What is body dysmorphic disorder (BDD)?

Body dysmorphic disorder is a mental health condition. A person with body dysmorphic disorder becomes very anxious about a physical defect. Often, they’re imagining the defect, or it’s so minor that others can’t see it. These feelings consume the person’s thoughts, affecting their social activities and job.

How does body dysmorphic disorder (BDD) affect people?

People with body dysmorphic disorder may:

  • See themselves as “ugly.”
  • Think about their perceived flaws for hours each day.
  • Miss work or school because they don’t want others to see them.
  • Avoid spending time with family and friends.
  • Have plastic surgery (possibly multiple surgeries) to try to improve their appearance.
  • Experience severe emotional distress and harmful behaviors.

Who gets body dysmorphic disorder (BDD)?

Body dysmorphic disorder affects people of any gender. It tends to begin during the teen years or early adulthood. That’s the age when children start comparing themselves to others. Body dysmorphic disorder is a chronic (long-term) condition.

Without treatment, body dysmorphic disorder can get worse as people get older. They become even more unhappy with physical changes that come with aging, such as wrinkles and gray hair.

Is body dysmorphic disorder (BDD) the same as an eating disorder?

People with body dysmorphic disorder may have other disorders. Some have eating disorders, anxiety disorders, depression and obsessive-compulsive disorder (OCD).

Body dysmorphic disorder has some similarities to eating disorders. People with body dysmorphic disorder and those with an eating disorder worry about their body image. The difference is that a person with an eating disorder focuses on their weight and body shape. A person with body dysmorphic disorder is anxious about a specific body part.

Body dysmorphic disorder is related to obsessive-compulsive disorder (OCD), an anxiety disorder. A person with OCD has upsetting thoughts they can’t control (obsessions). These thoughts result in a need to do certain activities or routines (compulsions).

A person with body dysmorphic disorder can be so preoccupied with the defect that they start doing ritualistic activities. They might look in the mirror all the time or pick at their skin. The obsession can affect their social, work and home life.

What areas of the body are people with body dysmorphic disorder (BDD) worried about?

The most common areas of concern for people with this condition include:

  • Skin imperfections, including wrinkles, scars, acne and blemishes.
  • Hair, including head or body hair or baldness.
  • Facial features, most often the nose.
  • Stomach or chest.

Other areas of concern include:

  • Penis size.
  • Muscles.
  • Breasts.
  • Thighs.
  • Buttocks.
  • Body odors.

How common is body dysmorphic disorder (BDD)?

Body dysmorphic disorder affects about 1 in 50 people. In the United States, an estimated 5 million to 10 million people have this condition. It may be even more common than these numbers represent. People with body dysmorphic disorder may be reluctant to discuss their symptoms and may not receive a diagnosis.

What causes body dysmorphic disorder (BDD)?

The exact cause of body dysmorphic disorder is not known. One theory suggests that there are problems with certain neurotransmitters (chemicals that help nerve cells in the brain send messages to each other). Body dysmorphic disorder often occurs in people with other mental health disorders, such as major depression and anxiety, which helps support this theory.

Other factors that might influence the development of or trigger body dysmorphic disorder include:

  • Experience of traumatic events or emotional conflict during childhood.
  • Low self-esteem.
  • Parents and others who were critical of the person's appearance.
  • Pressure from peers and a society that equates physical appearance with beauty and value.

What are the symptoms of body dysmorphic disorder?

People with body dysmorphic disorder have inaccurate views of themselves. This can cause them to avoid others, or lead them to harmful behaviors or to repeated surgeries to correct problems they think they have.

Some of the warning signs that a person may have body dysmorphic disorder include the following:

  • Preoccupation with one or more defects or flaws in physical appearance that cannot be seen by others, or that appear slight to others.
  • Engaging in repetitive and time-consuming behaviors, such as looking in a mirror, picking at the skin, and trying to hide or cover up the defect.
  • Constantly asking for reassurance that the defect is not visible or too obvious.
  • Having problems at work or school or in relationships because the person cannot stop focusing on the defect.
  • Feeling self-conscious and not wanting to go out in public, or feeling anxious when around other people.
  • Repeatedly consulting with medical specialists, such as plastic surgeons or dermatologists, to find ways to improve his or her appearance.

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