Nose job lessons

I don't know if you've seen the headlines (the story has been making the rounds in the psychology circles for the past day or two), but a study just came out that looked at the relationship between body dysmorphic disorder and nose jobs. The study found that one-third of people who wanted a nose job for cosmetic reasons had moderate to severe symptoms of BDD. Of those who wanted a nose job for medical reasons (to improve breathing, etc), 2% had been diagnosed with BDD.

Except that's not how the study was reported. Instead, headlines like "Nose job patients often mentally ill, study says." An excerpt from this piece below:

Of patients who were seeking the procedure to correct a breathing problem, only about 2 percent showed symptoms of BDD. But of those who wanted a nose job for cosmetic reasons, 43 percent showed symtoms of the disorder.

BDD was especially common among people with a history of mental illness, as well as those who had already had a nose job and were seeking “revision” surgery.

The problem, as John Grohol pointed out on the World of Psychology blog, is that "symptoms of BDD" aren't the same as being diagnosed with BDD. It's a subtle difference in words, yes. But it's a major difference in what we're actually talking about.

I had symptoms of the flu several winters ago. High fever, muscle aches, chills, feeling utterly crap, all with a sudden onset. Classic flu symptoms. Except a flu test revealed that whatever I had wasn't the flu. It looked a lot like the flu, it had the same symptoms as the flu, but it wasn't caused by the influenza virus.

Someone can have symptoms of depression (low mood, feeling hopeless), but not actually have clinical depression. Same with BDD. Same with EDs, too. The scales and questionnaires used in research aren't diagnostic tools. They can give you an idea whether you should see an actual living, breathing professional for evaluation and a potential diagnosis, but they don't say whether you actually have the condition.

It's not the public's job to know this. I'm not saying scientists shouldn't use these measures simply because they are so frequently misinterpreted by laypeople and journalists alike. But I am saying that journalists and editors need to know the difference. It's responsible reporting.

It happens with eating disorder stories all the time. Most commonly, it happens when people conflate disordered eating with eating disorders, or the scores on a survey with an actual diagnosis. The problem is that most people don't know there's a difference between these two things, or that the difference really matters.

Of course we would expect that people seeking nose jobs have higher concern and focus on their appearance. They are, after all, dropping thousands of dollars in an attempt to, you know, look better. But focus on your appearance isn't the same as BDD, and it's offensive to those who are suffering to make the two things equivocal. It's like saying someone who is obsessed with their weight has an eating disorder. They're not the same. At all.

We need to start distinguishing between these two things so that we stop trivializing deadly mental illnesses as little more than cultural fads.


Lucy said...

That's really interesting, I didn't know.

PJ said...

Luckily you've caught me on a not-too-chatty night or I'd fill up your comments space with my opinions regarding journalistic integrity and deliberate minimisation of eating disorders for the sake of a sensational story to grab readership.
It's crass, irresponsible, damaging and shameful. It is very generous of you to give them the benefit of the doubt that they are simply uneducated.

Carrie Arnold said...

I'm a journalist myself, and I realize that most health reporters have zero science background, and they're also underpaid and overworked. That being said, it's no excuse for sloppy reporting.

The other problem (in the ED community, anyway) is that even the professionals don't always make a meaningful distinction between disordered eating and eating disorders.


Jessie said...

Once again, you're right. (You're one of those people who is right about everything, but I can't find it annoying because I like and look up to you too much for that)You're so right about they're being little to no distinction between disordered eating and eating disorders. I keep trying to explain to one of my best friends but she just keeps saying 'You're just flipping the words around. There isn't really a difference.' Don't you wish we could talk some sense into reporters and journalists who also don't know the difference? Sigh.
You're doing great in y our recovery Carrie, keep it up!

Christine said...

I would agree with the you that there is a fine line between symptoms and diagnosis. It is also possible for one to show symptoms but have it be a completely different diagnosis, or an isolated experience. For example your Flu symptoms could have been allergies, COPD,or mono, etc..But the important thing is that you were able to recognize that something wasn't right and make your way to a professional. The same is true for eating disorders. I could have symptoms of anorexia (but in fact occasionally anorexia is the symptom of something larger), but infact it could just be OCD. I think that is why a lot of times therapists and nutritionists require a complete physical before beginning treatment. As always though, I truly enjoy reading your blog postings. Thank You!!

Jean Naomi said...

You seem kind of like a symptom snob.

Mark said...

Thanks for the article, I read it and the post and I have to say that this all gets more confusing when you are new to all this,just when I think I understand it all, someone throws in something new.
I guess I will all click in to place at some stage!
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nose lift philippines said...

I was agree to Jessie (You're one of those people who is right about everything, but I can't find it annoying because I like and look up to you too much for that) definitely right.


EvanDouglas said...

The study found that a tiered people who wanted the UN Working nose to aesthetic reasons had moderate to severe symptoms of BDD.

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It was so nice discussion going on here. The nose job surgery is most finest and the safest one to get reshape or improve the appearance of of the nose.

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Rhealyng Inguito said...

Individuals who are dissatisfied with their noses find it better to get a rhinoplasty, or a nose job. This is a procedure that improves the shape, width, and length of the nose, resulting to something that is more appropriate to that person’s profile.

nose job said...
This comment has been removed by a blog administrator.
Unknown said...

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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