Body dysmorphia: Signs, symptoms, and treatment
Reviewed by Susan Radzilowski, MSW, LMSW, ACSW
Written bytherapist.com team
Last updated: 09/08/2023
Body dysmorphia, also called body dysmorphic disorder (BDD), is a mental health condition where a person is obsessed with their own physical flaws. These flaws may be real but minor, or they may be entirely imagined.
An estimated one in 50 people are affected by body dysmorphia, but the figure could be much higher because people with the condition tend to hide their symptoms.1 BDD has similarities with obsessive-compulsive disorder (OCD), but body dysmorphia is more common, often more severe, and frequently unnoticed in clinical settings.2
How body dysmorphia relates to other conditions
Negative body image
It’s possible to have a negative body image without having body dysmorphia. People with a negative body image may be dissatisfied with their physical appearance, but they don’t necessarily experience the same level of distress or obsessive thoughts that someone with BDD does. Even so, if it goes unaddressed, negative body image may develop into body dysmorphia.
Gender dysphoria is related to body dysmorphia, but they’re different conditions. Having gender dysphoria means feeling uncomfortable or dissatisfied with the gender you were assigned at birth—this may be focused on specific body parts that cause distress, such as an Adam’s apple or other secondary sex characteristics. BDD involves feeling unsatisfied with minor or imagined flaws in your body that may or may not be related to your gender. The two conditions are interconnected, but they don’t cause one another.3 People can experience one or the other condition, or both at the same time.
Eating disorders and BDD both center on being preoccupied with your body, but eating disorders focus on body size, weight, and shape. People with eating disorders are typically concerned with losing or gaining weight through their eating habits. People with body dysmorphia, on the other hand, focus on specific physical features they dislike, which may or may not include weight. That said, people with BDD often have eating disorders as well, because they tend to count weight among their perceived flaws.4
Signs and symptoms
The most common signs and symptoms of body dysmorphia include:
- Being preoccupied with your physical flaws (real or imagined)
- Believing others are staring at or making fun of you
- Constantly looking at yourself in the mirror, avoiding mirrors altogether, or a mix of both
- Thinking obsessively about your body and physical appearance
- Constantly comparing yourself to others
- Avoiding social events or activities
- Using clothing or makeup to hide perceived flaws
- Seeking frequent reassurance
- Grooming yourself constantly
- Picking at your skin
- Spending a lot of money on cosmetic treatments or products
- Exercising too much
- Dieting constantly
- Feeling anxiety, depression, or shame
Muscle dysmorphia (also known as “bigorexia,” “megarexia,” or “reverse anorexia”) is a specific type of body dysmorphia where you think your body is too small and weak, even if you’re fit and muscular. People with muscle dysmorphia spend a ton of time and energy working out, monitoring their weight and appearance, and judging themselves harshly when they don’t meet their own standards.
Body dysmorphia by proxy
This type of BDD is less common and usually involves a loved one, such as a parent or partner, who’s obsessively concerned about the other person’s appearance. The concerned person may assess the other person’s features constantly, comment on their looks, or try to “fix” their appearance.
What causes body dysmorphia?
The exact cause of body dysmorphia is unknown, but several factors may increase your risk of developing it:
Cultural influences: The physical concerns of people with BDD tend to reflect the beauty standards of their respective cultures and ethnicities.7
Low self-esteem: People with low self-esteem often have difficulty seeing their positive qualities and tend to focus more on their perceived flaws, so it makes sense that body dysmorphia is associated with low self-esteem.8
Age, gender, and sexual orientation: Body dysmorphia tends to be higher among young adults aged 15 to 28, particularly girls and women.9 LGBTQIA+ people may also be more likely to experience body dysmorphia.10
Social media: Time spent on social media platforms is linked to having a negative body image, which can lead to body dysmorphia.12 Some experts say that “Snapchat dysmorphia,” where cosmetic surgery patients use social media filters as inspiration for their desired changes, is a growing issue.13
The impact of body dysmorphia
The distress of body dysmorphia can affect you in many ways. BDD increases your risk for:
Anxiety and depression: Studies link anxiety and depression with body dysmorphia, especially in young adults.15
Social isolation: It can be hard to leave the house when you don’t feel okay about your appearance, and it can be hard to socialize and connect if you have overwhelming shame, anxiety, or embarrassment about your looks.
Substance abuse and addiction: Many people use drugs, alcohol, and other kinds of self-medication to cope with distressing conditions. In one study, 68% of participants with a substance abuse disorder reported that body dysmorphia contributed to their substance misuse.16
Eating disorders: Body dysmorphia can distort your view of your body size and increase your risk for eating disorders like anorexia and bulimia.
Suicidal ideation: Body dysmorphia may be so distressing and debilitating that it leads to thoughts of suicide. If you’re in crisis, contact the 988 Lifeline for free, confidential support 24 hours a day, 7 days a week: 988 or 1-800-273-TALK (8255).
Getting a diagnosis
If you think you may have body dysmorphia, seek help from a mental health professional. To be diagnosed, you must have symptoms that suggest you’re:
- Excessively preoccupied with one or more perceived flaws
- Having severe enough thoughts about your perceived flaws that they affect your daily functioning
- Experiencing symptoms that aren’t caused by other underlying mental health conditions
Body dysmorphia can be treated with psychotherapy, medication, or a combination of the two.18 Cognitive behavioral therapy (CBT) can be very effective for BDD because it can help you challenge distorted thoughts about your body and learn new strategies for coping with those thoughts. Other types of counseling, such as interpersonal therapy or group therapy, may also help.
Certain medications, such as antidepressants and anti-anxiety meds, may help reduce your anxiety and improve your mood. However, medication shouldn’t be used as a replacement for therapy.
If you have symptoms of body dysmorphia or are struggling with your body image in other ways, support is available. Browse our directory to connect with a therapist who can help you manage your symptoms and start to build a healthier relationship with your body.
About the author
The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.
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