Many people have insecurities about their bodies. Nobody’s perfect; everyone has flaws— but minor physical details don’t normally limit people from living their lives fully.
Some people, however, perceive such flaws in their appearance as unacceptable, disgusting, or emotionally overwhelming. When an individual obsesses over specific physical characteristics and finds their negative body image debilitating, there’s a chance this could indicate body dysmorphic disorder (BDD).
What is Body Dysmorphic Disorder?
The BDD Foundation describes body dysmorphic disorder as “a preoccupation with one or more perceived flaws or defects in appearance.” It’s when someone experiences a debilitating hyper-focus on any area of their body that looks defective to them but is often unnoticeable to others.
Today, the disorder affects 5 to 10 million people— about 1 in 50 people— in the United States. 60% of those diagnosed with BDD are women. Other terms used in tandem include dysmorphophobia or body dysmorphia.
Top behaviors of BDD:
Repetitive behaviors
Mental acts of comparing
Disgust or hatred toward part of the body
Incessant grooming
Mirror checking
This is a complicated mental health disorder that requires professional attention, family support, and various forms of treatment. Read more to learn what types of support are available for people with BDD.
Symptoms of Body Dysmorphia Disorder
Those with BDD experience obsession with body areas most commonly related to their face, skin, hair, stomach, or any part of the body they believe is physically noticeable. Here are some of the most common symptoms:
Constant mirror-checking
Hiding parts of the body under baggy clothes, hats, scarves, or makeup
Incessant grooming
Negatively comparing oneself to others
Social isolation
Needing to look a certain way before going out
Panic or anxiety over one’s appearance
Addiction to plastic surgery
Picking, peeling, or agitating the skin
Unwilling to believe compliments or positive attention from loved ones
A constant need for validation from others, then refusing to believe validation
A person with BDD experiences many difficult emotions. It’s a sensitive disorder to live with and often requires professional mental health intervention to effectively address these underlying feelings.
Feelings Associated with BDD
This disorder overwhelms one’s self-esteem, social life, and intimate relationships. Body dysmorphic disorder and relationships can be challenging to navigate, as the internal world of a patient with BDD is riddled with obsession or delusion. Here are some feelings a person with BDD may often feel:
Shame
Disgust
Stress/anxiety
Overwhelm
Obsession
Fear
Anger
Panic
To hear from someone with experience overcoming BDD, listen to the episode: Body Dysmorphic Disorder (BDD): A Conversation We Must Have on the Fempower Health Podcast.
Body Dysmorphic Disorder vs Eating Disorders
Is BDD the same thing as anorexia or bulimia? While eating disorders include hyper-focus and obsessive control of body fat, body dysmorphic disorder often relates to aspects of physical appearance unrelated to weight.
Is BDD a Type of OCD?
Some research relates BDD more closely to obsessive-compulsive disorder (OCD). In the DSM-IV, body dysmorphic disorder was characterized as a somatoform disorder, then updated in the DSM-5 as obsessive-compulsive and related disorders.
The two can sometimes be comorbid (existing together). Statistics reveal higher rates of suicidal ideation in these cases. Individuals with body dysmorphia tend to struggle with anxiety, guilt, self-worth, and other mental health symptoms that prevent them from enjoying daily life.
Treatment for Body Dysmorphic Disorder
The proper treatment for BDD combines psychotherapy, exposure therapy, support groups, and sometimes medication.
Therapy
Cognitive-behavioral therapy (CBT) and other forms of talk therapy help BDD sufferers find support and relief from obsessive thoughts and negative emotions. Exposure therapy is also helpful.
Holistic Approach
People with BDD may notice great relief when they’re able to grasp a healthier perspective and understanding of themselves. Coming to believe they are worthy in mind, body, and spirit sometimes provides meaning and clarity when working through BDD.
Family Support
One important step toward recovering from BDD is to receive loving support from friends and family. Talk therapy and exposure-based treatment are ideal, but compassion and encouragement from loved ones can be life-changing.
Medications
In extreme cases, SSRIs or other medications are prescribed to relieve symptoms like suicidal ideation, depression, and anxiety. This helps regulate a patient’s emotions so they can begin other forms of treatment effectively.
From Delusion to Treatment
When diagnosed with BDD, patients might feel stuck believing what they see in the mirror. Treatment is a gradual process and should include the transition from false beliefs to realistic self-perception.
Mirror Hygiene
Here’s the concept of mirror hygiene from Rachel Koutnik: “You’re not getting ready in the morning so you can make yourself feel a certain way before going about your day. You’re getting ready just to get ready and practice proper hygiene.”
Physical Alterations: BDD Treatment or Avoidance?
Note: Many BDD sufferers become fixated on plastic surgery. This is when someone with BDD seeks physical solutions to perceived problems. But altering the body externally rarely addresses the root issue. “Treating” any BDD patient with physical alteration can sometimes lengthen the disorder and interrupt proper care.
There’s so much more to who you are than just your appearance. And there’s so much more to life than just your appearance. It IS possible to ultimately change what you think and how you feel about yourself. - Rachel Koutnik
What Causes BDD?
There is no single identified cause of body dysmorphic disorder. Many people with BDD have pre-existing mental health issues like anxiety or depression. Therapists and specialists who help treat patients with BDD often notice an improvement in talk therapy.
Is BDD a Type of Trauma Response?
From extreme childhood abuse to mild adolescent bullying, many painful or traumatic experiences can deeply impact someone’s beliefs about themselves. When undergoing therapy for BDD, some studies show that patients who address adverse childhood experiences find recovery.
Is Social Media Influencing Higher Rates of BDD?
More research is needed to determine how social media is impacting body image among young people today. One survey in Saudi Arabia found of 1,010 participants, more than 30% of young social media users scored high for one or more BDD criteria.
What to Do if You’re Concerned About a Loved One
If you’re concerned about someone you love, here are some ways to approach the body dysmorphic disorder issue gently.
Empathy
Hold empathy for your loved one. Remember they don’t want to view their body negatively or repeat seemingly uncontrollable mirror checks. They’re battling a mental disorder and need treatment, not guilt or criticism.
Education
Educate yourself and others about BDD. The more you learn about the disorder, the better you can understand and support your loved one.
Lovingly Express Your Concern
Don’t blame or shame your loved one about their behaviors. Lovingly tell them that you care about them and want them to be able to enjoy life again. Encourage them to join a support group, see a therapist, or talk more openly about what they’re feeling.
Struggling with Body Dysmorphic Disorder?
If you or someone you care about is experiencing BDD, here are some resources:
General Resources
Check out all of Fempower Health’s resources on Mental Health.
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