What Is Body Dysmorphic Disorder

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Body dysmorphic disorder can bring intense shame and hopelessness. If you are having thoughts of suicide, call or text 9-8-8 (Canada's Suicide Crisis Helpline) at any time, or call 911 if you are in immediate danger.

Body dysmorphic disorder (BDD) is a mental health condition in which a person is preoccupied with one or more perceived flaws in their appearance that others see as minor or do not notice at all. The preoccupation leads to repetitive behaviours, such as mirror checking, comparing, grooming, or seeking reassurance, and causes significant distress. BDD is related to obsessive-compulsive disorder. It is more common than many people realize and is treatable, particularly with specialized cognitive behavioural therapy.

What Body Dysmorphic Disorder Looks Like

Spending an hour or more a day thinking about perceived flaws, often much longer.
Checking mirrors repeatedly, or avoiding them entirely.
Excessive grooming, makeup, or clothing adjustments to hide the flaw.
Comparing appearance with others constantly.
Asking others for reassurance about how you look.
Avoiding photos, social events, work, or dating.
Seeking cosmetic procedures, often without lasting relief.

Common areas of concern include skin, hair, nose, and facial features, though any body part can be the focus. Muscle dysmorphia, a form of BDD, involves preoccupation with being too small or insufficiently muscular. At work or school, preoccupation can make it hard to concentrate. Socially, shame may lead to isolation. Many people also hate how they look in photos.

Why It Happens

BDD develops from a combination of factors. Genetics and differences in how the brain processes visual detail may play a role, with people with BDD tending to focus on small details rather than the whole picture. Experiences such as teasing or bullying about appearance, perfectionism, and cultural emphasis on looks can contribute. BDD often begins in adolescence. Once established, checking and reassurance-seeking bring brief relief but keep attention locked on the perceived flaw, strengthening the preoccupation over time.

People with BDD often feel intense shame and may keep their concerns secret for years, believing others will think them vain. In reality, BDD is a serious condition and not about vanity.

What It Is Not

Not vanity. BDD involves distress and shame, not self-admiration.
Not ordinary insecurity. Most people dislike aspects of their appearance. BDD involves time-consuming preoccupation and significant impact on life.
Not an eating disorder. Eating disorders focus on weight, shape, and eating. BDD can focus on any feature, though the two can coexist.
Not solved by cosmetic procedures. Procedures rarely relieve BDD and can shift the focus to new flaws.
Related to OCD but distinct. BDD shares the pattern of obsessions and compulsions, focused specifically on appearance.

How It Is Assessed and Treated

A psychologist or psychiatrist can assess BDD through interviews and questionnaires, exploring time spent on appearance concerns, behaviours, distress, and impact. Cognitive behavioural therapy adapted for BDD is the main treatment. It includes exposure and response prevention, such as reducing mirror checking and going out without camouflage, along with work on perception and self-focused attention. Medication prescribed by a physician may also help, especially when symptoms are severe. Treatment usually works best when the person understands that the problem is the preoccupation, not the feature itself.

Getting Support at Pacific Maple Psych Centre

If worry about your appearance takes up much of your day or keeps you from living fully, therapy can help. Specialized CBT for BDD can reduce preoccupation and help you engage more freely with life.

Pacific Maple Psych Centre offers individual therapy for body image concerns, including body dysmorphic disorder, in Vancouver and virtually across British Columbia.

Book a Session

Common Questions About Body Dysmorphic Disorder

How can I tell if my appearance worries have gone beyond normal insecurity?

Signs include long periods thinking about perceived flaws, mirror checking or avoidance, camouflaging, comparing, reassurance seeking, and avoiding social situations.

How much time do people with BDD spend on appearance worries?

Typically at least an hour a day, and often several hours, thinking about or checking perceived flaws.

Is body dysmorphic disorder a form of OCD?

BDD is closely related to OCD and grouped with it, sharing obsessions and compulsions, but it focuses specifically on appearance.

What is muscle dysmorphia?

Muscle dysmorphia is a form of BDD in which a person believes their body is too small or not muscular enough, often leading to excessive exercise or supplement use.

Can cosmetic surgery fix body dysmorphic disorder?

Usually not. Cosmetic procedures rarely relieve BDD and may lead to dissatisfaction or new areas of concern. Psychological treatment is more effective.

When does body dysmorphic disorder usually start?

BDD often begins in adolescence, though it may not be recognized or diagnosed until much later.

Why do people with BDD keep their concerns secret?

Shame and fear of being seen as vain lead many people to hide their concerns, which can delay treatment for years.

How is BDD different from an eating disorder?

Eating disorders centre on weight, shape, and eating. BDD can focus on any body part, such as skin or nose, though both can occur together.

Which therapy has the best evidence for BDD?

Cognitive behavioural therapy adapted for BDD, including exposure and response prevention, is the main treatment. Medication prescribed by a physician may also help.

How can I support someone with body dysmorphic disorder?

Avoid arguing about their appearance or offering constant reassurance, which can feed BDD. Express care, encourage professional help, and learn about the condition.