We all sometimes worry about how we look, but body dysmorphic disorder (BDD) is a serious illness in which a person is overly worried about minor or imaginary physical flaws. These perceived flaws are usually not apparent to anyone else or are seen as minor. A person with BDD may feel so anxious about these physical flaws that she avoids social situations and relationships. She may also try to fix perceived flaws with cosmetic surgery.
What is BDD?
Body dysmorphic disorder (BDD) is a serious illness in which a person is overly worried about their appearance or about minor or imaginary physical flaws. Most of us worry about our appearance sometimes or are unhappy with some part of the way we look, but these worries don’t usually affect our daily lives, such as whether we go to work or school. People with BDD check their appearance in a mirror constantly, try to cover up their perceived flaw, or worry about it for at least an hour a day, and that worry interferes with their life in some way.1,2
Women with BDD may worry about any part of their body, such as acne or another skin problem, a scar, the size and shape of their nose, their breast size, or their body shape.2
Being preoccupied with minor or imaginary physical flaws, which usually can’t be seen by others
Having a strong belief that you have a defect in your appearance that makes you ugly or deformed
Having a lot of anxiety and stress about the perceived flaw and spending a lot of time focusing on it
Frequently picking at skin
Excessively checking your appearance in a mirror and grooming yourself
Hiding the perceived imperfection
Constantly comparing appearance with others to the point that it becomes your biggest focus or worry
Constantly seeking reassurance from others about how you look and not believing them when they compliment your appearance
Getting cosmetic surgery but not being happy with the outcome many times
Who gets BDD?
One in every 50 people may have BDD.1 The condition is more common in women and usually starts in the teen years. People with BDD often have other mental health conditions, especially eating disorders, depression, and anxiety.
What causes BDD?
Researchers aren’t sure exactly what causes BDD, but certain factors probably play a role:3
Brain differences. Physical changes in the brain’s shape or how it works may play a role in causing BDD.
Family history. Some studies show that BDD is more common in people whose mother, father, or siblings also have BDD or obsessive-compulsive disorder.
Childhood experiences. Situations or events that happened in your childhood may make you more likely to develop BDD. For example, people who are teased about their bodies, whose families focused on the child’s worth only through physical appearance, or who were abused during childhood may be more likely to develop BDD.
Who is at risk for BDD?
Certain things seem to increase the risk of developing or triggering body dysmorphic disorder, including:3
A mother, father, or sibling with BDD or obsessive-compulsive disorder
Negative life experiences, such as being teased, bullied, or abused
Another mental health condition, such as depression or an anxiety disorder
How is BDD treated?
Your doctor may treat BDD with therapy and medicines.
Cognitive behavioral therapy. This type of therapy may involve putting yourself in social situations while forcing yourself not to check or cover up your “flaws.” Your therapist may also ask you to change your behaviors or environment at home by removing mirrors, taking less time with your beauty routine, or not using makeup.
Medicines. Certain antidepressants can help with obsessive and compulsive thoughts and behaviors.
Getting cosmetic surgery can make BDD worse. People with BDD are often not happy with the outcome of the surgery and continue to obsess over imaginary defects. Learn more about using caution with cosmetic surgery.
Did we answer your question about BDD?
For more information about BDD, call the OWH Helpline at 1-800-994-9662 or check out the following resources from these organizations:
The Office on Women's Health is grateful for the medical review 2016 by:
The National Institute of Mental Health (NIMH)
The Substance Abuse and Mental Health Services Administration (SAMHSA)
Danielle Johnson, M.D., FAPA, Psychiatrist, Medical Staff President, Chief of Adult Psychiatry, Director, Women’s Mental Health Program, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati
Cassidy Gutner, Ph.D., Assistant Professor, Department of Psychiatry, Boston University School of Medicine; National Center for PTSD, Women’s Health Sciences Division, VA Boston Healthcare System, U.S. Department of Veterans Affairs
Mark A. Lumley, Ph.D., Professor and Director of Clinical Psychology Training, Department of Psychology, Wayne State University, and his Stress and Health Laboratory team: Jennifer Carty, Heather Doherty, Hannah Holmes, Nancy Lockhart, and Sheri Pegram
Mark Chavez, Ph.D., Chief, Eating Disorders Research Program, NIMH
Kamryn T. Eddy, Ph.D., and Jennifer J. Thomas, Ph.D., Associate Professors of Psychology, Department of Psychiatry, Harvard Medical School; Co-Directors of the Eating Disorders Clinical and Research Program, Massachusetts General Hospital
Kendra Becker, M.S., Clinical Fellow in Psychology, Department of Psychiatry, Massachusetts General Hospital
Michael Kozak, Ph.D., Division of Adult Translational Research and Treatment Development, NIMH
Alicia Kaplan, M.D., Assistant Professor of Psychiatry, Temple University School of Medicine and Drexel University College of Medicine, and Staff Psychiatrist, Division of Adult Services, Department of Psychiatry, Allegheny Health Network, Allegheny General Hospital
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