Perhaps you've never heard of it, but body dysmorphia is more common than you might think. According to the International OCD Foundation, up to 10 million people have body dysmorphic disorder (BDD) here in the United States. In reality, this number may be much higher, but many individuals choose not to disclose their symptoms of body dysmorphic disorder to a physician or other healthcare provider.
What Is Body Dysmorphia?
Body dysmorphia disorder (BDD) is a mental health condition involving obsessive thoughts about perceived imperfections in an individual's physical appearance. These self-identified flaws may torment the person with body dysmorphic disorder, but they usually appear minor to others, if not completely unnoticeable. In this article, we'll discuss Body dysmorphic disorder in detail, including its history and its short and long-term effects. We'll also cover the three types of body dysmorphia, who's at risk, signs and symptoms, complications, and available treatment options.
If you're concerned you may have BDD, it's important to understand that your symptoms are not your fault and that this life-altering disorder can be treated. However, proper diagnosis is essential, as individuals with body dysmorphic disorder may exhibit symptoms of other mental health conditions, such as obsessive-compulsive disorder (OCD), depression, or experience eating disorders.
History of Body Dysmorphia
While BDD was not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) until 1987, body dysmorphia was first recognized as a mental health disorder back in 1891 when Italian psychiatrist Enrico Morselli defined the condition as dysmorphophobia. The term "dysmorphia" comes from a Greek word meaning ugliness. Other terms that have been historically used to describe body dysmorphia include "beauty hypochondria" and "dermatologic hypochondriasis."
Effects of Body Dysmorphia
The short- and long-term effects of body dysmorphia can have a significant influence on an individual's overall health and wellbeing. Many people with BDD symptoms avoid social situations, including family gatherings, invitations from friends, dating, and even work or school. As such, the disorder can make it difficult to function in society.
Because people with BDD often fear gaining weight, some also develop eating disorders, such as anorexia nervosa or bulimia. Eating disorders can be incredibly dangerous causing severe harm to an individual's physical health. In addition, a skewed self-image may prompt an individual to engage in a dangerous exercise regimen and/or undergo unnecessary cosmetic surgical procedures.
Types of Body Dysmorphia
Body dysmorphia can present in many ways, and there are three main diagnoses: body dysmorphic disorder, reverse body dysmorphia, and muscle dysmorphia. Body dysmorphic disorder is the most common diagnosis, although muscle dysmorphia is becoming more common in men. However, it's worth noting that body dysmorphia in general is almost just as likely to affect men as women.
Body Dysmorphic Disorder
If you have persistent obsessive thoughts about your appearance, your healthcare provider is likely to diagnose you with BDD. While these intrusive thoughts may zero in on any part of the body, the most common areas of concern are the hair, skin, eyes, nose, mouth, and stomach.
As mentioned previously, some people with BDD have co-occurring eating disorders, largely due to perceived fatness or fear of becoming fat. The specific causes of BDD are largely unknown, though experts agree that many individuals who exhibit BDD symptoms have a history of childhood trauma, including abuse and/or bullying. A traumatizing event in adulthood may also lead to BDD behaviors.
Reverse Body Dysmorphia
In many ways, reverse body dysmorphia is the polar opposite of BDD. Individuals with this condition may believe they are thin while living in a larger body. Therefore, they may routinely buy clothing that's several sizes too small without trying it on.
A small group of people with reverse body dysmorphia experience gender identity concerns. In other words, they may not identify with the gender they present to the world.
People with reverse body dysmorphia tend to avoid reflective surfaces, believing that store windows and mirrors are distorted. Some people with reverse body dysmorphia may also look into a mirror and see the person they perceive themselves to be rather than their true reflection.
Muscle dysmorphia, also known as reverse anorexia is a condition in which a person has a skewed perception of their muscles and is most commonly seen in men. An individual with muscle dysmorphia or reverse anorexia may see their physical stature or body size as weak when, in fact, they have visibly large, developed muscles.
People with muscle dysmorphia tend to workout excessively and follow a rigid diet in an effort to gain the physical appearance they desire, even if they already have a physically fit physique. Affecting men more often than women, muscle dysmorphia causes obsessive thoughts that makes the person with BDD feel as though their physical appearance is never good enough.
Research shows muscle dysmorphia is becoming more common, largely due to society's increasingly unrealistic standards. Men and women may compare themselves to fine-tuned images in the media, which may contribute to obsessive thoughts and worsen muscle dysmorphia or they may take anabolic steroids to increase muscle mass.
