Body dysmorphic disorder

By:

Project Semicolon

Reviewed:

6 months ago

Our articles are medically reviewed and medically fact-checked by board-certified specialists to ensure that all factual statements about medical conditions, symptoms, treatments, procedures and tests, standards of care, and typical protocols are accurate and reflect current guidelines and the latest research.

Overview

Body dysmorphic disorder is a mental health condition characterized by an obsessive preoccupation with perceived flaws in one's appearance. These flaws may be minor or even invisible to others, yet individuals with this disorder experience intense distress and anxiety about their appearance. Such concerns can lead to avoidance of social situations and a negative impact on daily functioning.

Individuals with body dysmorphic disorder may spend hours each day focusing on their appearance, engaging in repetitive behaviors like checking the mirror or seeking reassurance. While seeking cosmetic procedures may provide temporary relief, the anxiety often returns, leading to a cycle of searching for additional fixes.

Treatment for body dysmorphic disorder may involve cognitive behavioral therapy and medication.

Symptoms

Signs and symptoms of body dysmorphic disorder include:

Intense preoccupation: Being fixated on a perceived flaw in appearance that is either invisible to others or appears minor.
Belief in a defect: Strongly believing that a flaw exists, making one appear ugly or deformed.
Imagined negative attention: Believing that others notice and mock the perceived flaw.
Repetitive behaviors: Engaging in difficult-to-control behaviors to hide or fix the perceived flaw, such as frequent mirror-checking, grooming, or skin picking.
Comparison: Constantly comparing one's appearance with others.
Reassurance seeking: Frequently seeking validation about appearance from others.
Perfectionism: Having perfectionistic tendencies.
Unsatisfactory cosmetic procedures: Seeking cosmetic procedures without finding lasting satisfaction.
Avoidance: Avoiding social situations due to distress.

Individuals may intensely focus on different parts of their body, with common fixations including the face (nose, complexion, wrinkles), hair (appearance, thinning), skin (vein appearance), breast size, muscle size, and genitalia. In males, a fixation on having an insufficiently muscular body (muscle dysmorphia) is prevalent.

Insight into body dysmorphic disorder varies, with some individuals recognizing excessive beliefs, while others may be convinced that their perceived flaws are true. The stronger the conviction, the greater the disruption and distress in one's life.

When to See a Doctor

If you experience signs or symptoms of body dysmorphic disorder, it's essential to seek help from a health care provider or mental health professional. Left untreated, the condition may worsen over time, leading to severe depression, extensive medical expenses, and even suicidal thoughts or behavior.

Causes

The specific causes of body dysmorphic disorder are not known. Like many other mental health conditions, it likely results from a combination of factors, including family history, negative self-image or experiences, and abnormal brain function or serotonin levels.

Risk Factors

Body dysmorphic disorder typically begins in the early teenage years and affects both males and females. Several factors may increase the risk of developing or triggering the disorder:

Familial history: Having blood relatives with body dysmorphic disorder or obsessive-compulsive disorder.
Negative life experiences: Childhood teasing, neglect, or abuse.
Personality traits: Perfectionism.
Societal pressure: Unrealistic beauty expectations or standards.
Other mental health conditions: Anxiety or depression.

Complications

Body dysmorphic disorder can lead to various complications, such as:

Low self-esteem: Negative impact on self-confidence and self-worth.
Social isolation: Avoidance of social situations due to distress.
Depression: Severe depression or other mood disorders.
Suicidal thoughts: Common with body dysmorphic disorder.
Anxiety disorders: Including social anxiety disorder.
Obsessive-compulsive disorder: Repetitive behaviors can overlap with OCD.
Eating disorders: Such as anorexia or bulimia.
Substance misuse: In response to distress.
Physical harm: Skin picking leading to health problems.
Unnecessary procedures: Risk of disfigurement from repeated cosmetic surgeries.

Prevention

There is no known way to prevent body dysmorphic disorder. However, early identification and treatment may be beneficial since the disorder often begins in the early teenage years. Long-term maintenance treatment can also help prevent relapses of symptoms.

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Brian Richards, MD

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