Understanding Body Dysmorphic Disorder (BDD)

Table of ContentsView AllTable of ContentsDefinitionSymptomsDiagnosisCausesTypesTreatmentCoping

Table of ContentsView All

View All

Table of Contents

Definition

Symptoms

Diagnosis

Causes

Types

Treatment

Coping

Close

At a GlanceWe all have body insecurities, but people with body dysmorphic disorder are so preoccupied with their perceived flaws that it interferes with their daily lives. It’s not the same as having a distorted body image; it typically involves an intense focus on a specific aspect of a person’s physical appearance. People who have this condition may go to great lengths to try and hide their perceived flaws, such as using excessive makeup or getting surgery to alter their appearance. Factors like abuse, bullying, genetics, and social interactions may play a part in causing this condition. Learning to accept yourself can help, but BDD doesn’t just go away on its own. If you think you might have this condition, talk to your doctor or therapist about treatments that can help.

At a Glance

We all have body insecurities, but people with body dysmorphic disorder are so preoccupied with their perceived flaws that it interferes with their daily lives. It’s not the same as having a distorted body image; it typically involves an intense focus on a specific aspect of a person’s physical appearance. People who have this condition may go to great lengths to try and hide their perceived flaws, such as using excessive makeup or getting surgery to alter their appearance. Factors like abuse, bullying, genetics, and social interactions may play a part in causing this condition. Learning to accept yourself can help, but BDD doesn’t just go away on its own. If you think you might have this condition, talk to your doctor or therapist about treatments that can help.

Distorted Body Image vs. Body Dysmorphia

Where someone witha distorted body imagetends to focus on overall physical shape or size, a person with body dysmorphic disorder will place extreme focus on a particular body part or feature of their body. Thoughts of their specific flaws surface frequently and can become overwhelming, often consuming their thoughts and presenting an obstacle to their general well-being and daily functioning.

BDD differs from common body image concerns in that the thoughts arepersistent and intrusive, cause significant distress and impact behavior and functioning.

Another important factor is that, with BDD, the person is often preoccupied with a flaw or trait that is barely noticeable, even nonexistent. Features that others might see as a slight imperfection or inconvenience (or not see at all) become consuming and unbearable, to the point of threatening their quality of life.

Symptoms of Body Dysmorphic Disorder

If you are dealing with BDD, you may often be consumed with intrusive and persistent thoughts related to a feature on your body, such as a mark, scar, shape, or symmetry of a particular body part.

The thoughts can show up at any time without warning, and no matter how hard you try, you likely have difficulty stopping or changing your thoughts about the perceived flaw.

Because of the persistence of these thoughts, it’s possible you feel a significant disruption in your quality of life. If you think a loved one may be dealing with BDD, some of the behaviors they may be demonstrating include:

People with BDD will often engage in repetitive behaviors in an attempt to address these physical concerns. Even though you can spend hours a day on these behaviors, any relief is short-lived.

Diagnosing Body Dysmorphic Disorder

People with BDD often fear judgment from others even though their level of distress is so high that it severely impacts their quality of life and relationships.

In order to be clinically diagnosed with BDD, the following criteria must be met:

Conditions With Similar Symptoms

Body dysmorphic disorder can be easily misdiagnosed as another mental health disorder, so it is important for a properly trained clinician to do a thorough diagnostic assessment to avoid potentially misdiagnosis. Some symptoms of BDD overlap with other conditions, such as:

What Causes Body Dysmorphia?

Researchers are not 100% sure about what exactly causes body dysmorphic disorder. It’s a condition that can affect anyone, but experts believe that there are a variety of factors that can play a role, such as:

In addition to these factors, societal and cultural factors also undoubtedly play a part. Unrealistic beauty standards, social media images, and the society’s emphasis on the thin-ideal promote ideas about appearance and beauty that shape how people see themselves.

