Body Dysmorphic Disorder
Have you ever found yourself glued to a mirror, nitpicking a particular body part? Maybe you’ve pinched, picked, or rubbed that area out of frustration. Perhaps you’ve stared at a photo of yourself, wondering if your nose really looks like that, or why no one told you that top wasn’t flattering. Or maybe you’ve avoided a social event altogether because nothing in your closet felt right.
Defining Body Dysmorphic Disorder (BDD)
BDD is characterized by a persistent preoccupation with perceived flaws in one’s appearance.
People with BDD often fixate on features that appear minor—or even unnoticeable—to others, but feel deeply flawed to the individual. These obsessions can become so consuming that they interfere with daily life, leading to social avoidance, wardrobe limitations, and emotional distress. Even when loved ones try to reassure them that the flaw isn’t visible or important, the concern remains overwhelming and intrusive.
How Do I Know if I Have BDD?
While experiences vary, common signs of BDD include excessive mirror checking—or, conversely, avoiding mirrors altogether—frequent reassurance-seeking from friends or family, and compulsive behaviors like touching, rubbing, scratching, pinching, or picking at the skin. People with BDD often compare their appearance to others and avoid clothing or situations that might highlight the “flawed” body part.
Like many mental health conditions, there is a spectrum. Most people have moments of body dissatisfaction. However, when this dissatisfaction becomes persistent and interferes with your ability to live a confident, fulfilling life, a diagnosis of BDD may be considered.
What Causes BDD?
Several factors can contribute to the development of Body Dysmorphic Disorder. Here are three primary categories:
Biological Factors
Genetics and brain chemistry can play a role in how vulnerable someone is to developing BDD. Certain brain differences may increase sensitivity to perceived imperfections.
Psychological Factors
Traits like perfectionism or low self-esteem can influence how we perceive our bodies. In addition, psychological stressors such as trauma or bullying can have long-term effects on body image.
Social Factors
The era and environment in which you grew up matter. For instance, individuals raised in the 1990s were often exposed to rigid and unattainable beauty standards portrayed in media and early social media platforms.
How is BDD Diagnosed?
A therapist or psychiatrist typically diagnoses BDD using criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). If a person meets enough of the listed symptoms, a diagnosis can be made.
This process usually involves a detailed clinical interview where the therapist asks targeted questions to gather information about symptoms and their impact on daily life. Sometimes, professionals use screening tools like the Body Dysmorphic Disorder Questionnaire (BDDQ), the Yale-Brown Obsessive Compulsive Scale Modified for BDD (BDD-YBOCS), or the Body Image Disturbance Questionnaire (BIDQ) to supplement their assessment.
How to Treat BDD
The good news is that BDD is treatable. With therapy, medication, and lifestyle shifts, it’s possible to have a positive body image.
Evidence-based approaches like Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Cognitive Therapy (MBCT) help individuals challenge unhelpful thoughts and behaviors related to body image. Relational therapies such as Internal Family Systems (IFS) can further support healing by fostering self-compassion and reducing shame.
In some cases, SSRIs (Selective Serotonin Reuptake Inhibitors) are prescribed to help reduce the obsessive thoughts and distress that often accompany BDD. When these intrusive thoughts are minimized, individuals are often better able to make behavioral changes and engage more fully in therapy.
Lastly, lifestyle changes can make a meaningful difference. This includes reducing social media exposure, practicing mindfulness, cultivating self-compassion, and engaging in movement and nourishment that supports both mental and physical well-being—not just weight loss.
If you or someone you know is struggling with body image, know that help is available and that BDD is treatable. You deserve to feel at home in your body and to live a life free from the distress of constant self-scrutiny.