Online help for body image issues

Flinders psychology researchers are developing new approaches to body image-related issues. Stock photo: Getty Images.

Overcoming personal obsession with body image can be treated effectively through online therapy according to a new study by Flinders University researchers.

Cognitive Behavioural Therapy for Perfectionism (CBT-P) reduces not only the primary issues of perfectionism but also secondary outcomes such as depression and body image disturbance – and a new study has found that internet delivery of this program is comparable to face-to-face therapy sessions.

The study focuses on ways of addressing Dysmorphic Concern, which is characterised by a person’s overconcern with appearance-based imperfections, compulsions (such as mirror checking and reassurance-seeking) and which impairs their functioning.

Such appearance-based preoccupations occur in 30-46% of young adults and is of significant concern as an intensifying contemporary condition.

The study’s lead author Shevaugn Johnson, from Flinders University’s College of Education, Psychology and Social Work, says proof of effective online treatment for Dysmorphic Concern provides a safe environment for people who are already anxious about their appearance and therefore may be unwilling to seek therapy assistance.

“Perfectionism in our study group centred around perceived appearance-based flaws, and therefore targeting perfectionism can help reduce their unrealistic standards of beauty,” says Ms Johnson.

“This research is important because online dissemination of treatment will increase the likelihood of more people being treated for dysmorphic concern, which is a risk factor for the development of body dysmorphic disorder.”

The study evaluated the use of Internet-delivered Cognitive Behavioural Therapy for Perfectionism (ICBT-P), with 31 participants (28 being women), aged between 18 and 39, having high levels of dysmorphic concern, to examine the impact on perfectionism, dysmorphic concern, body image disturbance, negative affect, and selective attention towards appearance-based stimuli. Within this study group, 35% of participants experienced depression, and 42% experienced anxiety.

Through this process, perfectionism, dysmorphic concern, selective attention abnormalities, body image disturbance, depression, anxiety and stress were targeted. And the results found that aside from anxiety, there were significant reductions across all variables of interest at immediate and one-month post-treatment follow-up. Further, it was found that the treatment effects endured and became larger over time.

While replication in clinical populations is needed, it is hoped that randomised controlled trials will be used to compare the efficacy of ICBT-P against traditional Cognitive Behavioural Therapy for body dysmorphic disorder (BDD) in participants diagnosed with BDD.

Flinders’ Professor Tracey Wade says: “This is the first study to use a perfectionism intervention to treat dysmorphic concerns and it is encouraging to see that internet therapy can produce such strong and enduring results. Internet therapies are easy to access and can be used widely across a number of settings, and they offer great promise for future treatment of dysmorphic concerns.”

The results of this study support the use of ICBT-P as an efficacious treatment worthy of further examination in populations who experience high levels of dysmorphic concern.

The paper – Internet-delivered cognitive behavioural therapy for perfectionism: Targeting dysmorphic concern, by S Johnson, SJ Egan, G Andersson, P Carlbring, R Shafran and TD Wade – is being published in the September edition of the journal Body Image (

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College of Education, Psychology and Social Work