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Related and Co-Occurring Disorders

It isn’t uncommon for body dysmorphic disorder to occur alongside other conditions. Overlap has been shown to exist between BDD and other mental health disorders, particularly anxiety disorders such as OCD, social anxiety disorder (SAD), and substance-related disorders. In the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR), BDD is under the category of obsessive-compulsive and related disorders.

Research has shown that over 60% of people with BDD have a lifetime anxiety disorder, with 38% experiencing social anxiety disorder.The preoccupation with a perceived physical flaw can leave people feeling isolated and apprehensive of any social interaction, leading to feelings of hopelessness anddepression.

Although unhealthy body image is often associated with eating disorders, it is important to point out that body dysmorphia is not necessarily related to weight or weight loss. For many with BDD, the focus is on a body part such as the nose, hair, or scars—things that disordered eating behaviors would not change or influence.

When the obsessive focus for someone is related specifically to the size of a body part, such as the thighs or midsection, eating disordered behavior may take place in an effort to address that perceived flaw. Among people with anorexia, 25% to 39% are diagnosed with body dysmorphic disorder at some point during their lives, and 32% of people with BDD are diagnosed with a lifetime eating disorder.

The Link Between BDD and Eating Disorders

Prevalence

BDD is suggested to impact about 1 in 50 people within the general population, which would equate to roughly 5 to 7.5 million people in the United States alone. BDD seems to affect men and women equally, with an estimated 2.5% of women and 2.2% of men identified as having this disorder.

Although BDD can show up for people at any age, many start to show signs and behaviors of the disorder around the age of 12 or 13 years old.

Types of Body Dysmorphia

Although excessive focus and attention can be on a variety of body parts, traits, or characteristics, some of the more common include:

Treatment for Body Dysmorphic Disorder

If you or a loved one are dealing with BDD, you may feel reluctant to start psychiatric treatment. It’s very common for those with BDD to believe that psychiatric treatment is not an adequate solution to their concerns.

In fact, it is likely that you will have already sought out help in other ways, such as with makeup, hair and clothing consultants, plastic surgeons, aestheticians, dermatologists, and dentists (depending on the body feature in question). Those with BDD want their physical “problem” addressed. They want the perceived flaw to be fixed, transformed, or removed.

It may feel daunting, but psychiatric treatment can be very beneficial, addressing any thoughts and feelings around these physical concerns.

Psychotherapy

One approach that has shown to be effective in the treatment of body dysmorphic disorder iscognitive behavioral therapy(CBT). In fact, CBT is a first-line treatment for BDD.

It involves changing the maladaptive thoughts and beliefs present in the disorder. It can also involve exposure techniques that aim to decrease the repetitive behaviors and thoughts around bodily preoccupations.

It is important that those with body dysmorphic disorder allow themselves adequate time for psychotherapy to be effective.

Medications

Additionally, the use of medications, specifically selective serotonin reuptake inhibitors (SSRIs), have been shown to be effective in decreasing some of the symptoms of BDD. These medications are often used most effectively in combination with cognitive behavioral therapy.

Selective Serotonin Reuptake Inhibitors

Coping With Body Dysmorphic Disorder

There are also things that you can do to help make the symptoms of the condition more manageable. These strategies may include:

Avoiding Comparison

Social comparisonis a big challenge for many of us, and even more so if you’re living with BDD. Because of insecurities around physical characteristics and a tendency to judge ourselves so harshly, being around others can be challenging and intimidating.

Ensuring Your Safety

Physical safety is key in the treatment of BDD. By the time a person has started psychiatric treatment, they have likely already shown some physically unhealthy coping behaviors such as excessive skin picking or pursuing a variety of unhelpful medical treatments.

These behaviors can leave you and your loved ones feeling no hope that the situation can change. This behavior must be seen as not only harmful to one’s well-being but also ineffective in accomplishing the goal of “fixing” a perceived flaw.

