Body Dysmorphic Disorders

This fixation can lead to intense emotional distress, social isolation and repeated behaviors such as mirror checking, grooming or seeking reassurance. Though BDD isn’t just about vanity, it’s often misunderstood or minimized, making it more difficult for individuals to seek the help they need.

Body dysmorphic disorder is real, painful and treatable. By understanding how it works and how to address it, individuals can begin a path toward healing and self-acceptance.

What Is Body Dysmorphic Disorder?

Body dysmorphic disorder is classified under Obsessive-Compulsive and Related Disorders in the DSM-5. While many people have insecurities about their appearance, BDD goes beyond typical self-consciousness.

Individuals with BDD spend hours each day thinking about perceived flaws. These concerns can involve the skin, nose, hair, teeth, weight or other features. Commonly fixated areas include:

• Face (skin, nose, chin, eyes)
• Hair (thinning, texture)
• Body shape or muscle tone
• Skin imperfections (scars, acne, pores)

Even when reassured by others, people with BDD may continue to believe they look “ugly,” “deformed” or “unacceptable.”

How Common Is BDD?

According to the International OCD Foundation, 1.7% to 2.9% of Americans may experience BDD at some point in their lives. The condition often begins in adolescence or early adulthood, a time when appearance is strongly tied to identity and self-worth.

BDD affects all genders, though men may be more likely to focus on body size or muscle tone, while women may fixate more on skin, facial features or weight.

Signs and Symptoms of Body Dysmorphic Disorder

BDD often leads to obsessive thoughts and compulsive behaviors related to appearance. Signs can include:

• Checking mirrors constantly or avoiding mirrors
• Grooming, checking makeup or picking at skin excessively
• Comparing appearance with others
• Seeking cosmetic procedures or surgeries
• Frequently asking for reassurance about looks
• Wearing hats, masks or clothing to hide perceived flaws
• Avoiding social situations or being photographed

In severe cases, BDD can lead to major functional impairment, including trouble holding a job, maintaining relationships or leaving home.

What Causes BDD?

There’s no single cause of body dysmorphic disorder. Instead, several factors may contribute to its development:

• Genetic vulnerability. People with a family history of anxiety, depression or OCD may be more likely to develop BDD.
• Brain chemistry. Research suggests BDD may involve abnormal levels of serotonin, a brain chemical linked to mood regulation.
• Cultural and social pressures. Exposure to unrealistic beauty standards in media or social environments can increase body dissatisfaction and self-scrutiny.
• Personal trauma or bullying. Individuals who’ve experienced teasing, bullying, abuse or rejection related to appearance may be more vulnerable to BDD.
• Perfectionism. Many people with BDD also struggle with perfectionism and black-and-white thinking about beauty, worth and value.

Related Conditions

BDD is often misdiagnosed or overlooked, especially because its symptoms overlap with other conditions. It frequently coexists with:

• Obsessive-compulsive disorder
• Social anxiety disorder
• Depression
• Eating disorders
• Muscle dysmorphia (a subtype of BDD focused on body size or muscularity, often in men)

It’s also important to distinguish BDD from normal concerns about appearance. What makes BDD different is the intensity, duration and interference with daily life.

Treatment Options for Body Dysmorphic Disorder

Although BDD can be severe and isolating, it’s treatable. A combination of therapy, support and medication can significantly improve symptoms.

Cognitive Behavioral Therapy

CBT, especially a form called CBT for BDD, is one of the most effective treatments. It helps individuals:

• Challenge distorted beliefs about appearance
• Reduce compulsive behaviors
• Increase self-compassion
• Rebuild healthy social functioning

Exposure and response prevention, a technique used in OCD treatment, is also helpful for resisting urges to perform appearance-related rituals.

Medication

Selective serotonin reuptake inhibitors, such as fluoxetine or sertraline, are often prescribed to help regulate obsessive thoughts and improve mood.

Group or Family Therapy

Supportive therapy environments can reduce shame and promote a sense of community. Family involvement is also important, especially when loved ones are unintentionally reinforcing reassurance-seeking or avoidance.

Living With BDD

Body dysmorphic disorder often comes with deep shame, embarrassment and a fear of judgment. Because symptoms are so tied to self-image, many people hide their struggles for years. Others may turn to repeated cosmetic procedures only to find their distress remains or worsens.

Living with BDD can be exhausting, but it’s not a reflection of vanity, weakness or selfishness. It’s a mental health condition — and like all mental health challenges, it deserves empathy and treatment.

Frequently Asked Questions