Body dysmorphia - what it is and what you need to know


It’s natural not to love everything about your physical appearance. But if your casual dislike is more of an obsession, you may be among the 1 in 50 people living with body dysmorphic disorder (BDD).

People with body dysmorphia typically focus on one specific body part and have a hard time thinking about anything else. The constant thoughts can interfere with daily functioning and eventually cause other mental health issues.

The good news is that BDD is treatable. You just need to recognize the signs and seek the help of a medical professional. Here’s what you need to know:

What is body dysmorphic disorder?

BDD is a distressing and chronic mental health condition. It causes severe anxiety about a physical defect that sometimes might be imagined or so minor that others don’t see it.

If you have BDD, the negative self-talk and preoccupation with appearance can affect your self-esteem and make you feel excessively self-conscious. The extreme distress often interferes with daily activities such as going to school or work and socializing with family and friends.

Who develops body dysmorphia?

BDD affects men and women equally and no one is completely sure what causes it. Research on the physical causes of BDD is limited, but some believe there may be a genetic predisposition for BDD and a connection to neurobiological dysfunction.

Experts do associate the disorder with certain life experiences, including:

  • Childhood abuse, either emotional or physical
  • Peer abuse or bullying, related to appearance
  • Sexual trauma

Mild symptoms of BDD may occur during adolescence, around 12 to 13 years of age, but the most common onset is late adolescence (16 to 18 years old). People with BDD will need to manage the disorder for life and it may worsen later in life as signs of aging appear.

Symptoms of body dysmorphia

People living with BDD can find fault in any body part, but the focus is commonly on hair, skin, nose, chest or stomach. Other areas of concern include the genitalia, muscles, breasts, thighs, buttocks and body odor.

Signs of BDD may include:

  • Asking repeatedly for reassurance about their appearance and comparing their appearance to others all the time
  • Avoiding social situations
  • Camouflaging with body position, clothing or make-up
  • Constantly examining themselves in mirrors, or avoiding mirrors altogether if the reflection is distressing
  • Engaging in physical and possibly harmful behaviors, such as picking skin
  • Grooming excessively, such as redoing hair unnecessarily or overapplying make-up and cosmetic products
  • Seeking plastic surgery and other cosmetic procedures but never being satisfied with the result

Diagnosing and treating BDD

Diagnosing body dysmorphia can be difficult — people with BDD often feel shame and are secretive about their feelings and symptoms. Some people with BDD will live with symptoms for more than a decade before presenting their concerns to a mental health professional. Many others are never diagnosed.

BDD shares many symptoms with other mental health disorders, especially eating disorders, social anxiety disorder and obsessive-compulsive disorder (OCD). Sometimes BDD is misdiagnosed as one of these disorders. The differentiator for BDD is the focus on a specific body part.

Physicians tailor treatment for BDD to each patient. The best results often come from a combination of treatments, which may include:

  • Cognitive-behavioral therapy (CBT), which helps people recognize irrational thoughts and change negative thinking patterns and behaviors.
  • Antidepressant medications, to help to regulate production of the chemical serotonin and offer relief from the obsessive-compulsive symptoms of BDD.

The link between BDD and other mental health disorders

It’s important to get help from a medical professional for body dysmorphia. People with BDD may also have a social anxiety disorder, eating disorder or obsessive-compulsive disorder (OCD).

Living with BDD over time makes someone more likely to develop other mental health disorders, especially depression. BDD can be isolating and increases the risk of suicide and attempted suicide.

How to help someone with body dysmorphia

When someone has BDD, family and friends may feel stressed and confused. Knowing what to expect and how to help a loved one with BDD can ease stress. The Body Dysmorphic Disorder Foundation recommends:

  • Encouraging your loved one to seek help from a mental health professional
  • Recognize that your loved one’s behaviors are part of BDD and compulsive
  • Support treatment for BDD and recognize that it will take time and commitment to work

For more information about body dysmorphia, reach out to your primary care physician.