Body dysmorphic disorder, also called body dysmorphia, is a mental health condition that affects how you view and feel about your body and appearance. It involves intense preoccupation with one or multiple perceived "flaws" with the way you look that are minor or unnoticeable to others.
As a result of these thoughts, people with body dysmorphic disorder may repeatedly check the mirror, use makeup to cover up perceived "flaws," or seek constant validation from others. They may also feel so ashamed, embarrassed, or anxious about their appearance that they avoid social situations. Some with the condition have surgery to "fix" the flaw, but often aren't satisfied with the results.
There is no cure for body dysmorphic disorder, but there are effective treatments to address the symptoms.
Body dysmorphic disorder affects the way you think and feel about your appearance. Symptoms may include:
Extreme preoccupation with a perceived "flaw" that appears minor or that others don't notice at all
Excessive time (3 to 8 hours or more) spent thinking about a perceived flaw; these thoughts are difficult to control
Compulsion to look in the mirror or another reflective surface like a window to check your appearance
Shame or disgust about your appearance or perceived flaw
An all-consuming belief that your perceived flaw makes you "ugly" or "deformed"
Attempts to hide a perceived flaw with makeup, styling, or clothes.
Constantly comparing your appearance to how others look
Frequent attempts to get validation about your appearance from others.
Surgical procedures undergone to "fix" a perceived flaw, often with little satisfaction with the results
Avoidance of social situations due to anxiety, shame, or embarrassment
Thoughts of self-harm or suicide
This perpetual obsession with your appearance, excessive thoughts, and repetitive behaviors are often unwanted and difficult to control. They may take up so much of your time and energy that it takes a significant toll on your daily life, leading to problems with your social life, work, school, or other areas of functioning.
You may overly focus on one area of your body or multiple areas, and these areas can change over time. The most common body parts that people with body dysmorphic disorder focus on are:
Face, including your nose, acne, wrinkles, complexion, or blemishes
Hair and its appearance, including thinning or baldness
Chest or breast size
Muscle size and tone
Hips, thighs, or buttocks
Genitalia, including penis size or overall appearance of one's genitals
The exact cause of body dysmorphic disorder is not well understood. It's likely due to a combination of factors, including:
Genetics: You are 3 to 8 times more likely to develop body dysmorphic disorder if you have a first-degree relative (such as a parent or sibling) with the condition.
Brain structure and function: Certain areas of the brain work differently in people who have body dysmorphic disorder. These areas of the brain may be overactive, causing thoughts and actions to be difficult to control.
Certain brain chemicals: Problems with the brain chemical serotonin are thought to be a potential cause of body dysmorphic disorder.
Cultural influences: Life in a society with high pressures and expectations of beauty can increase your risk of developing the disorder.
History of childhood abuse or neglect: A history of adverse childhood experiences increases your risk of developing body dysmorphic disorder.
Bullying: Being bullied or teased as a child may increase your likelihood of developing the condition.
Certain personality traits: Certain qualities like perfectionism can increase your risk for the condition.
Other mental health conditions:Anxiety or depression can raise your risk for body dysmorphic disorder.
There are no medical tests that can diagnose body dysmorphic disorder, but there are other ways a mental health professional can determine if you have the condition. This includes talking to a healthcare provider about your symptoms. They may use a screening tool, a specialized set of questions designed to help your provider understand your symptoms.
Then, your provider will compare your symptoms with the criteria in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), the manual used to diagnose mental health conditions like body dysmorphic disorder.
Some people with body dysmorphic disorder live with the condition for many years before seeking formal diagnosis. That may be because they don't realize their symptoms are signs of a mental health condition or because they are embarrassed or afraid to ask for help.
If you notice signs and symptoms of body dysmorphic disorder in yourself, try to see your healthcare provider or a mental health professional as soon as possible. Early diagnosis and treatment may reduce its severity.
There's no cure for body dysmorphic disorder, but effective treatments are available to help manage its symptoms.
Treatment for body dysmorphic disorder commonly involves psychotherapy (talk therapy) and medications. Occasionally, severe symptoms may warrant hospitalization.
Talk Therapy
Talk therapy involves meeting with a licensed therapist to talk about your symptoms and and find ways to manage those symptoms. Two common types of talk therapy used to treat body dysmorphic disorder are cognitive behavioral therapy (CBT) and family therapy.
