NICE guidelines recommend that the approach taken is tailored to the particular difficulites that are being experienced and their severity. The guidelines state that Cognitive Behavioural Therapy (CBT) should be offered prior to medication.
Cognitive Behavioural Therapy – CBT aims to identify the patterns of thoughts, feelings and behaviours and then develop skills in order to manage the obsessive thoughts and compulsions. In the case of BDD sessions would focus on improving your attitude towards your body image and reducing the compulsive behaviours. This may involve using elements of Exposure and Response Prevention (ERP) which is a technique used to get you to confront your obsessive worries and deal with them without exhibiting compulsive behaviours.
Medication – a psychiatrist or GP will be able to prescribe medication depending on the symptoms you are experiencing at the time, the severity of the symptoms, past experiences, physical health and how likely you are to consistently take your medication.