What Is Body Dysmorphic Disorder?
Key takeaways:
Body dysmorphic disorder is a common and underdiagnosed mental health condition in which someone obsesses over a perceived problem in their appearance.
People with this condition struggle in their daily lives, workplaces, or social relationships as a result of their symptoms.
Treatments include medications called selective serotonin reuptake inhibitors (SSRIs) as well as cognitive behavioral therapy.
In today's body-conscious society, it is common for people to criticize how they look. And a negative self-image can contribute to mental health symptoms — like anxiety or disordered eating.
But some people obsess over a perceived defect in their appearance. This is called body dysmorphic disorder (BDD), and it can cause significant distress in someone's life.
BDD is more common than many people realize, and many who have it are likely undiagnosed. If you are curious about whether you or a loved one may have this condition, here’s a look at the symptoms of BDD, the people most commonly affected, and the available treatments.
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What are the symptoms of body dysmorphic disorder?
People with BDD often have the following symptoms:
A great deal of concern over a perceived physical flaw: People with BDD obsess over some aspect of their appearance that they believe is abnormal or ugly. But this perceived flaw is either very minor or not apparent to others. This is most often a facial feature — like someone’s nose or their eyes. But it can be any part of their body.
Negative effects on daily function: BDD can have a big impact on someone’s day-to-day activities. They may have problems with work or school, social life, or personal relationships. For example, people with BDD often avoid social interactions. Or they may spend a lot of time trying to cover up the perceived defect with clothing or makeup.
Compulsive behaviors: People with BDD often have repetitive actions associated with their condition. Examples include frequently checking the mirror (or avoiding their reflection), picking at their hair or skin, intensive and excessive grooming behaviors, or constantly seeking reassurance about their appearance from others.
Unnecessary cosmetic procedures or treatments: Those with this condition may seek cosmetic procedures to help correct the perceived defect. But they are usually not happy with the results.
Who is affected by body dysmorphic disorder?
BDD affects approximately 2% of people. And people are more likely to develop BDD as teenagers. The average age of onset is usually around late adolescence (approximately age 16). But the diagnosis is often made much later in adult life. That’s because many providers are not familiar with it. People with BDD also often don’t report their symptoms or seek help.
BDD may be more common in women than men. However, some studies show that both genders are equally affected. Men may focus on different aspects of the body than women. For example, muscle dysmorphia (MD) is a type of BDD that affects mostly men, though women may also be affected. People with MD worry that their body is not muscular enough.
Studies show that people with trauma in their childhood are more likely to develop BDD. They may have had sexual, emotional, or physical abuse during early childhood or adolescence. Past bullying or teasing by peers — especially about some aspect of appearance — is also linked to the development of BDD.
Finally, many people diagnosed with BDD also suffer from depression or anxiety disorders. These two conditions may increase your risk of developing BDD.
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How is body dysmorphic disorder treated?
BDD is usually treated with one or both of the following:
Medications: The primary medications that can help treat BDD are called selective serotonin reuptake inhibitors (SSRIs). These medications are also often used to treat other mental health conditions. So they may be able to help those who are suffering from BDD and depression or anxiety.
Cognitive behavioral therapy (CBT): This is a form of therapy that involves working with a mental health care provider to identify harmful ways of thinking or acting. When someone becomes aware of a negative pattern of thoughts or behaviors, they can then try to change them. CBT can also treat a variety of mental health conditions.
People with BDD are at a higher risk of suicide than the general population. A healthcare provider will usually assess someone’s risk. It’s important to seek help if you or a loved one is having thoughts of suicide.
Treatment for BDD often takes time and requires ongoing effort. But over time, these therapies can help people alleviate the burden and distress from their symptoms.
The bottom line
BDD is a mental health condition that affects millions of people in the U.S. And many more are undiagnosed. The main feature of this condition is obsession with a perceived or very slight physical abnormality. This leads to dysfunction in someone’s daily life.
Luckily, treatments can help those suffering from this condition, including medication and cognitive behavioral therapy. If you have symptoms of this condition, a healthcare provider familiar with BDD can make a diagnosis. They can get you started on a treatment plan that is best for you.
If you or a loved one is experiencing thoughts of suicide, help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255. Someone is available to talk and provide confidential emotional support 24 hours a day and 7 days a week.
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References
American Psychological Association. (2017). What is cognitive behavioral therapy?
Bjornsson, A. S., et al. (2013). Age at onset and clinical correlates in body dysmorphic disorder. Comprehensive Psychiatry.
Buhlmann, U., et al. (2012). Traumatic experiences in individuals with body dysmorphic disorder. The Journal of Nervous and Mental Disease.
Cerea, S., et al. (2018). Muscle dysmorphia and its associated psychological features in three groups of recreational athletes. Scientific Reports.
Krebs, G., et al. (2017). Recent advances in understanding and managing body dysmorphic disorder. Evidence-Based Mental Health.
Schneider, S. C., et al. (2017). Prevalence and correlates of body dysmorphic disorder in a community sample of adolescents. The Australian and New Zealand Journal of Psychiatry.
Snorrason, I., et al. (2020). Body dysmorphic disorder is associated with risk for suicidality and inpatient hospitalization: A replication study. Psychiatry Research.
Veale, D., et al. (2016). Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image.
Weingarden, H., et al. (2016). Anxiety and shame as risk factors for depression, suicidality, and functional impairment in body dysmorphic disorder and obsessive compulsive disorder. The Journal of Nervous and Mental Disease.
Weingarden, H., et al. (2017). Patient-identified events implicated in the development of body dysmorphic disorder. Body Image.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
