Randomized Control Trials for the Management of Body Dysmorphic Disorder: A Systematic Review

Body dysmorphic disorder (BDD) is a persistent psychological disorder that is unlikely to be remitted without proper treatment. The present systematic review aims to evaluate the effectiveness of cognitive behavior therapy (CBT) for BDD in both face-to-face and online formats. Online databases such as PubMed, ScienceDirect, Web of Science, Cochrane Library, ProQuest, and PsycINFO were searched for RCTs on BDD published between 2011 and 2025. After screening, eight RCTs were included. All studies used CBT as an active treatment and demonstrated moderate to large effects on BDD symptoms. Both digital and face-to-face CBT both showed significant improvements. A random-effects meta-analysis across the included studies revealed a large pooled effect of CBT in reducing BDD symptoms (SMD= -0.93, 95% CI [-1.17, -0.69], I2 = 33%). The potential risk of bias was also evaluated. Overall, the systematic review suggested that CBT is an effective treatment for reducing the symptoms of BDD across both face-to-face and online formats. It highlighted the potential of online therapy format as an accessible alternative treatment option.