Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is a mental health condition involving severe distress and dissatisfaction regarding one’s appearance. People with BDD identify as having one or more physical “flaws” or “defects”, which they likely perceive as exceptionally ugly, when others typically don’t see it that way. Everyday functioning and quality of life can be severely impacted.

Adverse long-term outcomes can include anxiety or depression, feelings of hopelessness, social isolation, or even needless cosmetic surgery or dermatological procedures.

Prevalence of BDD

Up to 2% of the general population is estimated to live with BDD, with relatively equal numbers of men and women affected. Like many other mental health conditions, BDD onset tends to occur in late adolescence, a time of significant physical and emotional change. Early onset BDD may be associated with more severe symptoms.

People with BDD tend to also have other mental health conditions, such as social phobia, substance use disorders or eating disorders. 

Possible causes

BDD is a complex disorder, and likely results from multiple interactions between genetics, psychological and environment factors. For instance, some studies suggest that BDD and a related condition, Obsessive-Compulsive Disorder (OCD), tend to cluster together in families. In other cases, adverse childhood experiences involving teasing or bullying can cultivate personal beliefs linking personal attractiveness with self-worth, possibly triggering BDD in the face of an adverse life stressor (e.g. relationship breakup).

Research has also shown that individuals with BDD tend to have difficulties with certain aspects of visual attention and emotion processing. 

Symptoms of BDD

Frequent concerns tend to relate to perceived flaws in facial features (e.g. shape or size of nose) and/or other body parts (e.g. thighs or body symmetry). Affected persons also experience frequent distressing thoughts alongside repetitive, time-consuming behaviours, such as scrutinising the affected feature(s) in the mirror, comparing with others, avoiding people or activities, or covering up with makeup and carefully selected clothing.

Treatment options

Evidence shows that medications, such as selective serotonin reuptake inhibitors (SSRIS), alongside cognitivebehavioural therapy (CBT) or acceptance and commitment therapy (ACT) can be immensely helpful in managing BDD. Novel therapeutic options, such as visual retraining, are also being trialled.