Body Dysmorphic Disorder (BDD): Definition, Symptoms & Treatment
Most people have something they wish they could change about their appearance. But for some, these concerns turn into an all-consuming source of distress that affects every aspect of life—from self-esteem and relationships to work and overall mental health. What might start as a minor worry can escalate into a relentless cycle of negative thoughts and behaviors that are difficult to break.
In this article, we'll explore the different types of BDD, its symptoms, treatment options, and everything else you need to know about this complex mental health condition.
Short Summary
- Body dysmorphic disorder (BDD) involves a distorted and obsessive focus on perceived flaws in one's appearance.
- Types of BDD include BDD by Proxy (concern about someone else's appearance) and muscle dysmorphia (preoccupation with muscularity).
- While BDD can't be prevented, early diagnosis and treatment can significantly improve quality of life and long-term outcomes.
Definition of Body Dysmorphic Disorder
Body dysmorphic disorder can severely impair a person's quality of life, affecting their relationships, work, and daily functioning. While concerns may focus on any part of the body, common areas include the skin, hair, nose, or body shape. Body dysmorphic disorder often stems from distorted body image and is not simply about vanity. It is a debilitating condition that involves intense shame and anxiety and often co-occurs with depression, social phobia, or eating disorders.
According to the American Psychiatric Association, body dysmorphic disorder is classified in the Obsessive-Compulsive and Related Disorders category in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Effective treatment for body dysmorphic disorder typically involves a combination of cognitive-behavioral therapy (CBT) specifically designed for BDD and medications such as selective serotonin reuptake inhibitors (SSRIs). Early diagnosis and intervention are crucial, as body dysmorphic disorder can lead to severe emotional distress and, in some cases, suicidal thoughts or behaviors.
Recognizing BDD as a legitimate and treatable mental health disorder is an essential step in supporting those who suffer from distorted body image and helping them move toward recovery.
Body Dysmorphia Symptoms
Body dysmorphic disorder symptoms can differ from one person to another. These are the most common BDD symptoms:
- Preoccupation with perceived flaws
- Compulsive actions like mirror checking or avoiding mirrors altogether, excessive grooming or skin picking, or seeking constant reassurance about appearance
- Avoiding social situations, photos, or bright lighting
- Low self-esteem
- Seeking cosmetic surgery or dermatological treatments repeatedly, often without satisfaction
- A strong conviction that others are mocking or judging based on the perceived flaw
- Co-occurring mental health issues such as depression, social anxiety, or even suicidal thoughts
Types of Body Dysmorphic Disorder
Body dysmorphic disorder, or BDD, can be exposed in two different types: muscle dysmorphia and BDD by Proxy. Both types are mental health conditions that have similarities and differences.
Muscle Dysmorphia
Muscle Dysmorphia (MD) is a subtype of Body Dysmorphic Disorder (BDD) characterized by an obsessive preoccupation with not being muscular or lean enough, even when the person is objectively very muscular or fit. It's sometimes referred to as bigorexia or reverse anorexia because, instead of trying to become thinner, the individual is fixated on becoming bigger and more muscular.
These are the key characteristics of muscle dysmorphia:
- Distorted body image
- Compulsive behaviors, such as strict dieting and excessive weightlifting
- Avoiding social activities, jobs, or relationships that interfere with workouts or eating routines
- Feelings of anxiety, shame, or depression related to body appearance or missing workouts
That said, keep in mind that there are certain risks that muscle dysmorphia can bring you. Examples are overtraining injuries, use of anabolic steroids, disordered eating patterns, isolation, and low self-esteem.
BDD By Proxy
Body dysmorphic disorder by Proxy is a rare and less commonly recognized form of body dysmorphic disorder in which the person becomes obsessively preoccupied with perceived flaws or defects in someone else's appearance rather than their own.
Key characteristics of BDD by Proxy are:
- Obsessive concern about another person's physical appearance
- The belief that the other person has a visible defect, even when others see nothing wrong
- Intrusive thoughts and constant checking, comparing, or analyzing the person's looks
- Attempts to "fix" or control the other person's appearance
BDD Risk Factors
Body dysmorphic disorder has several known biological, psychological, and environmental risks. These risk factors can increase a person's likelihood of developing the condition. It's important to say here that they often interact and can vary from person to person.
Biological risk factors include genetics, neurobiological differences, and neurochemical imbalance. Anxiety, depression, perfectionism, and low self-esteem are part of psychological risk factors, while environmental risk factors include bullying, cultural pressure, family dynamics, and trauma.
In most cases, the beginning of body dysmorphic disorder can be traced back to adolescent years. Most people who experience BDD have noticed these symptoms in their teenage years but haven't really paid attention to them. These symptoms are often followed by negative thoughts and spending the day worrying about a certain body part or your entire appearance.
Because BDD symptoms can arise from certain social situations, you might also decide to avoid similar social situations throughout your life. As much as BDD is focused on your appearance, it mainly affects your mental health, and it is therefore advised to seek the help of a mental health professional.
Can You Prevent Body Dysmorphic Disorder?
