What is BDD (Body Dysmorphic Disorder)?

Body dysmorphic disorder (BDD) is a distinct mental disorder in which a person is preoccupied with an imagined physical defect or a minor defect that others often cannot see. As a result, people with this disorder see themselves as “ugly” and often avoid social exposure or turn to plastic surgery to try to improve their appearance.

What does it mean to have body dysmorphic disorder (BDD)?
Have you ever looked in a mirror and become fixated on a pimple or a scar or other flaw that you perceive on your skin? Or have you been consumed by the idea that your nose looks weird? Now, imagine that this is all you saw every time you looked in the mirror. Imagine thinking that these flaws were the only things other people saw when they looked at you, with all of these thoughts leading to feelings of shame, self-hatred, and overly critical thoughts about your appearance. 

Although I was never diagnosed with this disorder, I am very familiar with what it means and how it feels. When I was a teenager I had a step-father who verbally and physically abused me. Not in a sexual way by any means. I was sixteen when my mom married this man. I vividly remember supper at our house. On a daily basis he would tell me I was “fat,ugly and would never amount to anything.” I realize now it was the alcohol talkiing but to a sixteen year old I couldn’t comprehend that. It stuck with me to this day. I developed eating disorders was pretty sick for awhile. My weight got down to 108 pounds and I have weighed as much as 226 pounds. Be careful what you say to your children. It will stay with them for the rest of their lives. I was fortunate enough to escape for the summer to California going into my senior year of high school. I came home to start my senior year, got a full time job while attending school and moved out by the time I was eighteen when I met my first husband. It wasn’t all fun and games but I felt safer at least and at twenty we married. My step father’s words have always haunted me. He is still alive and for the most part I forgave him but the damage was done. Name calling of any sort will damage your child. That’s a given.

When these thoughts and feelings become too time-consuming and cause significant emotional distress (such as anxiety, sadness, or self-consciousness) and/or significant problems in your daily life — this is body dysmorphic disorder.

In addition, at some point, people with BDD also engage in excessive repetitive compulsive behaviors (such as comparing with others or excessively checking mirrors or grooming) in response to the appearance concerns.

The common signs and symptoms of BDD

  • Frequent thoughts about appearance (at least an hour a day).
  • Spending a lot of time staring in a mirror and/or reflective surface while fixated on the perceived flaw, or in some cases, complete avoidance of mirrors/reflective surfaces.
  • Covering up the disliked body area (for example, using hats, scarves, make-up, body position, or posture).
  • Repeatedly asking others if you look okay (also referred to as ‘reassurance seeking’).
  • Frequent appointments with medical professionals/cosmetic surgeons to get the disliked body area “fixed.”
  • Repeated plastic surgery or dermatologic treatment.
  • Compulsive skin picking, which includes using fingernails and tweezers are to remove perceived blemishes and/or hair.
  • Avoiding social situations, public places, work, school, etc.
  • Leaving the house less often or only going out at night to prevent others from seeing the “flaw.”
  • Keeping your obsessions and compulsions secret due to feelings of shame
  • Emotional problems, such as feelings of disgust, depression, anxiety, low self-esIt is important to note that people living with BDD look “normal.” The appearance flaws that they perceive are, in reality, minimal or nonexistent. However, the person with BDD usually doesn’t realize this. They think that the flaws appear as ugly to others, and that they are as noticeable to everyone else as they are to themselves. This is probably because people with BDD have differences in visual processing – they seem to actually see themselves differently than other people do (click here to learn more about visual processing in BDD).
How to tell the difference between being unhappy with a part of your appearance and BDD.
  • Many people are unhappy with some part of the way they look; however, if the amount of time and energy spent thinking about the body part interferes with day-to-day functioning or causes significant emotional distress, then the person is diagnosed with BDD.
  • Many people are unhappy with some aspect of the way they look. However, you may have BDD if:
  • You spend at least one hour in total a day (add up all the time you spend) thinking about the perceived appearance flaws, and
  • Preoccupation with the perceived flaws interferes with day-to-day functioning or causes significant emotional distress, and
  • At some point you have performed repetitive behaviors in response to the appearance concerns.
  • NOTE: If you are preoccupied ONLY with thinking that you’re “too fat,” or that parts of your body (such as your stomach or thighs) are “too fat,” it is important to determine whether or not an eating disorder is a more fitting diagnosis than BDD.
  • Most often, the head or face (e.g. hair, nose, acne, neck, etc.) are the focus of concern. However, people with BDD can be excessively worried about any body part.
  • Other common areas of concern include the arms, legs, stomach, hips, weight, and body build (for example, feeling not muscular enough).