Clinics told to check Botox patients for OCD, BDD under new NHS guidance

The UK health agency, NHS, has issued new guidance to clinics and doctors who practise aesthetics to screen patients for OCD and body dysmorphic disorder (BDD).

The draft proposals were prepared by the National Institute for Health and Care Excellence (NICE).

The UK health watchdog further advises doctors and other NHS staff to take extra care in evaluating people with signs of depression, anxiety, autism and ADHD for OCD and BDD.

NICE new draft guidance states that healthcare professionals “do not routinely ask about or explore whether people have intrusive thoughts, images, urges, impulses, doubts, or worries about appearance”.

Instead, it outlined protocols asking surgeons, doctors and nurses who extend cosmetic services to enquire about patients with structured questions about look-related concerns before administering a procedure.

In case the responses show signs a person is suffering from BDD or OCD, they should be referred for a specialist before the treatment is performed.

“If BDD is suspected, they should not perform the procedure because it may reinforce or worsen BDD-related distress and behaviours,” the guidance states.

“These conditions are often misunderstood and difficult to talk about because of embarrassment, shame or fear of being judged,” said Eric Power, a director at NICE.

According to NICE, OCD is estimated to affect about 1.2 per cent of people while BDD affects about 2 per cent of the population.

The new proposals will take effect from next year, and NHS regulator NICE is encouraging healthcare professionals to take part in this consultation on the draft guidelines, which is open until October 21, 2026.