Body Dysmorphic Disorder: More Than Just Poor Body Image
When we talk about body image struggles, it’s important to understand the range of experiences people can have—and to differentiate between typical body dissatisfaction and more serious psychological conditions. One term that sometimes gets tossed around inaccurately is body dysmorphic disorder (BDD). While someone might say, “I’m so obsessed with my nose, I probably have BDD,” true body dysmorphic disorder goes far beyond everyday body image concerns.
What Is Body Dysmorphic Disorder?
Body dysmorphic disorder is a mental health condition categorized under the umbrella of anxiety disorders—more specifically, it’s a type of obsessive-compulsive disorder (OCD). People with BDD experience intense and persistent preoccupation with one or more perceived flaws in their physical appearance. Often, the perceived flaw is minor—or not visible at all to others—but to the person experiencing BDD, it can feel overwhelming, deeply distressing, and all-consuming.
These perceived imperfections become the focus of obsessive thinking, compulsive behaviors, and often significant emotional pain. While concerns may start with one body part (like the nose), they may shift over time to other areas, such as the skin, hair, abdomen, or even hands or feet.
It’s important to note: BDD is not an eating disorder, though it may share certain characteristics, like body dissatisfaction and compulsive checking. Unlike eating disorders, BDD is not centered around weight or shape, and people with BDD don’t necessarily engage in behaviors like restricting, binging, or purging.
What Causes Body Dysmorphic Disorder?
Like many psychological conditions, BDD appears to result from a combination of biological, psychological, and environmental factors. It typically begins in adolescence—a vulnerable time when identity and appearance concerns are heightened.
Research suggests that about 1 in 100 people are affected by BDD, and both males and females are impacted in roughly equal numbers.
Signs of Body Dysmorphic Disorder
While BDD can look different for each individual, there are some common signs to watch for. These may include:
- Frequent mirror-checking—or complete mirror avoidance
- Excessive grooming, skin picking, or use of makeup to cover the perceived flaw
- Avoidance of social situations due to shame or fear of being seen
- Constant comparison to others’ appearance
- Seeking repeated reassurance or undergoing medical consultations (e.g., dermatology or cosmetic surgery)
- Depression, anxiety, and in more severe cases, suicidal thoughts
- An inability to stop thinking about the flaw, even when it disrupts daily life
BDD is not vanity—it’s a debilitating and often invisible form of suffering that can erode self-worth, relationships, and quality of life.
Treatment for Body Dysmorphic Disorder
The gold standard treatment for BDD is Cognitive Behavioral Therapy (CBT), often combined with Exposure and Response Prevention (ERP). In CBT, individuals learn to identify and challenge distorted beliefs like, “Everyone notices my skin,” or “No one will love me because of how my face looks.” Over time, they work to replace these beliefs with more realistic, balanced thoughts.
ERP complements CBT by helping individuals gradually reduce avoidance behaviors (like hiding under layers of makeup or avoiding social events) and compulsive rituals (like mirror checking or excessive grooming). Through this structured, compassionate process, the person begins to regain freedom from the grip of BDD.
Because BDD often involves brain-based disruptions in serotonin regulation, medication—particularly SSRIs like Prozac or Lexapro—is often recommended, even if the person isn’t experiencing classic depression. These medications can help reduce obsessive thoughts and anxiety, making therapy more effective.
Getting Help
If you or someone you love is struggling with severe appearance concerns or symptoms that sound like BDD, please know that help is available—and recovery is possible. You don’t have to live under the weight of obsessive self-criticism and fear of being seen.
Our team at Columbus Park specializes in evidence-based treatment for BDD and related conditions. Reach out to us at info@columbuspark.com to learn more about how we can support you.
