Body Dysmorphia: What It Is and How to Cope With It

Body dysmorphia, also known as body dysmorphic disorder (BDD), is a mental health condition that affects how you see yourself and your appearance.

People with body dysmorphia have a distorted perception of their body image and obsess over one or more perceived flaws that are either minor or nonexistent. These flaws can affect any part of the body, such as the skin, hair, nose, eyes, lips, breasts, or muscles.

Body dysmorphia can cause significant distress and impairment in daily functioning. People with body dysmorphia may spend hours a day

• checking their appearance
• seeking reassurance from others
• comparing themselves to others
• trying to hide or fix their perceived flaws

They may also avoid social situations, have low self-esteem, experience depression or anxiety, or develop eating disorders or substance abuse problems.

Signs and Symptoms

Some of the common signs and symptoms of body dysmorphia include:

• Being extremely preoccupied with a perceived flaw in appearance that to others can’t be seen or appears minor
• Strong belief that you have a defect in your appearance that makes you ugly or deformed
• Belief that others take special notice of your appearance in a negative way or mock you
• Seeking reassurance about appearance from others or constantly asking for compliments
• Body checking behaviors, such as frequently looking in the mirror, touching or measuring the affected area, or taking selfies
• Avoiding mirrors or covering them up
• Skin picking, hair pulling, or other compulsive behaviors to improve the appearance of the affected area
• Spending an excessive amount of time on hygiene or grooming routines, such as applying makeup, styling hair, or shaving
• Buying products or getting cosmetic procedures to alter one’s appearance, often with dissatisfaction or regret
• Avoiding social events, work, school, or other activities where one’s appearance might be exposed or judged
• Wearing excessive clothing or accessories to hide the perceived flaw
• Comparing one’s appearance to others, especially celebrities or models
• Having low self-esteem, poor body image, or feelings of shame, guilt, or disgust about one’s appearance
• Experiencing depression, anxiety, suicidal thoughts, or other mental health issues related to one’s appearance

Causes and Risk Factors

The exact cause of body dysmorphia is not known. However, researchers believe that it is a complex condition that involves biological, psychological, and environmental factors. Some of the possible causes and risk factors of body dysmorphia are:

• Abnormalities in brain structure or function that affect how one perceives and processes visual information
• Genetic factors that make one more prone to developing body dysmorphia or other related disorders, such as obsessive-compulsive disorder (OCD) or eating disorders
• Environmental factors that influence one’s self-image and expectations of beauty, such as media exposure, cultural norms, peer pressure, bullying, trauma, abuse, or criticism
• Having mental disorders that affect one’s mood, self-esteem, or cognition, such as depression, anxiety, perfectionism, or low self-worth
• Having a family history of body dysmorphia or other related disorders
• Having a personal history of being teased, mocked, or rejected because of one’s appearance

Diagnosis and Treatment

Body dysmorphia can be hard to diagnose because people with this condition may be ashamed or embarrassed to talk about their concerns. They may also fear being judged or misunderstood by others. Therefore, it is important to seek professional help if you suspect that you or someone you know has body dysmorphia.

The diagnosis of body dysmorphia is based on a psychological evaluation and the criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To be diagnosed with body dysmorphia, one must have:

• A preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others
• At some point during the course of the disorder, have performed repetitive behaviors (e.g., mirror checking) or mental acts (e.g., comparing) in response to the appearance concerns
• The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
• The appearance preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder

The treatment of body dysmorphia usually involves a combination of medication and psychotherapy.

The most common types of medication used for body dysmorphia are antidepressants called selective serotonin reuptake inhibitors (SSRIs), which can help reduce obsessive thoughts and compulsive behaviors related to one’s appearance.

The most effective type of psychotherapy for body dysmorphia is cognitive-behavioral therapy (CBT), which can help challenge and change negative thoughts and beliefs about one’s appearance, and teach coping skills and strategies to deal with appearance-related distress and anxiety.

Other types of therapy that may be helpful for body dysmorphia are acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), or family or group therapy.

What You Can Do About Body Dysmorphia

If you have body dysmorphia, you may feel hopeless or helpless about your situation. However, there are some things you can do to cope with your condition and improve your quality of life. Here are some tips:

Seek professional help

The first and most important step is to get a proper diagnosis and treatment from a qualified mental health professional. You don’t have to suffer alone or in silence. There is hope and help available for you.

Join a support group

Find a support group for people with body dysmorphia or other related disorders. This can provide you with a safe and supportive environment where you can share your experiences, feelings, and challenges with others who understand what you are going through. You can also learn from others’ coping skills and strategies, and get encouragement and motivation from them.

Organizations such as the Body Dysmorphic Disorder Foundation and The National Eating Disorders Association have resources to help you find online support groups.

Practice self-care

Take care of your physical, mental, and emotional health. Eat a balanced diet, get enough sleep, exercise regularly, and avoid alcohol and drugs. These can help boost your mood, energy, and self-esteem. Also, do things that make you happy, such as hobbies, interests, or activities that you enjoy or find meaningful.

Challenge negative thoughts

When you catch yourself having negative thoughts about your appearance, try to challenge them with more realistic and positive ones.

For example, instead of thinking I’m ugly and deformed, think I’m unique and beautiful in my own way. You can also use affirmations, such as I accept myself as I am or I am more than my appearance.

Reduce appearance-related behaviors

Try to limit or stop the behaviors that fuel your body dysmorphia, such as checking your appearance in the mirror, seeking reassurance from others, comparing yourself to others, or hiding or fixing your perceived flaws. These behaviors only reinforce your negative self-image and make you feel worse.

Instead, focus on other aspects of yourself that are not related to your appearance, such as your personality, skills, talents, or achievements.

Seek help from others

Don’t isolate yourself or avoid social situations because of your appearance concerns. Reach out to your family, friends, or other trusted people who can support you and help you cope with your condition. You can also ask them to give you honest feedback about your appearance, but not in a way that feeds your obsession or insecurity.

Be compassionate with yourself

Don’t be too hard on yourself or blame yourself for having body dysmorphia. Remember that it is not your fault and that you are not alone. You are a valuable and worthy person regardless of how you look. Treat yourself with kindness, respect, and love.

Body dysmorphia can be a challenging condition to live with, but it is not impossible to overcome. With proper treatment and support, you can learn to accept yourself as you are and live a fulfilling life.