What Is Body Dysmorphia?

Body dysmorphic disorder (BDD), also called 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.

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

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

Symptoms

People with body dysmorphia worry excessively about minor or nonexistent flaws in their body and/or face. To "fix" those flaws, they may go to extreme lengths, such as drastically altering their looks with plastic surgery. 

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

Common symptoms of body dysmorphia include:

• Extreme preoccupation with physical flaws that are either very minor or imagined
• Spending an excessive amount of time covering perceived flaws with makeup, different outfits, or new hairstyles
• Buying products or getting plastic surgery to alter one's appearance
• Checking the mirror excessively or avoiding mirrors 
• Trying to hide certain body parts with clothing or accessories
• Repetitive behaviors, such as picking at their skin
• Needing constant reassurance from others about physical appearance
• Worrying excessively about appearing "ugly" or unattractive
• Constantly comparing one's looks to others

Someone with body dysmorphia may feel so consumed with thoughts about their looks that they neglect other areas of their life. They may even avoid school, social events, dating, or work out of fear of being judged for their looks. 

When left untreated, BDD can lead to serious negative consequences. Over half of people with BDD are unmarried, and over 20% of people with body dysmorphia are unemployed. Around 20% of people with BDD are so distressed by their appearance that they attempt suicide.

Diagnosis

If you think you may have BDD, talk to your healthcare provider. They can refer you to a mental health specialist who can make a diagnosis using the criteria in the DSM-5. If your worries about your looks are focused more on your body weight or size, you may be diagnosed with an eating disorder instead.

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

During the diagnostic process, your mental health specialist may specify whether you have good, fair, or poor insight into 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 body are not true. People with “fair” or “poor” insight aren’t aware that their worries are excessive or not based in reality.

Causes

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

• Genetics: In some cases, BDD may be inherited. According to twin studies, genetic factors account for about 44% of the variance in body dysmorphic disorder symptoms. 
• Trauma: People with a history of trauma have a higher chance of developing body dysmorphia. Many people with BDD report having been bullied by peers at school, and up to 79% of people with body dysmorphia experienced childhood abuse.
• 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 condition at the same time. It’s 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 (AN).
  

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, gain insight into their beliefs, and resist the urge to perform 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 have to take SSRIs on a long-term basis to reduce their symptoms.
  

Coping

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

• Joining an online or in-person peer support group for people with BDD
• Spending time with loved ones 
• Practicing mindfulness techniques, such as meditation
• Managing stress with relaxation techniques, such as deep breathing exercises
• Writing your thoughts in a journal
• Using positive affirmation statements to build your confidence
• Participating in a new hobby or learning a new skill

Summary

Body dysmorphic disorder (BDD), is a mental health disorder that involves an extreme preoccupation with minor or imagined flaws in one’s physical appearance. People with BDD feel overwhelmed by negative thoughts about their body or face. They may spend excessive amounts of time and/or money in attempts to conceal their imperfections or “fix” the way they look. 

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

A Word From Verywell

If you worry excessively about your looks, you’re not alone. Body dymorphia is common, especially among young adults. Many people have low self-esteem and body image concerns. Talk to your healthcare provider about your options for treatment, support, and empowerment.