Health officials have issued new draft guidance recommending that individuals seeking cosmetic surgery should be assessed for body dysmorphic disorder (BDD) prior to undergoing any procedures. According to the National Institute for Health and Care Excellence (NICE), if healthcare workers suspect that a patient may have BDD, cosmetic interventions should be deferred and the patient should be referred to a specialist for further evaluation.
BDD is a mental health condition characterised by excessive preoccupation with perceived flaws in one’s appearance, often leading to significant distress. The guidance also highlights the importance of identifying obsessive compulsive disorder (OCD), which involves persistent intrusive thoughts and repetitive behaviours, and suggests that patients with depression, anxiety, autism, or ADHD may warrant assessment for these conditions.
NICE notes that healthcare professionals providing cosmetic treatments often do not routinely inquire about intrusive thoughts or compulsions related to appearance. The new recommendations call for structured questioning about appearance-related concerns to better identify those at risk.
If assessment responses indicate possible BDD, practitioners are advised to withhold cosmetic procedures as performing them might exacerbate the condition. Instead, patients should be referred for specialist mental health support.
The guidance emphasises that OCD and BDD are frequently under-recognised and that fear of stigma or judgement can prevent individuals from disclosing symptoms. By normalising these experiences, healthcare workers can help reduce stigma and encourage open discussions.
Early identification and intervention are seen as crucial to prevent symptoms from worsening. It’s estimated that roughly 1.2% of the population has OCD, while BDD affects approximately 2%.
Eric Power, interim director of the Centre for Guidelines at NICE, commented: “People with obsessive compulsive disorder and body dysmorphic disorder often experience symptoms for a long time before receiving an accurate diagnosis and support. These conditions can be difficult to talk about due to embarrassment or fear of judgement. Our draft recommendations aim to aid healthcare professionals in recognising symptoms earlier, asking appropriate questions, and guiding patients to suitable treatment sooner.”
He added, “Early detection can ensure that care reflects individuals’ needs and circumstances, potentially avoiding the progression of symptoms to a more severe or crisis stage.”