Body Dysmorphic Disorder (BDD) is a mental health condition that causes individuals to become excessively preoccupied with perceived flaws in their appearance.[1] The flaws are often minor or completely unnoticeable to others, yet they dominate the thoughts and daily lives of those affected.
Below, we’ll discuss the condition in more detail, potential causes, and possible treatment options.
- Body dysmorphic disorder (BDD) is a mental health condition that causes obsessive focus on perceived physical flaws, often leading to distress and compulsive behaviors.
- BDD is linked to anxiety, depression, and obsessive-compulsive disorder (OCD), increasing the risk of social isolation, suicidal thoughts, and substance use.
- Treatment options include cognitive-behavioral therapy (CBT), medication, and support groups, which can help individuals manage symptoms and improve their quality of life.
_-Symptoms,-Risks,-and-Help-.jpg?v=1740038516)
What is body dysmorphic disorder?
Body Dysmorphic Disorder (BDD) is a psychiatric condition that causes individuals to obsess over perceived defects in their physical appearance, leading to compulsive behaviors aimed at hiding or correcting these imperfections. [1] BDD is classified as a form of anxiety disorder and shares similarities with obsessive-compulsive disorder (OCD) due to the compulsive behaviors that often accompany it.[2]
Unlike general dissatisfaction with body image, BDD is marked by persistent and intrusive thoughts that significantly impair daily functioning. According to research, individuals with BDD exhibit heightened activity in brain regions associated with visual processing and emotional regulation, suggesting that the disorder has a neurobiological basis.[3]
Furthermore, because BDD often coexists with anxiety disorders, patients frequently experience excessive worry, avoidance behaviors, and distress that can interfere with relationships and work.[1]
Is body dysmorphia the same as negative body image?
Although negative body image and BDD may seem similar, they are two distinct conditions with different levels of severity.
Negative body image is a common condition and is often influenced by societal beauty standards, social media, and cultural norms. However, BDD goes beyond general unhappiness with your appearance, leading to obsessive thoughts and compulsive behaviors that disrupt everyday life.
A 2017 study highlights that individuals with BDD often engage in repetitive behaviors such as excessive grooming, seeking reassurance, or undergoing multiple cosmetic procedures without achieving satisfaction.[4] This excessive fixation creates a cycle of distress, anxiety, and avoidance that sets BDD apart from standard body image concerns.
Symptoms of body dysmorphic disorder
Individuals with BDD frequently experience intense distress over their perceived flaws, which can result in compulsive behaviors aimed at hiding or fixing these imperfections. Symptoms often include:
- Excessive mirror-checking or avoiding mirrors
- Seeking reassurance about your appearance
- Constant comparison to others
- Avoidance of social situations
- Relentless pursuit of cosmetic surgeries or beauty procedures
- Body checking with your fingers (e.g. pinching skin, fat, muscle between your fingers in an effort to examine your body more closely)
- Overexercising to target area(s) of concern
These compulsive behaviors serve as maladaptive coping mechanisms that temporarily alleviate distress, but ultimately reinforce negative self-perceptions.[5]
Many individuals with body dysmorphia also suffer from coexisting mental health conditions, further complicating their ability to seek help and manage symptoms effectively.
Conditions linked to body dysmorphic disorder
BDD is closely associated with other psychiatric conditions, including obsessive compulsive disorder (OCD), major depressive disorder, anxiety disorders, and eating disorders. The overlap between these conditions and BDD can make it a complex disorder that requires comprehensive treatment.
Research published in 2015 found that individuals with body dysmorphia are at up to a three times greater risk of developing OCD. [6] In fact, research has found these conditions often coexist due to their similar thought patterns and repetitive behaviors that drive the conditions. Individuals with BDD have been found to have poorer insight, more frequent co-occurring depression and substance use disorders, and suicidality.[7]
Not surprisingly, due to BDD’s impact on body image research has found it often co-occurs with eating disorders like anorexia nervosa and bulimia.[8] Although not everyone with BDD has an eating disorder, their distorted body image perceptions and compulsive behaviors related to appearance can drive the development of disordered eating and make successful treatment more challenging.[8]
Depression and anxiety disorders are also common for individuals with body dysmorphia, with studies suggesting that people with BDD experience increased levels of social anxiety and low self-esteem.[9][10][11]
Substance use disorders have also been linked to BDD, as some individuals use drugs or alcohol to cope with the distress associated with BDD.[12]
Who is likely to get body dysmorphic disorder?
BDD typically begins in adolescence but can develop at any age. It affects both men and women, though the specific areas of concern often differ between the two genders.
Research has found men are more likely to be preoccupied with muscularity, genitals, and hair thinning, whereas women often focus on hips, weight, skin, or facial features.[13]
Genetic predisposition, childhood trauma, and exposure to unrealistic beauty standards have also been linked to contributing to the development of BDD.[1][14][15]
Research has also found that social media plays a significant role, with individuals who spend excessive time on image-focused platforms where they can view pictures or profiles of other people) reporting higher levels of body dissatisfaction and compulsive appearance-related behaviors.[16]
What causes it?
Although the exact cause of BDD has not been identified, some of the possible factors that may contribute to its development include genetics, neurobiological, and environmental factors.
