Body Dysmorphic Disorder (BDD) is a common, often drastic, and under-recognized body image disorder, whereby people are either distressed or preoccupied by the way they see themselves to the point that it impairs their lives. The perceived flaws in their appearance lead to obsession and they are convinced their body is imperfect when they actually look completely normal. Over 75% of people with BDD feel suicidal at some point, with 25% having already attempted to take their own life.

Suicide and Life Threatening Behavior has just published a study revealing researchers have now discovered a link between limited food intake or excessive dieting and a rise in suicide attempts in those suffering from BDD.

The researchers concentrated their study on the acquired capability of suicide in terms of physical pain tolerance and reduced fear of death according to Joiner’s (2005) interpersonal psychological suicide theories.

Tracy K. Witte, Ph.D., of Auburn University, Elizabeth R. Didie, Ph.D., a psychologist in the department of psychiatry at Rhode Island Hospital, and Katharine A. Phillips, M.D., director of the Body Dysmorphic Disorder Program at Rhode Island Hospital assessed the link between attempted suicides with physically painful BDD-related behaviors, such as excessive exercise, restrictive food intake, physical self-mutilation, BDD-related cosmetic surgery and compulsive skin picking.

The researchers surveyed 200 individuals, of whom 68.5% were women aged between 14 and 64 years with a lifetime diagnosis of BDD who had committed between 0 to 25 suicide attempts, and of which 78% had a history of suicide-related thoughts. The study did not include suicide deaths.

The findings revealed that restricting food intake in BDD sufferers was linked to over double the number of suicide attempts, although there was no link to suicide thoughts, whilst in those with a history of BDD-related excessive exercise the number of attempted suicides were less than half compared with those who had no such excessive exercise history. The researchers also established that none of the other BDD-related behaviors, such as cosmetic surgery linked to BDD or compulsive skin picking were substantial markers for suicide attempts.

The researchers hypothesize that because drastically restricting one’s food intake can be physically painful, those able to endure this kind of discomfort are potentially more capable than others in enduring the physical pain required to inflicting self-harm. According to their theory, drastically restricted of food intake that results in long-standing physical pain is a potential predictor of being capable to commit suicide, whilst moderate dieting has a smaller association, if any.

Phillips commented:

“Significantly limiting food intake can be physically painful. It goes against our natural instincts to feed our bodies and respond to the physical pain that comes with extreme hunger. The results of this study suggest the importance of assessing individuals with BDD for restrictive eating behaviors to identify suicide risk, even if they have not previously been diagnosed with an eating disorder.”

Didie concluded:

“While some of the other BDD-related behaviors may seem outwardly more painful – such as undergoing repeated cosmetic procedures, or compulsive skin picking, the level of pain associated with excessive dieting could significantly increase a person’s pain tolerance. This study suggests that those who are capable of enduring such physical discomfort and pain from restrictive eating also may be capable of enduring the physical discomfort required to inflict self harm.”

Written By Petra Rattue