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Five Questions Answered About Body Dysmorphia

While standing in front of a mirror, it’s natural to zero in on that one annoying flaw. But if that casual dislike has become more of an obsession, you may be among the millions of Americans living with body dysmorphic disorder (BDD), or body dysmorphia.

People with body dysmorphia typically agonize over one specific body part and have difficulties thinking about anything else. The all-consuming obsession can interfere with work, relationships, and daily functioning. The good news is that BDD is treatable. Here’s what you need to know to get on the path to healing.

What Is BDD?

BDD is a mental health condition characterized by compulsive and intrusive obsessions over an imagined or slight defect in one's appearance. Bodily features that are most often found at fault include hair, skin, nose, chest, and stomach.

“Body dysmorphia means that someone sees their body, or a feature of their body, differently than it is in reality,” says Kristin Francis, MD, an assistant professor and psychiatrist at Huntsman Mental Health Institute at University of Utah Health. “When people who suffer from eating disorders have body dysmorphia, they often misperceive their size and overly focus on perceived flaws such as how their stomach looks.”

Repetitive behaviors associated with BDD include:

  • Obsessively examining your “flaw” in front of the mirror
  • Repetitively grooming yourself to conceal a perceived flaw
  • Incessantly seeking assurance from others
  • Believing that others are mocking your appearance
  • Constantly comparing yourself to others

Do I Have BDD or OCD?

BDD has much in common with obsessive-compulsive Disorder (OCD), which entails a cluster of disorders characterized by intrusive thoughts and compulsive self-soothing behaviors. Both conditions can occur together, yet they are not the same. One difference is that BDD patients are more likely to lack insight, meaning they aren’t able to accept and/or recognize the severity of their disorder.  Without treatment, Francis says this unhealthy fixation can escalate to dangerous levels. 

“People with this condition can become focused on changing their bodies to a degree that it becomes unhealthy,” Francis says. “Some examples include seeking surgery or taking medicines to change their muscle size.” 

What Causes BDD?

BDD, which affects both males and females, typically presents itself around puberty and continues into adolescence. Biological risk factors include a history of anxiety or depression or having a parent or sibling with BDD or OCD.

External forces—particularly mainstream media and social media—also contribute to the manifestation of BDD and intensify symptoms.

“Our society puts a lot of focus on how someone looks on the outside, and the images perpetuated by the media often portray an unrealistic body standard,” Francis says. “When we compare ourselves to these impossible standards, we increasingly feel bad about ourselves and lose sight of what is important and realistic.”

How Do I Treat BDD?

Left untreated, BDD can take a significant toll on your quality of life, robbing you of your time, joyous occasions with friends and loved ones, and even your livelihood. Without medical intervention, obsessive thoughts and compulsive behaviors could intensify and lead to serious complications, such as eating disorders, physical pain and disfigurement, social phobia, and suicidal thoughts.

The most effective line of defense for BDD are SSRIs (antidepressants and antianxiety medications) and certain types of psychotherapy such as cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT). ACT is a common treatment that can help patients with BDD learn how to tolerate anxiety-provoking triggers by incorporating the core concepts of mindfulness, acceptance, and value-based living into their daily lives. These practices give patients the support they need to live more in the present and better manage their emotions.

Where Can I Find Help?

Living with BDD can feel isolating and overwhelming. But you’re not alone. The first step is seeking help as soon as possible. Free online resources are available to access therapist directories, support groups, and educational materials. Despite the extreme suffering you may be experiencing with this disorder, it is possible to learn to cope and even fully recover.