What is body dysmorphic disorder BDD?

Body dysmorphic disorder (BDD) is a mental health problem. If you have BDD, you may be so upset about the appearance of your body that it gets in the way of your ability to live normally. Many of us have what we think are flaws in our appearance. But if you have BDD, your reaction to this “flaw” may become overwhelming

Who is affected by body dysmorphic disorder?

Body dysmorphic disorder (BDD), or body dysmorphia, is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. These flaws are often unnoticeable to others. People of any age can have BDD, but it’s most common in teenagers and young adults. It affects both men and women.


People with BDD are most commonly worried about parts of their face or head, such as their nose or the presence of acne. They can fixate on other body parts too, however.

  • obsessing over body flaws, real or perceived, which becomes a preoccupation
  • difficulty focusing on things other than these flaws
  • low self esteem
  • avoiding social situations
  • problems concentrating at work or school
  • repetitive behavior to hide flaws that can range from excessive grooming to seeking plastic surgery
  • obsessive mirror checking or avoiding mirrors altogether
  • compulsive behavior such skin picking (excoriation) and frequent clothes changing


Researchers aren’t sure what causes BDD. It may be related to any of the following:

Environmental factors

Growing up in a household with parents or caregivers who are heavily focused on appearance or diet may increase your risk for this condition. “The child adjusts their perception of self to please the parents,” says Mayer.
BDD has also been associated with a history of abuse and bullying.


Some studies suggest that BDD is more likely to run in families. One studyTrusted Source found that 8 percent of people with BDD also have a family member diagnosed with it.

Brain structure

There’s some evidence Trusted Source that brain abnormalities may contribute to BDD in some people.

How is body dysmorphic disorder diagnosed?

BDD is included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a type of obsessive compulsive disorder (OCD) and related disorders.
BDD is often misdiagnosed as social anxiety or one of a number of other mental disorders. People with BDD often experience other anxiety disorders as well.

To be diagnosed with BDD, you must present the following symptoms, according to the DSM:

  • A preoccupation with a “flaw” in your physical appearance for at least one hour per day.
  • Repetitive behaviors, such as skin picking, repeatedly changing your clothes, or looking in the mirror.
  • Significant distress or a disruption in your ability to function because of your obsession with the “flaw.”
  • If weight is your perceived “flaw,” an eating disorder must be ruled out first. Some people are diagnosed with both BDD and an eating disorder, however.

Treatment options

You’ll likely need a combination of treatments, and you and your doctor may need to adjust your treatment plan a few times before finding a plan that works best for you. Your treatment needs may also change over time.

  • Therapy : One treatment that may help is intensive psychotherapy with a focus on cognitive behavioral therapy. Your treatment plan may also include family sessions in addition to private sessions. The focus of the therapy is on identity building, perception, self-esteem, and self-worth.
  • Medication : The first-line of medicinal treatment for BDD is serotonin reuptake inhibitor (SRI) antidepressants such as fluoxetine (Prozac) and escitalopram (Lexapro). SRIs can help reduce obsessive thoughts and behaviors.
    Studies show approximately two-thirds to three-quarters of people who take an SRI will experience a 30 percent or greater reduction in BDD symptoms.
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