Focusing on Self-Acceptance

After spending so much time focused on personal flaws, the idea ofself-acceptancecan feel foreign and sometimes even impossible but, with the help of treatment, it can be possible to challenge debilitating thoughts and unhealthy behaviors, improve yourself-talk, and come to a place of greater acceptance and self-compassion.

If you or a loved one are struggling with body dysmorphic disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat 1-800-662-4357 for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with body dysmorphic disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Malcolm A, Pikoos TD, Grace SA, Castle DJ, Rossell SL.Childhood maltreatment and trauma is common and severe in body dysmorphic disorder.Compr Psychiatry. 2021;109:152256. doi:10.1016/j.comppsych.2021.152256Arienzo D, Leow A, Brown JA, et al.Abnormal brain network organization in body dysmorphic disorder.Neuropsychopharmacology. 2013;38(6):1130‐1139. doi:10.1038/npp.2013.18Bienvenu OJ, Samuels JF, Riddle MA, et al.The relationship of obsessive-compulsive disorder to possible spectrum disorders: Results from a family study.Biol Psychiatry. 2000;48(4):287‐293. doi:10.1016/s0006-3223(00)00831-3Mufaddel A, Osman OT, Almugaddam F, Jafferany M.A review of body dysmorphic disorder and its presentation in different clinical settings.Prim Care Companion CNS Disord. 2013;15(4):PCC.12r01464. doi:10.4088/PCC.12r01464Vaughn DA, Kerr WT, Moody TD, et al.Differentiating weight-restored anorexia nervosa and body dysmorphic disorder using neuroimaging and psychometric markers.PLoS One. 2019;14(5):e0213974. doi:10.1371/journal.pone.0213974Anxiety and Depression Association of America.Body dysmorphic disorder (BDD).Bernstein EE, Phillips KA, Greenberg JL, Curtiss J, Hoeppner SS, Wilhelm S.Mechanisms of cognitive-behavioral therapy effects on symptoms of body dysmorphic disorder: a network intervention analysis.Psychol Med. 2023;53(6):2531-2539. doi:10.1017/S0033291721004451Hong K, Nezgovorova V, Hollander E.New perspectives in the treatment of body dysmorphic disorder.F1000Res. 2018;7:361. doi:10.12688/f1000research.13700.1

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Malcolm A, Pikoos TD, Grace SA, Castle DJ, Rossell SL.Childhood maltreatment and trauma is common and severe in body dysmorphic disorder.Compr Psychiatry. 2021;109:152256. doi:10.1016/j.comppsych.2021.152256Arienzo D, Leow A, Brown JA, et al.Abnormal brain network organization in body dysmorphic disorder.Neuropsychopharmacology. 2013;38(6):1130‐1139. doi:10.1038/npp.2013.18Bienvenu OJ, Samuels JF, Riddle MA, et al.The relationship of obsessive-compulsive disorder to possible spectrum disorders: Results from a family study.Biol Psychiatry. 2000;48(4):287‐293. doi:10.1016/s0006-3223(00)00831-3Mufaddel A, Osman OT, Almugaddam F, Jafferany M.A review of body dysmorphic disorder and its presentation in different clinical settings.Prim Care Companion CNS Disord. 2013;15(4):PCC.12r01464. doi:10.4088/PCC.12r01464Vaughn DA, Kerr WT, Moody TD, et al.Differentiating weight-restored anorexia nervosa and body dysmorphic disorder using neuroimaging and psychometric markers.PLoS One. 2019;14(5):e0213974. doi:10.1371/journal.pone.0213974Anxiety and Depression Association of America.Body dysmorphic disorder (BDD).Bernstein EE, Phillips KA, Greenberg JL, Curtiss J, Hoeppner SS, Wilhelm S.Mechanisms of cognitive-behavioral therapy effects on symptoms of body dysmorphic disorder: a network intervention analysis.Psychol Med. 2023;53(6):2531-2539. doi:10.1017/S0033291721004451Hong K, Nezgovorova V, Hollander E.New perspectives in the treatment of body dysmorphic disorder.F1000Res. 2018;7:361. doi:10.12688/f1000research.13700.1

