What is body dysmorphic disorder?
01What are the symptoms of body dysmorphic disorder?
02What causes body dysmorphic disorder?
03How can counselling help with body dysmorphic disorder?
04Popular body dysmorphic disorder FAQs
05Getting Support
06Body dysmorphic disorder (BDD), also known as body dysmorphia, is an anxiety disorder related to body image and appearance. A person with body dysmorphic disorder will obsessively worry about flaws in their appearance, even though these flaws may be slight or unnoticeable to other people.
Someone with body dysmorphic disorder may appear overly self-conscious, and can develop compulsive behaviours and routines to cope with their anxiety surrounding their appearance. Examples of these behaviours include camouflaging perceived flaws using clothes and make-up, excessive use of mirrors, skin picking, or undergoing unnecessary cosmetic procedures.
The condition can affect people of any gender and background, and is most common in teenagers and young adults. The 2018 Mental Health of Children and Young People survey revealed that 1 in 20 girls aged seventeen to nineteen years old in England may have body dysmorphic disorder.
The severity of body dysmorphic disorder can also vary for each person, fluctuating from day to day in some cases.
The obsessions and behaviours associated with body dysmorphic disorder can cause high levels of emotional distress, making everyday life difficult. Some people with body dysmorphic disorder may feel reluctant to be seen in public, which in turn can affect their work and personal relationships.
It can be difficult for people living with body dysmorphic disorder to be open about their experiences for fear of being seen as vain or self-obsessed. This can result in someone living with the condition for a long period of time without receiving the support they require and deserve.
A person with body dysmorphic disorder will develop compulsive thoughts and behaviours as a result of their anxieties surrounding their appearance.
Everyone can experience the effects of body dysmorphic disorder differently, but experts have identified common thought patterns and behaviours associated with the condition:
Compulsive thoughts
If you have body dysmorphic disorder, you might spend several hours per day dealing with intrusive, negative thoughts about your appearance. This can result in feelings of significant stress and anxiety.
There may be one or several areas of your body that you believe to be flawed. Common areas of concern can include your skin, nose, chin, lips, hair, or genitals.
Some of the worries you might have about these areas include:
• The body part is too big or too small.
• The body part is disfigured.
• The body part is out of proportion.
• The body part isn’t symmetrical.
Compulsive behaviours
If you are experiencing constant negative thoughts about your appearance, you might also develop compulsive behaviours and routines to cope with the stress and anxiety this causes.
These behaviours and routines can also take up a significant amount of your time and energy each day, often only alleviating your anxieties for a short time or even making them worse.
Some of these compulsive behaviours and routines can include:
• Seeking constant reassurance about your appearance.
• Frequently discussing your own appearance or other people’s appearance with others.
• Frequently weighing yourself.
• Frequently touching and checking your body with your hands and fingers.
• Altering your posture to change your appearance.
• Wearing heavy or oversized clothes to disguise your body shape.
• Applying heavy make-up to conceal areas of your face or body.
• Applying excessive amounts of tanning products, teeth whiteners, etc.
• Obsessively combing or styling your hair.
• Picking your skin to make it look smooth.
• Avoiding having your photograph taken.
• Obsessively checking your appearance in mirrors and reflective surfaces, or avoiding them completely.
• Constantly comparing your appearance to people on social media, in magazines, or on the street.
• Undergoing unnecessary cosmetic, dermatological, or other medical procedures in order to change your appearance.
The effects of these compulsive thoughts and behaviours can also make people living with body dysmorphic disorder more vulnerable to self-harm, suicidal thoughts, or further mental health conditions.
No exact cause for body dysmorphic disorder has been identified, but a number of factors are thought to contribute to the development of the condition. These factors can vary from person to person.
Low self-esteem may lead to body dysmorphic disorder, especially if your physical appearance is very important to you. You might become fixated on the idea of improving your appearance if your opinion of your appearance is very negative to begin with.
Similarly, someone who has been bullied or abused may also develop body dysmorphic disorder if their experience has left them with negative self-esteem. A teenager who has been bullied may be particularly sensitive about their appearance, for example.
Certain professions and hobbies can encourage perfectionism and comparison with others, which in turn increases the likelihood of someone developing body dysmorphic disorder. Personal trainers, models, professional athletes, or similar could all be at greater risk.
Someone who believes that they must look a certain way in order to maintain personal relationships or meet certain social standards could also develop negative thought patterns that lead to body dysmorphic disorder. This can stem from a fear of being alone or feeling isolated.
A person with a family member who experiences symptoms of body dysmorphic disorder is more likely to develop the condition themselves, though there is no clear evidence to suggest genetics contribute to this. Learned behaviour in childhood, such as witnessing an adult’s frequent mirror checking or overhearing discussions about physical appearance, could also play a part in this risk.
Other mental health conditions including anxiety, depression, and obsessive compulsive disorder have also been linked with body dysmorphic disorder. However, it is unclear whether these conditions themselves contribute to the development of body dysmorphic disorder, or if body dysmorphic disorder causes these conditions as a result of symptoms.
Counselling provides a safe and confidential space to discuss body dysmorphic disorder with a professional therapist.
Cognitive behavioural therapy (CBT) is a particularly useful treatment option for body dysmorphic disorder. This form of talking therapy allows you to better understand how your thoughts, behaviours, and emotions influence each other. It can also help you to identify practical skills for managing life challenges and stressful situations.
Your therapist will work with you to address the symptoms of body dysmorphic disorder and their impact on your daily life. This can involve exercises to help you build up positive self-esteem, tackle concerns surrounding specific areas of your appearance, and dismantle compulsive patterns of thought and behaviour.
If you are experiencing an urgent mental health crisis, seeking assistance from an emergency mental health service may be more beneficial than counselling. Visit the Samaritans website for more information on what to do if you or someone you know is experiencing a mental health crisis. In urgent circumstances, contact the emergency services by dialing 999.
What is muscle dysmorphia?
Muscle dysmorphia is a type of body dysmorphic disorder where a person might obsessively worry about being too skinny, weak, or not muscular enough. In reality, they look average or already are noticeably muscular. This can result in compulsive thoughts and behaviours surrounding workouts and the gym, taking nutritional supplements, or using steroids and other enhancement substances.
What is the difference between body dysmorphic disorder and eating disorders?
Body dysmorphic disorder and eating disorders share symptoms, but ultimately aren’t the same. Both share similar concerns around body image, excessively worrying about appearance, and the development of compulsive behaviours. However, eating disorders are generally only related to weight and body shape. Body dysmorphic disorder can relate to one or several areas of physical appearance, such as the face or skin. Some people with body dysmorphic disorder might also have an eating disorder, but not everyone with an eating disorder will have body dysmorphic disorder.
How can I help a friend or relative with body dysmorphic disorder?
One of the most important forms of support you can provide to a loved one with body dysmorphic disorder is acceptance. Being able to approach their situation free from judgement and with a willingness to learn can help them feel understood. Offering your loved one opportunities to talk about their symptoms can also act as a first step to seeking professional help. Identify situations that may trigger their symptoms, and be consistent in your support.