Body dysmorphia, officially known as body dysmorphic disorder (BDD), is characterized by constant worry and negative thinking about one’s physical appearance. Body dysmorphic disorder (BDD) is a mental health condition in which a person has an unhealthy and excessive fixation with perceived defects or flaws in physical appearance (particularly the face) that are unnoticeable or appear slight to others.BDD
Body dysmorphic disorder (BDD) is a mental health condition in which a person has an unhealthy and excessive fixation with perceived defects or flaws in physical appearance (particularly the face) that are unnoticeable or appear slight to others.
BDD is included in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the handbook used by clinicians and psychiatrists to diagnose psychiatric illnesses.
Having BDD does not mean you're self-obsessed or vain. The preoccupation with "flaws" can cause significant distress or impairment in all areas of your life.
People with BDD have inaccurate views of themselves. This can cause them to become socially isolated, lead them to harmful behaviors, or spur them to undergo repeated surgeries to correct problems they think they have.
Some of the warning signs that a person may have body dysmorphic disorder include:
Although excessive focus and attention can be on a variety of body parts or characteristics, some of the more common include:
People with BDD will often engage in repetitive behaviors such as constantly looking in a mirror and skin picking in an attempt to address their physical concerns. Even though they can spend hours a day on these behaviors, any relief is short-lived.
BDD is associated with high rates of suicidality. A recent meta-analysis concluded that patients with BDD were four times more likely to experience suicidal ideation (serious thoughts about taking their life) and 2.6 times more likely to engage in suicide attempts compared with individuals without BDD.
To diagnose BDD, your healthcare provider will ask about personal and family medical history and do a physical exam. If the provider suspects body dysmorphic disorder, they may refer you to a psychiatrist or psychologist.
The DSM-5 states that you must present the following symptoms to be diagnosed with BDD:
As body dysmorphic disorder can be easily mistaken for another mental health disorder, it's important for a properly trained clinician to do a thorough diagnostic assessment with you. Some symptoms of BDD overlap with other conditions, such as:
Many individuals with BDD feel ashamed of their appearance and the fact that they are so focused on it. As a result, they may not report their BDD symptoms to clinicians. In one study of psychiatric inpatients, only 15.1% had revealed their body image concerns to their mental health clinicians, and the most common reason for not disclosing their concerns was embarrassment.
The causes of BDD are unclear, but certain biological and environmental factors may contribute to the development of the condition. One theory suggests that there are problems with certain neurotransmitters (chemicals that help nerve cells in the brain send messages to each other) in those with BDD.
Other factors seem to increase the risk of developing or triggering body dysmorphic disorder, including:
BDD is said to impact about 1 in 50 people within the general population and seems to affect men and women equally. An estimated 2.5% of women and 2.2% of men identified as having this disorder. Although BDD can show up for people at any age, many start to exhibit signs and behaviors of the disorder around the age of 12 or 13 years old.
While there is no cure for body dysmorphic disorder, the symptoms of BDD can get better with treatment. Body dysmorphic disorder treatment often includes a combination of:
One approach that has shown to be effective in the treatment of BDD is cognitive behavioral therapy (CBT). CBT can help you manage your BDD symptoms by changing the way you think and behave. It helps you learn what triggers your symptoms and teaches you different ways of thinking about and dealing with your habits.
The use of medications, specifically selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and escitalopram (Lexapro), has been shown to be effective in decreasing some symptoms of BDD. These medications are often used most effectively in combination with cognitive behavioral therapy.
If you or a loved one are struggling with body dysmorphic disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database.
Talk with your doctor or therapist about how to improve your coping skills and ways to focus on monitoring and changing negative thoughts and behaviors about your appearance.
Consider these tips to help cope with body dysmorphic disorder:
It’s normal to focus on your appearance from time to time and feel insecure about your body. But if your preoccupation with your appearance causes you significant distress or interferes with your day-to-day life, those are signs that you’re dealing with a bigger problem than insecurity.
You might have BDD if you:
BDD is suggested to impact about 1 in 50 people within the general population, which would equate to roughly 5 million to 7.5 million people in the United States alone.
Researchers have determined that the brains of people with BDD have abnormalities in processing visual input when it comes to examining their own faces. Furthermore, they found that the same systems of the brain are overactive in BDD and in obsessive-compulsive disorder, suggesting a link between the two
It can be upsetting to see a loved one's obsessive worries and compulsive behaviors impact their daily life. But there are a number of things you can do to support them:
Many people with BDD do not seek help because they are worried that people will judge them or think they are vain. This means that many people with BDD are likely to experience it for a long time before seeking support.
While there is no cure for body dysmorphic disorder, treatment, including therapy, can help you improve your symptoms. The goal of treatment is to decrease the effect that the disorder has on your life so that you can function at home, work, and in social settings.