Body Dysmorphic Disorder

What causes body dysmorphic disorder?

Experts think that the cause of body dysmorphic disorder is a combination of environmental, psychological, and biological factors. Bullying or teasing may create or help lead to the feelings of inadequacy, shame, and fear of ridicule.

Who is at risk for body dysmorphic disorder?

Nobody knows the cause of BDD. It often starts in the teen years. Experts think that about 1 out of every 100 people has BDD. Men and women are equally affected. Factors that may contribute to BDD include:

• A family history of BDD or a similar mental disorder
• Abnormal levels of brain chemicals
• Personality type
• Life experiences

What are the symptoms for body dysmorphic disorder?

You can become obsessed with any part of your body. The most common areas are your face, hair, skin, chest, and stomach.

Symptoms of BDD include:

• Constantly checking yourself in the mirror
• Staying away from mirrors
• Trying to hide your body part under a hat, scarf, or makeup
• Constantly exercising or grooming
• Always comparing yourself with others
• Always asking other people if you look OK
• Not believing other people when they say you look fine
• Staying away from social activities
• Not going out of the house, especially in the daytime
• Seeing many healthcare providers about your looks
• Having unneeded plastic surgeries
• Picking at your skin with fingers or tweezers
• Feeling anxious, depressed, and ashamed
• Thinking of suicide

How is body dysmorphic disorder diagnosed?

A mental health provider will diagnose BDD based on your symptoms and how much they affect your life.

To be diagnosed with BDD:

• You must be abnormally concerned about a small or nonexistent body flaw.
• Your thoughts about your body flaw must be severe enough that they interfere with your ability to live normally.
• Other mental health disorders must be ruled out as a cause of your symptoms.

Other mental health disorders are common in people with BDD. They include obsessive compulsive disorder, social anxiety, depression, and eating disorders.

How is body dysmorphic disorder treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for BDD may include talk therapy or medicines. The best treatment is likely a combination of both. Research shows that the sooner treatment begins, the better the chance for controlling symptoms and recovering. Cognitive behavioral therapy (CBT) is the most effective talk therapy. In CBT, you work with a mental health provider to replace negative thoughts and thought patterns with positive thoughts. Antidepressant medicines called SSRIs (selective serotonin reuptake inhibitors) often work best for BDD.

You can look for a provider or learn about BDD treatment at the National Institute of Mental Health .

If you are thinking of harming yourself or others, call or text the 988 Suicide & Crisis Lifeline at 988 or 800-273-TALK (8255). You will be connected to trained mental health crisis services. An online chat option is also available. This service is free and available 24/7.

What can I do to prevent body dysmorphic disorder?

The best way to prevent BDD from becoming a serious problem is to catch it early. BDD tends to get worse with age. Plastic surgery to correct a body flaw rarely helps. If your child or teen seems overly worried about their looks and needs constant reassurance, talk with their healthcare provider. If you have symptoms of BDD yourself, talk with your healthcare provider or a mental health provider. 

Living with body dysmorphic disorder

It’s important to follow your healthcare provider’s advice for treating your BDD. Treatment for BDD can be a long-term commitment.

When should I call my healthcare provider?

Tell your healthcare provider if:

• You have thoughts of harming yourself or others
• You have new symptoms
• Your symptoms get worse

Key points about body dysmorphic disorder

• Body dysmorphic disorder (BDD) is a mental health disorder. If you have BDD, you may be so worried about the way your body looks that it interferes with your ability to function normally.
• You may take extreme measures, such as repeated cosmetic surgery procedures, to fix the perceived flaw.
• Treatment includes counseling and medicines to help with feelings of discomfort and anxiety.
• The sooner treatment begins, the better the chance for recovery.
• The fear of being judged can lead to staying away from social gatherings, and isolation.
• Left untreated, BDD can lead to severe depression and even suicidal thoughts. It should not be ignored.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.