Body dysmorphic disorder cannot be prevented. However, you can reduce the risk of developing it in your adult or teenage years. By seeking help on time, you can ensure that BDD doesn't become severe. Besides seeking therapy treatment, other ideas can be quite helpful for anyone at risk of developing BDD symptoms, such as:
- Encourage self-worth based on character, talents, and relationships, not appearance
- Teach children and teens that all bodies are different and no one is perfect
- Avoid negative self-talk about your own body around others (especially kids)
- Discuss unrealistic beauty standards in media, advertising, and social platforms
- Follow diverse and body-positive content online
- Unfollow accounts that trigger appearance comparisons or self-judgment
- Teach and model emotional regulation, stress management, and coping skills
- Support healthy communication of feelings and concerns
Body Dysmorphic Disorder Vs. Other Disorders
At first, you might confuse body dysmorphic disorder with other disorders or mental health conditions. Each mental illness will need a unique approach and treatment, so being sure you know whether you have BDD, severe depression, anorexia nervosa, or any other condition is crucial. You will also want to be aware of your family history, as many mental health conditions are hereditary.
Obsessive Compulsive Disorder
Although obsessive-compulsive disorder and BDD can have certain symptoms in common, they are two different diagnoses. OCD is characterized by recurring, intrusive thoughts and repetitive behaviors, while with a BDD diagnosis, a person is only experiencing negative thoughts and feelings around their physical appearance.
OCD will affect all your life areas, but it will not focus solely on your appearance. That is why the medication that a person with OCD might be prescribed to take will not have an impact on someone with BDD.
Anorexia Nervosa
It is easy to understand why eating disorders such as anorexia nervosa can be confused with BDD. Both conditions target appearance, but anorexia is only related to weight. People with anorexia nervosa fear putting on weight even when they have a normal weight or are underweight.
A person experiencing BDD doesn't worry about their weight, although it's not excluded. Instead of fear about gaining weight, they could fear their face is ugly, their body unattractive, their skin pale or too dark, etc. Two people with BDD can be focused on different parts of their appearance.
Social Anxiety Disorder
As much as certain social situations can trigger BDD, having social anxiety is not implied by having body dysmorphic disorder. If you have a BDD, you could also experience signs of social anxiety, but you will not feel the need for social isolation as someone who has a social anxiety disorder.
These two mental disorders might result in similar behavior, but a person with social anxiety will not have body image issues. Their disorder will revolve around being with other people or in situations that make them feel uncomfortable.
Severe Depression
We've mentioned above that depression and anxiety are tied to BDD. However, they should not be mistaken for each other. Severe depression is a mental illness that has been present in your life for more than six months and has resulted in a loss of interest in almost every activity in your life.
People with BDD can go about their everyday lives, go to work, and spend time with their loved ones. People with severe depression will struggle to do anything, and they will not enjoy it.
When to Reach Out to Healthcare Providers?
Body dysmorphic disorder will be easier to treat if it's caught on time. Once you've noticed the symptoms mentioned above and identified that they have been occurring for a while, it's best to seek adequate treatment. You can reach out to a healthcare provider or a trusted mental health professional.
Make sure you prepare a list of symptoms for healthcare providers. These can be repetitive negative thoughts or uncomfortable feelings. Body dysmorphic disorder can show up differently in different people. Even different cultures will show different BDD symptoms when compared. Body dysmorphic disorder is especially present in cultures where popular media is very vocal about appearance, cosmetic surgery, and beauty standards.
That is why it's important to be very clear about when you started noticing your symptoms and describe them to the health professional of your choice. All of this information is necessary to identify the best treatment for your case. Depending on the severity of your symptoms, you might be advised to seek a mental health professional or take medication.
Conclusion
Living with a constant sense of dissatisfaction about your appearance can be overwhelming. When these thoughts begin to take over, it's a sign that something deeper needs attention—not your reflection, but your well-being.
True healing starts by addressing the emotional pain beneath the surface. Seeking professional help, especially therapy designed for BDD, can make a powerful difference. With the right support, it's entirely possible to build a healthier relationship with yourself and move forward with greater confidence and peace.
Frequently Asked Questions
How Is Body Dysmorphic Disorder Diagnosed?
Body dysmorphic disorder (BDD) is a mental illness that has to be diagnosed by healthcare providers. If you suspect you have body dysmorphic disorder, you should seek help from healthcare providers you trust. Only they can diagnose you with BDD and suggest adequate treatment. In severe cases, doctors might advise taking medication apart from mental health therapy. Cosmetic surgery is not a part of treatment and is only a symptom of your BDD. It's up to you to analyze your symptoms and decide which route to take first - a mental health professional or a healthcare provider.
How Is Body Dysmorphic Disorder BDD Treated?
To treat BDD, a person will need to address the underlying causes of their disorder. Body dysmorphic disorder can be linked to feelings such as anxiety, depression, and perfectionism. It might even share symptoms with related disorders like anorexia nervosa. A mental health professional can support you with talk therapy and help you solve underlying mental health issues that actually cause these feelings of not being good-looking. A therapist can help you understand why you're obsessed with a certain body part of yours or why this perceived flaw is such an issue for you.
What Are the Most Common BDD Symptoms?
BDD has a range of symptoms that can differ from one person to another. Depending on the severity of your case, you could be experiencing worrying about your appearance, seeking cosmetic procedures and dermatological treatments with a goal to fix your perceived defect, avoiding meeting people, etc. Whatever symptoms you're experiencing, it's best to seek treatment immediately.