care that reflects their needs, preferences and circumstances, rather than waiting until symptoms become more severe or reach crisis point.”