Please note that this is an Archived article and may contain content that is out of date. The use of she/her/hers pronouns in some articles is not intended to be exclusionary. Eating disorders can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights.
By Wesley Gallagher
We all have insecurities about our looks. Our focus may change from our weight to our skin, or we may have one particular feature that always bothers us. No one is perfect, and we can often be our own worst critic.
While it’s normal to experience insecurity and low self-esteem due to body image issues, prolonged, excessive worry about specific bodily flaws may point to body dysmorphic disorder.
What Is Body Dysmorphia?
Body dysmorphic disorder (BDD) is an anxiety disorder characterized by obsessive thinking and preoccupation with a minor or imagined bodily defect, which often leads to compulsive behaviors and disrupts a person’s everyday life. The International OCD Foundation says that body dysmorphic disorder affects between 5 and 7.5 million people in the US.1 According to Psycom, it usually surfaces in adolescence and affects men and women equally.2
So when is it simply insecurity, and when might symptoms signal something more serious?
Causes and Symptoms of Body Dysmorphic Disorder
It’s important to realize that body dysmorphic disorder is an actual clinical diagnosis, not just vanity or insecurity about looks. Thoughts about appearance often rule the lives of those with body dysmorphic disorder, causing them to spend exorbitant amounts of time thinking about, checking or trying to conceal perceived flaws. The disorder is closely linked to OCD, anxiety and eating disorders, but it carries specific symptoms unique to the disorder.
While the exact cause of body dysmorphic disorder is unknown and symptoms vary from person to person, Psycom lists certain factors that likely lead to the disorder, symptoms and common areas of fixation.
Causes and factors leading to body dysmorphic disorder:
– Genetic predisposition or having relatives with similar disorders
– Negative childhood experiences, such as bullying or teasing
– Personality traits like low self-esteem or competitiveness with others
– Societal pressures to be pretty
– Other psychiatric disorders, such as anxiety or depression2
Symptoms of body dysmorphic disorder:
– Fixation on a real or imagined bodily imperfection
– Engaging in behaviors to minimize or hide the perceived flaw
– Engaging in activities such as exercising or getting plastic surgery to try to “fix” the flaw
– Obsession with or avoidance of mirrors
– Repetitive grooming activities or compulsive touching, checking or measuring of the flaw
– Frequent thoughts about appearance
– Avoidance of social situations
– Repeatedly asking others for their opinions of appearance
– Belief that others are taking special notice of the flaw
– Feelings of depression, disgust, low self-esteem and anxiety2
Common areas of fixation related to body dysmorphic disorder:
– Moles or freckles
– Minor scars
– Facial and body hair
– Size and shape of genitalia
– Size of breasts
– Muscle size
– Size, shape or symmetry of face or other body part2
People with certain temperaments and ways of thinking may be predisposed to body dysmorphic disorder and show obsessive or anxious tendencies in other areas of life. 2 This disorder is often mistaken for others due to its similarities in symptoms, but also because those dealing with it often hide their symptoms out of shame and embarrassment over their appearance and obsessions. If left untreated, it can get worse over time and lead to depression, anxiety and suicidal thoughts and actions.3
It’s important to remember that if your loved one has body dysmorphic disorder, their flaws are real to them, even if they don’t seem real to you. No amount of reassurance or reprimanding will help them see things more rationally. It is a mental illness, and it should be treated as such.
How to Treat BDD
Fortunately, body dysmorphic disorder is diagnosable, treatable and can be improved and managed with proper attention and lifestyle changes, along with professional help. If you notice any of the above symptoms in yourself or a loved one, take action to get necessary help.
Read on for the most common treatments for body dysmorphic disorder.
Cognitive Behavioral Therapy (CBT) has been found to be the most effective treatment for body dysmorphic disorder. This is a specific type of therapy that teaches people how to recognize irrational thoughts and replace negative patterns of thinking with positive ones. Two key processes in CBT are exposure, in which patients confront the situations that cause them fear, and response prevention, which teaches them how to resist the urge to perform compulsions.2
Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), are often prescribed alongside therapy to help relieve obsessive and compulsive thoughts and behaviors associated with body dysmorphic disorder. It is believed that serotonin is a factor in the disorder.2
In addition to therapy and medication, there are lifestyle changes you can make to ensure the success of your treatment. Don’t skip medicine doses or therapy sessions, even if you feel fine or don’t feel like talking. Educate yourself on the disorder and how it affects you, and pay attention to warning signs and triggers so you can get ahead of symptoms. Exercise can help alleviate symptoms, especially anxiety and depression, so stay active and take care of yourself. Avoid drugs and alcohol, which can interact with medication and worsen symptoms.2
There Is Help and Hope
Above all, know that if you or someone you love is wrestling with body dysmorphia, there is help, which means there is hope. Reach out to your physician or a mental health professional to find out how to get started on the road to recovery.
1 Phillips, Katharine. “Prevalence of BDD.” International OCD Foundation, Accessed January 15, 2018.
2 Lieber, Arnold. “Body Dysmorphic Disorder: A Guide to an Emotionally Painful Obsession.” Psycom, Accessed January 14, 2018.
3 “Body Dysmorphic Disorder.” Mayo Clinic, April 28, 2016.