Body Dysmorphic Disorder: Causes and Diagnosis


Body dysmorphic disorder (BDD) is a serious illness in which a person can’t stop thinking about his or her minor or imaginary physical flaws, usually of the skin, hair, and facial features. A person with BDD tends to have cosmetic surgery, and as a rule, is unhappy with the outcome. BDD is similar in some ways to eating disorders in that both are concerned with body image.

It usually begins during the teen years or early adulthood and affects 1.7% to 2.4% of the general population, or about 1 in 50 people. This means that more than 5 million people to about 7.5 million people in the United States alone have BDD.


While the specific causes of body dysmorphic disorder are not yet fully understood, several factors have been identified in those with this disorder, including:

  • Biological

Biological causes play a role in causing
body dysmorphic disorder, which may include abnormalities in brain structure or

  • Genes

People whose blood relatives also have this condition or obsessive compulsive disorder have a greater risk of developing BDD.

  • Environment.

A person’s growing environment, as well as his culturally-based beliefs that involve a negative body image or self-perception, may contribute to the development of the disorder.


People with BDD usually have an obsessive preoccupation with their physical appearances by especially focusing on perceived flaws or barely noticeable real ones.

Common symptoms are listed below:

  • Strong belief that the flaw or physical abnormality makes him or her ugly
  • Strong belief that others view his or her physical appearance as ugly
  • Undergoing frequent plastic surgery or non-invasive cosmetic procedures
  • Performing excessive grooming rituals
  • Having excessive self-consciousness and low self-esteem
  • Having problems concentrating at work or school
  • Refusing to appear in photographs under any circumstances
  • Avoiding social situations
  • Using excessive make-up and going to great lengths to camouflage the imagined defects with clothing
  • Checking mirrors obsessively or avoiding mirrors altogether
  • Having compulsive behaviors such as skin picking, and frequent clothes changing


BDD is often misdiagnosed as social anxiety or one of a number of other mental disorders. However, people with BDD often experience other anxiety disorders as well.

Diagnosis of body dysmorphic disorder is typically based

  • Psychological evaluation

It assesses risk factors and thoughts, feelings, and behaviors related to a negative self-image.

  • Personal, social, family and medical
  • DSM-5

Symptoms listed in the Diagnostic and
Statistical Manual of Mental Disorders, published by the American Psychiatric
Association, provide criteria to the diagnosis of BDD.


Treatment for body dysmorphic disorder often includes a
combination of cognitive behavioral therapy and medications.

Cognitive Behavioral Therapy

It will help individuals challenge negative thoughts about their body image and adopt a more realistic way of thinking, as well as learn about alternate ways to handle urges that come with the disorder such as excessive mirror-checking.


Medications, such as antidepressants, used to treat disorders such as depression may be effective here. SSRIs may be prescribed.

Keywords: body dysmorphic disorder.

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