Want her to be a doll: A case report on body dysmorphic disorder by proxy

Body Dysmorphic Disorder by Proxy (BDDBP) is a rare and under-recognised variant of Body Dysmorphic Disorder (BDD), where an individual's preoccupation is focused on perceived flaws in another person's appearance. We describe an 18-year-old male with persistent preoccupation regarding his partner's skin tone and appearance, driven by an idealised image of a “doll-like” female. His attempts to alter her appea-rance included cosmetic products, skin-whitening injections, and behavioural restrictions, leading to distress and impaired functioning in both. Differential diagnoses such as psychosis, mood, obsessive-compulsive, and autism spectrum disorders were excluded. The phenomenology was consistent with BDDBP. Treatment with sertraline and cognitive-behavioural strategies led to improvement in insight and reduction in controlling behaviour. This case underscores the need for early recognition and a multimodal therapeutic approach to BDDBP.