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Malcolm A, Pikoos TD, Grace SA, Castle DJ, Rossell SL.Childhood maltreatment and trauma is common and severe in body dysmorphic disorder.Compr Psychiatry. 2021;109:152256. doi:10.1016/j.comppsych.2021.152256Arienzo D, Leow A, Brown JA, et al.Abnormal brain network organization in body dysmorphic disorder.Neuropsychopharmacology. 2013;38(6):1130‐1139. doi:10.1038/npp.2013.18Bienvenu OJ, Samuels JF, Riddle MA, et al.The relationship of obsessive-compulsive disorder to possible spectrum disorders: Results from a family study.Biol Psychiatry. 2000;48(4):287‐293. doi:10.1016/s0006-3223(00)00831-3Mufaddel A, Osman OT, Almugaddam F, Jafferany M.A review of body dysmorphic disorder and its presentation in different clinical settings.Prim Care Companion CNS Disord. 2013;15(4):PCC.12r01464. doi:10.4088/PCC.12r01464Vaughn DA, Kerr WT, Moody TD, et al.Differentiating weight-restored anorexia nervosa and body dysmorphic disorder using neuroimaging and psychometric markers.PLoS One. 2019;14(5):e0213974. doi:10.1371/journal.pone.0213974Anxiety and Depression Association of America.Body dysmorphic disorder (BDD).Bernstein EE, Phillips KA, Greenberg JL, Curtiss J, Hoeppner SS, Wilhelm S.Mechanisms of cognitive-behavioral therapy effects on symptoms of body dysmorphic disorder: a network intervention analysis.Psychol Med. 2023;53(6):2531-2539. doi:10.1017/S0033291721004451Hong K, Nezgovorova V, Hollander E.New perspectives in the treatment of body dysmorphic disorder.F1000Res. 2018;7:361. doi:10.12688/f1000research.13700.1

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Malcolm A, Pikoos TD, Grace SA, Castle DJ, Rossell SL.Childhood maltreatment and trauma is common and severe in body dysmorphic disorder.Compr Psychiatry. 2021;109:152256. doi:10.1016/j.comppsych.2021.152256

Arienzo D, Leow A, Brown JA, et al.Abnormal brain network organization in body dysmorphic disorder.Neuropsychopharmacology. 2013;38(6):1130‐1139. doi:10.1038/npp.2013.18

Bienvenu OJ, Samuels JF, Riddle MA, et al.The relationship of obsessive-compulsive disorder to possible spectrum disorders: Results from a family study.Biol Psychiatry. 2000;48(4):287‐293. doi:10.1016/s0006-3223(00)00831-3

Mufaddel A, Osman OT, Almugaddam F, Jafferany M.A review of body dysmorphic disorder and its presentation in different clinical settings.Prim Care Companion CNS Disord. 2013;15(4):PCC.12r01464. doi:10.4088/PCC.12r01464

Vaughn DA, Kerr WT, Moody TD, et al.Differentiating weight-restored anorexia nervosa and body dysmorphic disorder using neuroimaging and psychometric markers.PLoS One. 2019;14(5):e0213974. doi:10.1371/journal.pone.0213974

Anxiety and Depression Association of America.Body dysmorphic disorder (BDD).

Bernstein EE, Phillips KA, Greenberg JL, Curtiss J, Hoeppner SS, Wilhelm S.Mechanisms of cognitive-behavioral therapy effects on symptoms of body dysmorphic disorder: a network intervention analysis.Psychol Med. 2023;53(6):2531-2539. doi:10.1017/S0033291721004451

Hong K, Nezgovorova V, Hollander E.New perspectives in the treatment of body dysmorphic disorder.F1000Res. 2018;7:361. doi:10.12688/f1000research.13700.1

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