CBT is a type of therapy that can help you understand how negative thoughts, feelings, and behaviors feed into your symptoms, challenge those thoughts, and learn other ways to manage your symptoms that do not include mirror checking, reassurance seeking, or excessive use of cosmetic procedures.
Family Therapy is a type of therapy that involves multiple family members meeting with a therapist to improve relationships within the family unit and behaviors among family members.
Medication
Although no medications are approved by the U.S. Food and Drug Administration (FDA) for body dysmorphic disorder, medications such as antidepressants can help manage symptoms. A class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) may be particularly effective for body dysmorphic disorder because the condition is thought to be related to issues with the brain chemical serotonin.
Hospitalization
If your symptoms are severe enough that they're making it difficult for you to function, or if you're having thoughts of self-harm or suicide, you may need to be temporarily hospitalized for your safety.
Because the root cause isn't fully known, there's currently no way to prevent or reduce risk of body dysmorphic disorder. But with treatment, it's possible to manage the symptoms.
Along with standard treatment, the following lifestyle strategies can help you manage the symptoms of body dysmorphic disorder.
Take your medications as prescribed. Most people with body dysmorphic disorder experience fewer symptoms and feel better when they take their medication. Don't stop your medication without first talking to your doctor, as stopping suddenly could increase thoughts of suicide.
See your therapist regularly. Talk therapy is an important treatment for body dysmorphic disorder, and attending these appointments with your therapist can help you learn the skills necessary to alleviate your symptoms. Therapy also increases the effectiveness of medication.
Avoid cosmetic surgery. Many people with body dysmorphic disorder think that cosmetic surgery will make them feel better, but most of the time, it doesn't. It may make you feel worse about your area of concern, and cause a perpetual cycle of cosmetic procedures.
As mentioned, body dysmorphic disorder has no cure. Once you develop the condition, you will have it for life. But evidence-based treatments like therapy can lessen the frequency and severity of symptoms, resulting in fewer disruptions to your daily life.
If you have body dysmorphic disorder, the all-consuming negative thoughts and feelings about your appearance can become intense and cause distress. This distress can make it difficult to study, work, spend time with others, or complete your daily responsibilities.
Body dysmorphic disorder tends to get worse over time if it's not treated. Thoughts of self-harm and suicide are common in those with the disorder, and these thoughts tend to intensify if the condition is untreated. Up to 80 percent of people living with untreated body dysmorphic disorder have suicidal thoughts, and nearly 25 percent of people with the condition attempt suicide. People with body dysmorphic disorder are also 45 times more likely to die by suicide than those without it.
That's why it's important to see your doctor as soon as possible if you're having symptoms of body dysmorphic disorder. Early diagnosis and treatment may stop these symptoms from getting worse.
Signs and symptoms of suicidal thoughts or behaviors may include:
Mentioning death or wanting to die
Feeling guilt, shame, or like a burden to others
Emotional or physical pain that feels like it's too much to bear
Feelings of emptiness or hopelessness
Intense sadness, anxiety, rage, agitation, or mood swings
Increased drug or alcohol use
Changes in eating or sleeping patterns
Increased risky behaviors, such as driving too fast
Social withdrawal or saying goodbye to loved ones with no other logical reason for doing so
Researching ways to die or creating a plan
Other complications of body dysmorphic disorder may include:
Substance abuse disorders, such as steroid use disorder in people whose condition affects their view of their muscles
Body dysmorphic disorder typically begins to develop in the teen or early adult years. An estimated 2 to 3 percent of adults and 2 to 5 percent of adolescents in the United States have the condition. It happens more often in women than men.
Body dysmorphic disorder is a mental health condition involving obsessive thoughts and worries around appearance or perceived "flaws," which often seem minor or unnoticeable to others.
The symptoms of body dysmorphic disorder can significantly disrupt one's ability to function at work, school, their social life, and other areas.
People with body dysmorphic disorder are at an increased risk for self-harm and suicidal thoughts, which is why early diagnosis and treatment are important.
Although body dysmorphic disorder has no cure, treatments like talk therapy and medication can help manage the symptoms.
