Could your negative body image be Body Dysmorphic Disorder?

Feeling anxious or confused about what you see when you look in the mirror? There’s a chance you could be suffering from Body Dysmorphic Disorder (BDD). Whilst at times it can feel overwhelming, the good news is there is treatment available that can really help.

Summer is just around the corner, so naturally it’s the time when people shed their clothing and start to work towards that perfect ‘beach body’. Whether it’s spending hours at the gym, trying the new ‘fad’ diet or just cutting back on alcohol and food, there are plenty of ways we can try to change the way we look. There comes a time, however, when focusing too much on our appearance can have a negative impact on our mental health.

This is known as Body Dysmorphic Disorder (BDD) – and it affects around 2% of the UK population.

What is BDD?

BDD is an anxiety disorder that causes people to worry excessively about their appearance. Those living with BDD spend a lot of time worrying about a perceived physical flaw that may not actually be noticeable to others.

The whole thing can be very upsetting and have a significant impact on your everyday life, with symptoms varying in intensity. For example, some people may recognise that they blow things out of proportion, whilst others are so convinced of their flaws, they become delusional. And BDD can affect anyone and everyone too – including men and women of any age (although it’s most common in teenagers and young adults).

Signs you might have Body Dysmorphic Disorder:

  • Are you overly worried about a specific area of your body (often your face)?
  • Do you spend a lot of time comparing your appearance to other people's?
  • Do you spend a lot of time in front of the mirror (or avoid mirrors completely)?
  • Do you make a lot of effort to conceal physical ‘flaws’?
  • Do you avoid social situations because of concerns about your appearance?
  • Do you pick at your skin?
  • Do you spend a lot of time researching how to get rid of your ‘flaw’, like plastic surgery, for example?

BDD is also linked to low mood, anxiety and eating disorders, and sometimes it’s compared to obsessive compulsive disorder (OCD), due to the obsessive nature of the disorder. In reality though, OCD and BDD are completely separate conditions (although it is possible to suffer from both). BDD may also be confused with eating disorders, as some people display eating disorder type behaviours to manage their worry about their perceived physical flaw.

What causes Body Dysmorphic Disorder?

The simple answer is, we don't actually know. However, it could be associated with one or more of the following:

  • Genetics – you may be more likely to develop BDD if you have a relative with it, OCD or depression
  • A chemical imbalance in the brain
  • A traumatic experience in the past — for example, you might be more likely to develop BDD if you were teased, bullied or abused as a child

Is there anyone who can help?

In a word, yes. Mild symptoms of BDD can be treated with Cognitive Behavioural Therapy (CBT) and a trained CBT therapist will help you understand the condition in greater depth and give you effective coping mechanisms to manage your anxiety and worry. Actually, CBT techniques can really help people with BDD recognise the difference between reality and perception, tackling unhelpful thoughts and behaviours, building body confidence and tackling the fixation with body image.

And, in more severe cases, symptoms of BDD may also be treated with selective serotonin reuptake inhibitors (SSRIs), which are a type of antidepressant, too.

It’s good to talk.

Feelings of shame or embarrassment may make it difficult to seek help for BDD but take some reassurance from knowing that BDD has nothing to do with vanity or self-obsession. It’s really important to speak to your GP, who will take your condition seriously, ask about your symptoms and how they impact your life. They may also ask if you’ve considered harming yourself. Depending on the situation, they’ll either provide support in the surgery or refer you to a mental health specialist.

That important first step.

Recognising you have an unhealthy body image is an essential first step in treating BDD. Monitoring and tracking your unhelpful behaviours can also be useful – things that could be deemed excessive or obsessive, for example.

For information, advice and practical tips on coping with BDD, some people may find support groups helpful. The BDD Foundation has plenty of further information about this.

Mindfulness techniques can help if you're feeling low or anxious, with breathing and relaxation exercises often helping to relieve stress and anxiety.

The good news

Above all, it’s important to stay positive. BDD can be treated and symptoms can be managed by self-control and conditioning. With self-help strategies and guidance from a therapist, you can learn to accept your body image without altering your physical appearance.

Remember – be positive and don’t be afraid to ask for help. Good luck!

Talk to a therapist

If you'd like further advice you can book a call with one of our therapists at a time and date that is convenient for you by using the calendar below. A therapist will help you to understand why you feel like you do, give you time to explore your concerns, answer any questions you have, and if further therapy is required, will discuss with you what approach is right for you to enable you to feel better. If you choose to continue with therapy we can then arrange the support that you need with one of our mental health professionals. Your call will last approximately 30 minutes.


Last updated Friday 7 October 2022

First published on Friday 17 May 2019