How Do I Know If I Have Body Dysmorphia, and How Is It Treated?

Body dysmorphic disorder (BDD) is a serious mental health condition. It causes people to become obsessed about a minor or imaginary physical flaw. People with BDD become so fixated with their appearance that it can affect their everyday life. As a result, they may experience social anxiety, isolation, and depression.

Body dysmorphic disorder affects up to 3% of the population. But how do you know if you have it? Here we’ll review the symptoms associated with BDD, how it’s different from an eating disorder, and the different treatment options available.

What are the symptoms of body dysmorphia?

People with BDD are usually focused on a specific feature involving their face or head (like their hair, nose, or skin). But any part of the body can be an area of concern. Some people aren't worried about a specific feature, but feel “ugly” in general. Or, they might think they don’t look right compared to others — like not being muscular enough. BDD can also have slightly different symptoms in different genders.

Most people with BDD worry so much about their appearance that it causes serious emotional distress. It’s common for them to be preoccupied with their looks for several hours every day. At its worst, BDD prevents people from socializing, being successful in school, or keeping a job. 

People with BDD often perform repetitive and compulsive behaviors to try and cope with their appearance concerns. These behaviors may focus on checking, fixing, or hiding the area of concern. It can also include behaviors like compulsive exercise or dieting. 

Common signs and symptoms of BDD

Here are some other common signs and symptoms associated with BDD:

• Frequently thinking about your appearance (at least an hour a day)

• Covering up the body area of concern (like with makeup or clothes)

• Frequently asking others if you look OK (called reassurance seeking)

• Getting surgery or treatments to try and “fix” the area

• Keeping compulsive behavior a secret

• Frequent mirror-checking or complete avoidance of mirrors

• Skin picking to remove perceived flaws

• Leaving the house less often or only at night

What causes body dysmorphia? 

We’re not entirely sure what causes BDD, but it’s probably a combination of your genes and life experiences. Developing BDD may also be associated with different risk factors, including:

• Having been abused as a child

• Being teased or bullied 

• Having a close relative — like a parent or sibling — with BDD or obsessive-compulsive disorder (OCD)

• Being a perfectionist 

• Having a fear of being isolated or alone

Who usually develops body dysmorphia?

Body dysmorphic disorder can affect all ages, but it usually starts during adolescence, around ages 12 or 13. For most people, BDD starts sometime before the age of 18. Body dysmorphic disorder can also affect any gender, race, and socioeconomic class. 

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How is body dysmorphia linked to disordered eating? 

Body dysmorphic disorder is different from an eating disorder, but they can have similar symptoms. For example, BDD and eating disorders are both usually associated with a distorted body image and low self-esteem.

People with certain eating disorders (like anorexia) worry about their weight or size. This can lead to behaviors aimed at losing or controlling weight. People with BDD don’t usually worry about their weight but are focused on a specific area of concern in their appearance. 

Some people can have both an eating disorder and BDD. This can happen when someone with an eating disorder is also preoccupied with a perceived physical issue besides their weight. They may also focus on a perceived flaw in their hair or skin, for example.

How does body dysmorphia impact your mental health?

Having BDD can affect your mood. People may experience sadness, low self-esteem, or feel disgusted with themselves. It’s also common for people with BDD to have other mental health conditions. The most common one is depression, but others include: 

• Substance use disorders

• Social anxiety disorder

• Obsessive compulsive disorder (OCD)

People with BDD may also be more likely to think about suicide or attempt suicide. If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255, or text HOME to 741-741 to reach the Crisis Text Line. 

How do you treat body dysmorphia?

There are effective treatments that can help people with BDD. Treatments can help lower your distress about physical appearance and the compulsive behaviors associated with it.  

Treatment for BDD usually includes cognitive behavioral therapy (CBT), medications, or a combination of both. If you have BDD, your healthcare provider will review your symptoms to see what the best treatment option is for you. 

Cognitive behavioral therapy

CBT is a type of psychotherapy. It helps you identify negative thoughts and beliefs that impact your feelings and actions. You’ll then learn new thinking patterns and skills for coping with your distress. Cognitive behavioral therapy has been shown to help with BDD. It can be tailored to treat your specific BDD symptoms.

Medications

There are no specific medications approved by the FDA to treat body dysmorphic disorder. But a group of medications called selective serotonin reuptake inhibitors (SSRIs) have been shown to help. 

SSRIs work by increasing the level of a chemical messenger in the brain called serotonin. These medications are often used to treat depression and other disorders. Examples of SSRIs include:

• Fluoxetine (Prozac)  

• Escitalopram (Lexapro)

• Citalopram (Celexa)

Another medication that has been shown to work is clomipramine (Anafranil). It also increases serotonin in the brain but works a bit differently than SSRIs.

What’s the prognosis for treating body dysmorphia? 

We’re still learning how people with BDD respond to different treatments. Studies have shown that most people with BDD can completely recover with treatment. Only about 15% of people will relapse over 8 years. For some people, however, BDD may be a more chronic problem. 

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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