Risk Factors for Developing Body Dysmorphia
It's hard to know exactly what causes BDD, but the risk factors are clear. According to the Mayo Clinic, abnormalities in brain structure may contribute to body dysmorphia. Genes may also play a role, as people with a blood relative with BDD or OCD are believed to be at greater risk.
In addition, past and present experiences may shape an individual’s body image. Environmental factors come into play, including childhood neglect or abuse and bullying due to physical imperfections and/or poor self-esteem. Finally, people with perfectionistic tendencies may have an increased risk for developing BDD symptoms, or other coexisting mental health conditions could trigger the onset of the condition.
Signs and Symptoms of Body Dysmorphia
If someone has BDD, certain signs and symptoms are almost always present, while others are less common. However, the person in question may not recognize the telltale signs and symptoms. They're more likely to believe that the object of their obsession is truly a problem. In most cases, someone else has to notice the signs and symptoms of BDD before the person with BDD will acknowledge the problem and seek help. Alternatively, an individual might seek treatment for depression or another mental or physical health concern and will later be diagnosed with BDD. Knowing the signs and symptoms can empower a person to seek help. If you or someone you know experiences any of the following symptoms, speak to a mental health professional:
Individuals with body dysmorphia may experience the following complications:
Please note: If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7.
Getting You Started on the Road to Recovery
There are many resources available for individuals with body dysmorphia and their loved ones:
The Broken Mirror, by Dr. Katharine A. Phillips, is an excellent resource for individuals who feel alone in their BDD struggles. The author demystifies the disorder and shares the personal stories of several people with BDD. It's a must-read for anyone affected by the condition.
The Body Image Workbook, by Dr. Thomas F. Cash, is an 8-step program that helps individuals heal from BDD. Readers are taught to tap into their strengths and vulnerabilities while learning to accept their bodies.
Shattered Image, by Brian Cuban, is an enlightening account of how BDD affected this highly successful lawyer, television host, and activist for 30+ years. This is an excellent resource for men and women alike.
SSRI antidepressants have been found to be helpful in treating body dysmorphia by negating obsessive thoughts. SSRI antidepressants commonly used to treat OCD are also used to treat body dysmorphia as both conditions have similar characteristics.
The most common SSRI drugs prescribed for body dysmorphia include:
As with any medication, all of these SSRI drugs come with benefits and risks, including side effects. It's important to discuss the pros and cons with your doctor before starting a new medication. In addition, you should know that not all of these prescription drugs are suitable for children and adolescents, and it can take several weeks to see results after starting an SSRI.
Treatment Options for Body Dysmorphia
There are currently two types of treatment commonly prescribed to individuals with body dysmorphia. Research show that cognitive behavioral therapy (CBT) is an effective treatment option, and SSRI antidepressants can be effective in a 12-week regimen.
Cognitive Behavioral Therapy
CBT is the only type of psychotherapy that has proven effective for individuals with BDD. This type of therapy allows the individual to recognize their thoughts and actions, examine them, and replace them with healthier thoughts and behaviors.
To be effective, this approach requires self-reflection and honesty. A therapist leads the patient through the process and encourages them to practice the methods they've learned at home.
A study showed that online therapy to treat body dysmorphic disorder is effective. Thirty-two participants used asynchronous electronic messaging to consult with their therapist over a 12-week period. Results showed that participants improved significantly immediately after treatment and that this was maintained at a 3-month follow-up. Participants also saw a reduction in depression symptoms. Participants were also satisfied with their online therapy experience.
How BetterHelp Can Help
When it comes to healing from body dysmorphia, connecting with an experienced therapist can make a significant difference. A BetterHelp licensed online therapist skilled in dealing with BDD can get you started on your healing journey. Online therapy is a convenient, confidential, and affordable way to receive treatment for your BDD. Read below for some reviews of BetterHelp counselors from people experiencing similar issues.
"Bella has saved my life in so many ways. She listens without judgment. She helps me walk through my struggles and has helped me learn new healthier ways of coping. I'm so glad I was paired with her."
