Body dysmorphic disorder (BDD) is an anxiety disorder related to body image.
You might be given a diagnosis of BDD if you:
- experience obsessive worries about one or more perceived flaws in your physical appearance; the flaw cannot be seen by others or appears very slight
- develop compulsive behaviours and routines, such as excessive use of mirrors or picking your skin, to deal with the worries you have about the way you look
If you have BDD, these obsessions and behaviours cause emotional distress and have a significant impact on your ability to carry on with your day-to-day life. In this way, BDD is closely related to obsessive-compulsive disorder (OCD).
BDD can vary in severity from person-to-person and from day-to-day. For some people, concerns around appearance may make it difficult for them to go out in public or see other people.
It varies day-to-day. It can sit quietly or it can be completely debilitating.
BDD may also cause other problems such as:
Many people with BDD do not seek help because they are worried that people will judge them or think they are vain. This means that many people with BDD are likely to experience it for a long time before seeking support.
What are the common signs of BDD?
People with BDD see themselves differently to how others see them. Although everyone's experience of BDD is unique, there are some common signs:
Common obsessive worries about the body
If you have BDD you experience intrusive, negative thoughts about one specific area (or several areas) of your body which you think is:
- out of proportion
- too big or too small
- lacking symmetry
These thoughts cause you significant anxiety and you will often spend several hours a day thinking about the area or areas of concern.
BDD can affect any area of the body but common areas of anxiety include your skin, hair, nose, chin, lips or genitals.
BDD and eating disorders
BDD and eating disorders share similar symptoms, such as:
- having poor body image
- worrying excessively about your physical appearance
- developing compulsive behaviours to try to deal with these worries
However, BDD and eating disorders are not the same. When a person is experiencing an eating problem, such as anorexia nervosa, they are mainly concerned about their weight and shape. Someone experiencing BDD is likely to experience other concerns around body image – for example, they may also have concerns about a particular facial feature.
Some people with BDD experience an eating disorder but not all people with eating disorders have BDD.
A mental health professional, such as a psychiatrist, can assess your symptoms to help you find out whether you are experiencing BDD, an eating disorder or both. For more information, see our pages on eating problems.
I've struggled with BDD for 13 years. It changes. Sometimes it is something little, like my nose, that is really bothering me that day. Sometimes it is every centimetre of my body that just feels wrong.
Common compulsive behaviours
If you have BDD, at some point during the course of your obsessions you develop compulsive behaviours and routines to deal with the anxiety you feel about your appearance.
You may spend hours each day carrying out these behaviours to try to reduce your anxiety. The behaviours may briefly lessen your worries or they may make you feel worse.
Common compulsive behaviours include:
- obsessively checking your appearance in mirrors or avoiding them completely
- using heavy make-up to try to hide the area you're concerned about
- changing your posture or wearing heavy clothes to disguise your shape
- seeking constant reassurance about your appearance
- exercising excessively, often targeted at the area you're concerned about
- frequent body checking with your fingers
- picking your skin to make it smooth
- excessive use of tanning products
- frequent weighing
- brushing or styling your hair obsessively
- constantly comparing yourself with models in magazines or people in the street
- seeking cosmetic surgery or having other types of medical treatment to change the area of concern
What is muscle dysmorphia?
Muscle dysmorphia (or muscle dysmorphic disorder) is a type of BDD where you experience obsessive worries about your body being too small, skinny or insufficiently muscular. Despite this, you are of average build or, in some cases, exceptionally muscular.
This often leads to compulsive behaviours that focus on building muscle, such as:
- spending excessive time exercising, specifically lifting weights
- taking nutritional supplements
- abusing steroids and other substances
You can find out more about muscle dysmorphia on the Body Dysmorphic Disorder Foundation website.
This information was published in May 2016. We will revise it in 2019.