There is a common saying, “you are your own worst critic”. For someone experiencing body dysmorphia, this concept is particularly relevant when it comes their judgement of their own appearance. They may focus a particular aspect of their body to a dangerous degree. Body dysmorphia and distorted beliefs about appearance are common in young adults today with the rise in social media and obsessions over physical appearances.
Body Dysmorphic Disorder
Body dysmorphic disorder (BDD) occurs when a person is preoccupied with perceived imperfections in their physical appearance, such as their body shape or weight, body parts, or facial features. The key word is ‘perceived’ – the flaw may not be observable by others or may not exist, yet to the person, they become largely exaggerated. Another feature of BDD is engagement in repetitive behaviours to fix, hide or disguise the perceived flaws, for example through constant grooming, makeup or clothing, excessive exercise, or cosmetic procedures. It is because of these fixated thoughts and behaviours that BDD is seen as similar to obsessive-compulsive disorder (OCD). BDD is prevalent at similar rates in both females and males; it can be all-consuming and cause distress and difficulty for one’s daily functioning and self-esteem. There is also an increased risk of health concerns and comorbid mental health conditions such as depression, anxiety disorders or eating disorders.
Risk factors for developing BDD
There are some factors that are associated with a higher chance of developing BDD, such as family history of BDD or OCD, negative or traumatic childhood events, existing mental health conditions and environmental influences like societal expectations of appearances. Particularly, social media is often in the spotlight as impacting users’ body image, due to the wealth of visual content that perpetuates unrealistic beauty standards. It may lead to constant scrutiny and comparison of oneself to highly polished and edited images seen on Instagram, TikTok and so on. A more malicious effect of social media may be the occurrence of bullying targeted towards someone’s appearance. As online interactions become more prominent in our lives, so do the risks of negatively influences on people’s self-image.
Symptoms of BDD
The symptoms of BDD are driven by one’s distorted thoughts about their appearance. In a Psychology Today article, Professor Shahram Heshmat outlines some common cognitions that someone with BDD may have:
- A false belief that their appearance is ugly or significantly flawed.
- Excessive and disproportionate focus on small details of their appearance.
- Aesthetic sensitivity or placing a lot of importance on attractiveness as an ideal.
- Believing that other people are also focused on their perceived flaw.
- Intrusive, uncontrollable thoughts about their perceived flaws.
- Difficulties controlling their impulses to attend to the perceived flaws.
- Worrying about the appearances of other people.
- Constantly making comparisons between themselves and other people.
- Protective behaviours and avoidance of situations where the flaw may be noticed.
- Internalisation and reluctance to reveal their appearance concerns to other people.
Treatment of BDD
It is important to intervene if any signs of BDD occur. In terms of treatment, the most often-cited psychological therapy is cognitive behavioural therapy (CBT), which uses cognitive strategies to address and change distorted thoughts like the ones mentioned, as well as reduce the compulsive behaviours associated with the disorder. There are some medications that have also been found as effective to treat BDD, such as selective serotonin reuptake inhibitors (SSRIs). A person recovering from BDD can also benefit from additional supports such as encouragement from family, friends, and peers with similar experiences.
If you feel that you or someone you know may have thoughts or behaviours linked to body dysmorphia, it is advised that you seek help from a health professional to access support. CONTACT US – Copecentre
If you would like to learn more about body dysmorphia or other aspects of disordered eating, The Butterfly Foundation has a range of articles and support tools to help: Support for Eating Disorders and Body Image Issues | Butterfly Foundation
If you would like to read our blog series on eating disorders, please find the links below:
 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
 Schneider, S. C., Mond, J., Turner, C. M., & Hudson, J. L. (2019). Sex Differences in the Presentation of Body Dysmorphic Disorder in a Community Sample of Adolescents. Journal of Clinical Child and Adolescent Psychology. 48(3), 516–528. https://doi.org/10.1080/15374416.2017.1321001
 Mayo Clinic. 2019. Body dysmorphic disorder – Symptoms and causes. Available at: <https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/diagnosis-treatment/drc-20353944>
 Heshmat, S., 2017. 10 Faulty Thoughts That Occur in Body Dysmorphic Disorder. Psychology Today. Available at: <https://www.psychologytoday.com/au/blog/science-choice/201709/10-faulty-thoughts-occur-in-body-dysmorphic-disorder>
 Mayo Clinic. 2019. Body dysmorphic disorder – Diagnosis and treatment. Available at: <https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/diagnosis-treatment/drc-20353944>