According to a 2010 study, brain imaging studies show that individuals with BDD have hyperactivity in the visual processing areas of the brain, which may lead to a distorted self-perception. [17]
Genetic factors also play a role, with family studies indicating that first-degree relatives of individuals with BDD have a higher risk of developing the disorder. [1]
Environmental influences, such as childhood bullying, body shaming, or traumatic experiences, further increase vulnerability to body dysmorphia. [14]
Can it be prevented?
While there is no surefire way to prevent BDD, early intervention and awareness can reduce its impact.
Education about unrealistic beauty standards, media literacy programs, and promoting self-acceptance can help reduce body image concerns.
Research emphasizes that teaching coping strategies and providing mental health resources at an early age (and when symptoms first present) can decrease the likelihood of developing severe BDD later in life. [18]
Body dysmorphia self-assessment
If you believe you or someone you know is suffering from symptoms of BDD, taking a self-assessment can be a great way to begin getting the help necessary to treat this complex condition. [19]
Self-assessment tools can help individuals determine whether they may have symptoms of body dysmorphia, and start them on their path to recovery.
However, these tools are not diagnostic and should only serve as an initial indicator. A professional evaluation by a mental health provider is necessary for an accurate diagnosis and appropriate treatment.
Risks of body dysmorphic disorder
BDD is associated with severe risks, including heightened levels of anxiety, depression, and social withdrawal.
A 2024 study found that individuals with BDD are at a significantly increased risk of self-harm behaviors, suicidal ideation, and death by suicide due to the distress caused by their perceived physical flaws. [20]
Financial strain from repeated cosmetic procedures is also common, as individuals with BDD often seek repetitive corrections to their appearance.
Help for suicidal ideation
If you or someone you know is experiencing suicidal thoughts due to body dysmorphia, immediate help is available.
Resources may vary based on your location, but help exists in most areas. In the US the 988 Suicide & Crisis Lifelife is available 24/7 providing call, text, chat, or deaf/hard of hearing video support. In the UK, Samaritans is available 24/7 by calling 116 123 for free. You can also chat with them online if you prefer. [21][22]
Local emergency services are always available to provide support and can be reached via telephone.
When to seek professional help
If you believe you are experiencing symptoms of BDD, it is crucial to seek professional help as soon as possible. This is especially true if symptoms are interfering with daily life, relationships, or self-esteem.
Signs that indicate the need for intervention include severe distress, avoidance of social situations, compulsive appearance-related behaviors, and thoughts of self-harm.
Early treatment can prevent the condition from worsening.
Treatment options for body dysmorphic disorder
There are multiple treatment options available for body dysmorphia. For most individuals a combination of therapies is the most effective. Below, we’ll discuss the most common and effective treatment options for individuals with BDD.
Therapy
Psychotherapy, better known as talk therapy or therapy, involves speaking with a licensed mental health professional. There are various types of psychotherapy that have been proven successful. This includes Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness-based therapies.
According to research, CBT has been shown to be better and work faster than supportive psychotherapy at reducing symptoms of BDD. [23] It has also been shown to be even more effective when combined with medication. [24] It works by helping individuals challenge distorted thoughts and reduce compulsive behaviors.
ACT has also been proven effective in providing significant reductions in body dissatisfaction and fear of negative evaluation. [25] Mindfulness-based therapy (with one of the most common forms being mindfulness-based stress reduction, or MBSR) has also shown improvement in emotional dysregulation and other symptoms of BDD. [26]
Medications
Certain medications can be helpful at improving the symptoms of BDD, especially in more severe cases or where suicidal ideation or attempts have been involved. Selective serotonin reuptake inhibitors (SSRIs) are currently the first-line treatment for BDD and have been found to significantly reduce obsessive thoughts and anxiety. [27] Other medications may be prescribed if SSRIs do not effectively reduce symptoms including buspirone, aripiprazole, and pimozide. [27]
Support groups
For those suffering with body dysmorphia, having the support of other individuals going through the same issues can help with recovery. These support groups exist online, in-person, and in inpatient treatment settings. If you are interested in learning more about support groups in your area, reach out to your mental health provider.
Specialist services
Due to the complexity of the condition, BDD-specific clinics and psychiatric services are available that offer tailored treatment plans. Often these services are covered by insurance and use a combination of therapies to treat the condition such as therapy, medications, and support groups.
Remote/Telehealth
For some individuals getting to a therapy session in person can be quite challenging. Online therapy services can increase accessibility for those unable to seek in-person care. In fact, research has shown that cognitive behavior therapy delivered remotely via a telehealth platform and through a smartphone app can effectively reduce symptoms. [28][29]
Next steps
If you suspect you or someone you know has body dysmorphic disorder, the next step is to seek an evaluation from a mental health professional. Educating yourself about the condition, exploring treatment options, and reaching out for support can all support a successful recovery.
Conclusion
Body dysmorphic disorder is a mental health condition that can significantly impact an individual's quality of life and functioning. Fortunately, there are treatment options that can be tailored to meet the individual needs of those with the condition.
Recognizing symptoms and seeking professional help as soon as symptoms begin can improve quality of life and reduce the severity of the condition.
By promoting awareness, supporting evidence-based treatments, and encouraging early intervention, we can help those struggling with body dysmorphia find hope and recovery.
-guide-detail.jpg?v=1722503025)
-(1)-guide-detail.jpg?v=1722502701)
