Body dysmorphic disorder (BDD)

Explains some of the possible causes of body dysmorphic disorder (BDD).

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What causes BDD?

No one knows exactly what causes BDD. It can affect people of all genders, and commonly begins in adolescence. But research suggests that there are a number of different factors that could mean you’re more likely to experience BDD. For example:

Abuse or bullying
Low self-esteem
Fear of being rejected
Perfectionism or comparing yourself with others
Genetics
Depression, anxiety or OCD

Abuse or bullying

Going through traumatic experiences such as abuse or bullying can cause you to develop a negative self-image, which can lead you to have obsessions about your appearance. This is particularly true if you experienced abuse, bullying or other forms of trauma when you were a teenager, as it’s a time when you may have felt sensitive about the way you looked or how your body was changing.

LGBTQIA+ and BDD

Some research also suggests that people who identify as LGBTQIA+ may be more likely to have BDD.

The possible reasons for this are complex. But part of the explanation could be that experiences of homophobia, biphobia or transphobia may contribute to feelings of low self-esteem, which include difficult feelings about our physical appearance.

Find out more about LGBTQIA+ and mental health.

Low self-esteem

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.

Racism and BDD

If you’ve experienced racism you may hold negative views about yourself because of how you’ve been treated. This can lead to low self-esteem.

You may also have experienced colourism, which is when someone treats you differently based on how light or dark your skin shade is. Subtle messages in society and the media about lighter skin being preferable can make some of us feel like our skin shade is too dark, or like our hair or features don’t meet society’s ‘ideal’. This can contribute to the pressure we feel to change parts of ourselves.

Some people who have BDD may change parts of their identity, such as their skin colour, to deal with this.

See our racism and mental health page for more information.

Fear of being rejected

If you worry about not fitting in, or being rejected or 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 obsessive worries about your appearance. If a relationship then breaks down or a friendship group changes, this could make your worries worse.

There have been so many times where I've looked in the mirror and just cried. Or I've thought I looked ok but 2 seconds later I'll feel that it's all still wrong.

Perfectionism or comparing yourself with others

Messages about body image that we get from films, magazines, social media and adverts can have a negative impact on our body image and self-esteem. They can give us unachievable ideas about how we should look and make us feel we're not good enough. Apps and filters that improve the way we look online can also contribute to this.

If you try to appear physically 'perfect' or you regularly compare your appearance to other people, you may be more likely to develop BDD. Or if you do activities that are very focused on your body – for example, modelling, bodybuilding or fitness – you may also be at greater risk.

My hardest trait was comparing myself to others, especially girls who I thought were flawless.

Genetics

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're 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's unclear whether depression, anxiety or OCD are a cause of BDD, or if BDD is a cause of these mental health problems.

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This information was published in July 2022. We'll revise it in 2025.

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