"Working with Carrie has been incredibly helpful, since we began text based sessions a few weeks ago. Carrie is helping me remember my own strength and build new confidence, and I see its effects in every part of my life. She is helping me build a solid foundation for my life, starting with remembering/allowing myself to eat regularly. I need baby steps, and while I felt a bit silly and ashamed to ask for help when I first started with BetterHelp, I am so grateful for the small steps she's helping me work through, and the confidence I'm building as a result of each small step. Thank you, Carrie. To anyone who needs help with a complex set of issues that feel unconquerable, I highly recommend working with Dr. DuPont. She's helped me change my life, and with active engagement, she can help you change yours."
How do you fix body dysmorphia?
The most common treatment for body dysmorphic disorder is therapy. Some people find that medication, such as antidepressants helps their condition in addition to therapy. There are organizations such as the Body Dysmorphic Disorder foundation that aim to help those who suffer from BDD.
Please consult with your doctor or primary care physician before considering any medication options.
How common is body dysmorphia?
Body dysmorphic disorder is classified as a common health disorder or condition. Body dysmorphic disorder or BDD affects 200,000 people in the United States alone every year. It is unclear what causes a person to develop BDD for sure, but some factors can contribute to your risk of developing BDD. Individuals with body dysmorphic disorder sometimes have a genetic predisposition, environmental factors, personality traits, other health disorders, or a history of trauma or bullying that could have impacted the development of their disorder.
Is body dysmorphia an eating disorder?
Body dysmorphia is not an eating disorder, but some people with body dysmorphic disorder do have eating disorders as well. It is important to note that poor body image is not the same as body dysmorphic disorder and that, despite the name of the condition, a person with BDD can be fixated on a perceived flaw on the head or body. Some people with BDD have comorbid or co-occurring disorders such as OCD, bipolar disorder, anxiety disorders like panic disorder or social anxiety disorder, PTSD, sleep disorders, schizoaffective disorder, and eating disorders such as reverse anorexia. Eating disorders affect about 30 million people in the United States alone, and because they sometimes go misdiagnosed or undiagnosed, the true prevalence of eating disorders is unknown. Eating disorders can affect people of all ages and genders, and according to recent statistics, eating disorders in children or adolescents appear to be on the rise.
Do I have body dysmorphia, or am I just insecure?
If the symptoms of BDD are taking over your life and present experiences or you have an eating disorder, you may have BDD and should see a mental health provider for confirmation and treatment. Symptoms of BDD span far beyond insecurity, but a person with BDD will experience insecurities related to a perceived flaw.
What is it called when you think you're fat but you’re not?
Often, this perception is a distorted body image. When you have BDD, you don't see your body accurately, and you might perceive yourself as a different size than you are. It's common to label yourself a certain way when you have BDD. Your perception of how you look could change daily.
What does body dysphoria feel like?
BDD feels like being trapped by your thoughts. You're fixated on your perceived flaw or flaws and body image, and no matter what you do, your mind will not let you focus on other things. The flaw is always in the back of your mind, but usually, it's more than that. Body dysmorphic disorder is more than disliking a physical feature or having a self-perception of your body image that fluctuates. It's normal to feel better about yourself on some days more than others, but body dysmorphia is an obsession. Living with symptoms of body dysmorphic disorder or BDD feels exceptionally distressing. When you have BDD, you are entirely preoccupied with the flaw on your face or body that you perceive, and often, it comes to rule a person's life. Many people with BDD feel severe anxiety and may isolate themselves from others as a result of the flaw or flaws that they perceive. Some people even become housebound as a result of the condition. Although there's no cure for BDD, there is treatment available that can help a person live a healthy life.
How is BDD diagnosed?
BDD is typically diagnosed by a psychiatrist or by another type of doctor, such as a general practitioner. When you go in for a potential diagnosis of BDD, the doctor will check your medical history, ask about the symptoms you experience and when they started, and go down a list of BDD symptoms to see if you meet the criteria. Signs of body dysmorphic disorder can cross over with symptoms of other conditions, so getting an accurate diagnosis is essential. Some people might have more than one mental health condition, such as a combination of BDD and OCD.
How do you test for body dysmorphia?
To get tested for body dysmorphia, seek professional help from a licensed metal health provider. According to the diagnostic criteria, symptoms of BDD include:
People with BDD who seek surgery often find that their obsession with their flaw remains. People with BDD might be fixated on any physical feature. The most standard features that people with BDD fixate on are facial features, such as the nose or skin, head or body hair, genitalia, chest shape or size, or muscle tone and size, which is also called muscle dysphoria.
What does BDD mean sexually?
BDD can impact your sexual life, especially if your BDD relates to a body part that's exposed during sex. You might struggle to engage in intimate activities with your partner.
