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Body dysmorphia: definition, symptoms, causes, treatment

Body dysmorphic disorder (BDD), also known as body dysmorphia, is a mental health condition that involves an overwhelming preoccupation with one’s body and appearance. Someone with BDD may focus excessively on minor physical flaws or worry about perceived flaws that others don’t notice.

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In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), BDD is listed under the category of obsessive-compulsive and related disorders. This means that it involves both obsessions (intrusive, persistent thoughts) and compulsions (actions that someone repeatedly performs in an attempt to reduce anxiety).

Learn more about body dysmorphia, including symptoms, causes, and available treatment options.

Prevalence of body dysmorphic disorder

Estimates suggest that up to 4% of the US population meets diagnostic criteria for body dysmorphic disorder. It is most common in people between the ages of 15 and 30.

Symptoms

People with body dysmorphia worry excessively about minor or non-existent flaws in their body and/or face. To “correct” these defects, they can go to great lengths, such as radically altering their appearance through plastic surgery.

Research suggests that people with BDD often spend three to eight hours a day worrying about their perceived physical imperfections. Any part of the body can become the target of these concerns. However, people with body dysmorphia are more likely to worry about their skin, nose, or hair.

Common symptoms of body dysmorphia include:

  • Extreme concern for physical flaws that are either very minor or imaginary
  • Spending too much time covering up perceived flaws with makeup, different outfits, or new hairstyles
  • Buying products or undergoing plastic surgery to alter one’s appearance
  • Excessively checking the mirror or avoiding mirrors
  • Trying to hide certain body parts with clothes or accessories
  • Repetitive behaviors, such as scratching skin
  • Constant need to be reassured by others about their physical appearance
  • Worrying excessively about looking “ugly” or unattractive
  • Constantly comparing their appearance to that of others

A person with body dysmorphia may feel so caught up in thoughts about their appearance that they neglect other areas of their life. They may even avoid school, social events, dates, or work for fear of being judged for their appearance.

When left untreated, BDD can lead to serious negative consequences. More than half of people with BDD are unmarried and more than 20% of people with body dysmorphia are unemployed. About 20% of people with BDD are so upset by their appearance that they attempt suicide.

Diagnostic

If you think you have BDD, talk to your healthcare provider. They can refer you to a mental health specialist who can make a diagnosis using DSM-5 criteria. If your concerns about your appearance focus more on your weight or height, you might be diagnosed with an eating disorder instead.

To be diagnosed with body dysmorphia, preoccupation with your appearance must negatively affect your life and/or cause significant emotional distress. Your healthcare provider can also clarify if you have muscle dysmorphia, a type of body dysmorphia that involves worrying about looking “too small” or not muscular enough.

During the diagnostic process, your mental health specialist can clarify whether you have a good, fair, or poor understanding of your BDD symptoms.

According to the DSM-5, some people with body dysmorphic disorder have “good” insight, which means they are aware that their beliefs about their bodies are not true. People with “fair” or “poor” insight are unaware that their worries are excessive or not based on reality.

causes

The exact cause of body dysmorphia is unknown. Researchers believe that several factors may contribute to the development of BDD, including:

  • Genetic: In some cases, BDD can be inherited. According to twin studies, genetic factors account for about 44% of the variance in symptoms of body dysmorphic disorder.
  • Trauma: People with a history of trauma have a higher risk of developing body dysmorphia. Many people with BDD report being bullied by their peers at school, and up to 79% of people with body dysmorphia have been bullied as children.
  • Personality traits: People with certain personality traits, such as perfectionism and sensitivity to aesthetics, are more likely to develop body dysmorphia.
  • Comorbid conditions: Many people with BDD have at least one other mental health problem at the same time. It is especially common for someone with body dysmorphia to have obsessive-compulsive disorder (OCD), social anxiety disorder (SAD), or an eating disorder, such as anorexia nervosa (A).

Treatment

Treatment for body dysmorphia usually involves psychotherapy (talk therapy) and/or medication. Research suggests that the following approaches are effective in treating people with BDD:

  • Cognitive-behavioral therapy (CBT): CBT can help people with BDD learn to manage their anxiety and depression, better understand their beliefs, and resist the urge to engage in compulsive behaviors.
  • Selective serotonin reuptake inhibitors (SSRIs): Studies indicate that certain antidepressants, such as SSRIs, have been shown to be 53% to 70% effective in treating BDD. Many people with body dysmorphia need to take SSRIs long-term to reduce their symptoms.

To face

If you have BDD, it’s important to build your self-esteem and ask others for help. In addition to seeking professional treatment, here are some ways to deal with the symptoms of body dysmorphia:

  • Join an online or in-person peer support group for people with BDD
  • Spend time with loved ones
  • Practice mindfulness techniques, such as meditation
  • Manage stress with relaxation techniques, such as deep breathing exercises
  • Write your thoughts in a journal
  • Use positive affirmations to boost your confidence
  • Engage in a new hobby or learn a new skill

Summary

Body dysmorphic disorder (BDD) is a mental health disorder that involves extreme preoccupation with minor or imagined flaws in physical appearance. People with BDD feel overwhelmed with negative thoughts about their body or face. They may spend too much time and/or money trying to hide their imperfections or “fix” their appearance.

Researchers believe that BDD is caused by a combination of genetic and environmental factors. Many people with BDD have been bullied about their appearance. A history of trauma, such as child abuse, also increases the likelihood of developing BDD. Treatment for BDD usually involves psychotherapy, medication, or both.

A word from Verywell

If you care excessively about your appearance, you’re not alone. Body dysmorphia is common, especially in young adults. Many people have low self-esteem and body image issues. Talk to your healthcare provider about your options for treatment, support and empowerment.

Frequently Asked Questions


  • Is body dysmorphia the same as insecurity?

    Many people are unsure of their appearance. However, people with body dysmorphia are so preoccupied with certain aspects of their appearance that it interferes with their daily lives.

    They may go to extreme measures to change or hide certain body parts. They may also avoid going out at all because of their imagined physical flaws.


  • How do you know if you have body dysmorphia?

    You may have body dysmorphic disorder if you are overly preoccupied with minor or imagined flaws in your body and/or face. You may also perform repetitive actions, such as comparing yourself to others or excessively grooming yourself, to remedy your perceived imperfections. Talk to your healthcare provider if you feel consumed or overwhelmed by negative thoughts about your appearance.


  • How common is body dysmorphic disorder?

    Body dysmorphic disorder is a fairly common mental health condition. According to estimates, between 0.6% and 4% of the population suffer from body dysmorphia. It is even more common in people who have plastic surgery or who regularly see a dermatologist.


  • What does science say about BDD?

    Research suggests that both biological and environmental factors contribute to the development of body dysmorphia. A history of trauma, including bullying and/or abuse, greatly increases a person’s likelihood of developing BDD. Twin studies indicate that genetics also plays a role, accounting for up to 44% of BDD cases.


  • How to support a person with body dysmorphia?

    If your friend or family member has body dysmorphic disorder, try to be an empathetic listener. Help build their self-esteem and confidence by providing support and companionship.

    If your loved one is open to professional help, contact a health care provider or support group. Remember to set boundaries and prioritize self-care to keep your communication healthy and effective.