No one knows exactly what causes BDD. However, recent research suggests that there are a number of different risk factors that could mean you are more likely to experience BDD, such as:
Abuse and bullying
Experiencing abuse or bullying can cause you to develop a negative self-image and may lead you to have obsessions about your appearance. This is particularly true if you experience abuse or bullying when you are a teenager, when you may be more sensitive about the way you look or how your body is changing.
If you have low self-esteem, you may become fixated on aspects of your appearance that you want to improve. This is more likely if you attach a lot of importance to how you look, or if you feel your appearance is the most valuable thing about you.
Fear of being alone or isolated
If you worry about not fitting into a group of friends or being lonely, you may develop thought patterns that can lead to BDD. For example, if you believe that you need to look a certain way to maintain friends or find a partner, you may develop unhelpful concerns about your appearance. If a relationship then breaks down or a friendship group changes, this could make your concerns worse.
There have been so many times where I have looked in the mirror and just cried. Or I've thought I looked okay but two seconds later I will feel that it is all still wrong.
Perfectionism or competing with others
If you try to appear physically 'perfect' or you regularly compare your appearance to other people, you may be more likely to develop BDD. If you have a hobby or job that is very focused on your body – for example, modelling, bodybuilding or gymnastics – you may be at greater risk.
Some evidence suggests that BDD is more common in people whose family members also have BDD. But it's difficult to know whether symptoms – such as believing that you are disfigured or frequent mirror checking – are inherited from your parents' genes or picked up from their behaviour.
Depression, anxiety or OCD
People with other mental health problems, specifically depression, anxiety and OCD, are also more likely to have BDD. But it is not clear whether depression, anxiety or OCD are a cause of BDD, or if BDD is a cause of these mental health problems.
This information was published in November 2018. We will revise it in 2021.