What is the difference between body dysmorphia and dysphoria?
Body dysmorphia is a mental health condition, whereas dysphoria is often used to refer to gender dysphoria.
Why does my body look weird?
All bodies are different, so in the grand scheme of things, it's genuinely impossible for your body to "look weird." There are people of all different heights, sizes, shapes, abilities, and more in this world. If your body looks weird to you, there might be a variety of reasons as to why. You could have distorted body image, or you may have undergone bullying that caused you to obtain this belief about yourself. Maybe you grew up around family members with poor body image that was passed down to you, or possibly, you have BDD or related disorders that could cause you to see your body in a way that doesn't match reality.
Often, we're our own worst critics. Think about how if you say the same word over and over again, it starts to sound weird. Because we typically see ourselves daily, the same can start to happen with our bodies. If you are partially or fully blind, you may also struggle with ideas about how other people see you. Remember that you are more than your body. Even if you feel "weird," there are so many other things that you have to offer to this world.
Do I have atypical anorexia?
If you think that you might have atypical anorexia and meet the criteria for it, you very well might have it. Atypical anorexia is diagnosed under the umbrella of OSFED or Other Specified Feeding or Eating disorder, as outlined in the Diagnostic and Statistical Manual of Mental Disorders. Atypical anorexia and other eating disorders are severe conditions, and it is essential to seek eating disorder treatment if you are struggling.
Can you have body dysmorphia without an eating disorder?
Yes! BDD doesn't discriminate. Anyone can develop BDD regardless of if they have an eating disorder or not, and not everyone with an eating disorder has BDD. Also, note that many people with body dysmorphia aren't fixated on body size at all. They are otherwise preoccupied with something like a facial feature, head or body hair, or another perceived flaw. Similarly, people with eating disorders aren't always fixated on body size. Like with any mental health disorders, BDD and related disorders manifest differently for everyone, so if you believe that you may have a mental health condition, be sure to see a mental health provider.
What is distorted body image?
Distorted body image is when you don't see your body as it is or as other people see it and is considered one of many mental disorders and a psychological illusion. Jennifer Lawrence, a famous celebrity has recently admitted she also has issues with her body image and believes she may have reverse body dysmorphia.
Can body-shaming lead to depression?
Body shaming and other forms of bullying can be a trigger for depression. It can also contribute to the development of eating disorders, including anorexia, bulimia, and binge eating disorder.
How does BDD affect relationships?
BDD and other health concerns, such as post-traumatic stress disorder, obsessive-compulsive disorder (OCD), generalized anxiety disorder, eating disorders, and more, can all affect relationships. With BDD, it may impact you so that you isolate yourself. You don't see your partner as often as you'd like. You wear makeup to bed or do other things to hide features from your partner. You modify your body position in ways that are uncomfortable or strange during intimate activities to protect your perceived flaw or flaws, and so on. It can be devastating for a person to watch their loved one experience BDD and related disorders.
How do you not feel fat when you’re not?
First, remember that fat is not a feeling. When you say that you "feel fat," what does that mean to you? Furthermore, how might perceiving that as a bad thing affect people who are indeed in larger bodies? Radical acceptance is often helpful for those with distorted body image because it allows you to stop letting negative body image rule your life. It can also be useful to look at people of all shapes and sizes, whether that's on social media or in person. Prolonged exposure to body diversity is shown to help people improve their body image and self-perception.
How do you love your body?
Again, exposure to body diversity is beneficial. Follow diverse social media accounts and start to look at what you like about yourself that isn't related to your body. Limit your exposure to heavily photoshopped images if possible and make an effort to learn about body diversity as a natural occurrence. Move toward self-acceptance first and remember that loving your body is a process that often takes time. Have self-compassion throughout this process, and don't be afraid to seek therapy if you need to, especially if you have a mental health disorder or multiple mental health disorders that are contributing to this issue.
What causes self-consciousness?
Many things can cause a person to become self-conscious. Bullying from peers, family members, or other people around you can cause self-consciousness. Unrealistic beauty standards can also contribute to self-consciousness. Eating disorders, BDD, anxiety disorders, and other related conditions can also make you feel self-conscious.
With the information and resources introduced in this article, you've hopefully gained a greater understanding of body dysmorphia. If you have BDD, it's possible to enjoy a healthier, happier life free from obsessive thoughts. Take the first step today.