Sometimes known as ‘Imagined Ugliness Syndrome’, Body Dysmorphic Disorder or BDD is a body image problem. Sufferers typically are obsessed with how they look and how other people see them and are convinced that one or more aspects of their body or image is abnormal, when there is actually nothing wrong at all. When this obsession with body image is so severe that it begins to interfere with normal day to day life or causes so much distress that it no longer becomes possible for someone to function normally, they may be suffering from BDD.
It is thought that between 1-2% of the UK population may suffer from BDD. For those that do, it can rule their lives. People with BDD can be obsessed by any aspect of their appearance or part of their body. Concerns can be about size – too big or too small, symmetry or proportion. People with BDD often check themselves out in any mirror or convenient reflective surface; pick their skin to make it ‘smooth’; constantly seek reassurance from others about their appearance or compare themselves to others in magazines and in social media and worry that they don’t meet the mark; use make-up excessively, or obsessively comb their hair. Some people try to avoid social situations and public places and/or to hide the part of the body they feel most ashamed. Maintaining close relationships and keeping a steady job therefore become very difficult.
In extreme cases, someone with BDD can resort to drastic changes to their appearance, including undergoing unnecessary plastic surgery to correct the perceived fault in their appearance. In some cases, even this extreme action does not succeed in altering the way in which a sufferer of BDD sees their appearance and the disorder continues.
There is some overlap between the symptoms of BDD and those of eating disorders such as anorexia and bulimia. For example, sufferers can exercise excessively or weigh themselves frequently, as a way of controlling their physical appearance. Some may also develop compulsive behaviours.
BDD can be the result of a social phobia or clinical depression, and some sufferers may have a genetic tendency to the disorder. Others may find it is the result of low self-esteem, sometimes caused by teasing or bullying in childhood which has planted the seed of self-doubt and self-judgment in the mind. Today’s increased emphasis on celebrity culture and on social media has a role too, as we are bombarded with images of ‘perfect’ faces and bodies – many of which are merely a perception or a fabricated image. This can play particularly on those who are vulnerable or already unsure of themselves.
There are two main routes of treatment for body dysmorphic disorder. One is the prescription of anti-depressants. Cognitive Behavioural Therapy (CBT) can also be beneficial to some sufferers of BDD, and some patients may benefit from both treatments. What is most important once it has been recognised that someone may be suffering from BDD, is to seek professional help and support.
If you spend a lot of time worrying about perceived flaws in your appearance, especially if others don’t notice them, and it interferes with your daily life, work, or relationships, you may have BDD. Seeking a professional opinion from a GP, psychologist, or psychiatrist is the best first step.
While low self-esteem can be a contributing factor, BDD is more specific and intense. It involves obsessive thoughts and behaviors related to a particular aspect of appearance, often accompanied by rituals like mirror checking or skin picking.
Yes. BDD affects both men and women. Men are often more likely to focus on concerns such as muscle size (sometimes called muscle dysmorphia) or hair loss, whereas women may focus more on skin, weight, or facial features.
No. BDD is a serious mental health condition, not a sign of vanity or narcissism. People with BDD usually feel ashamed or distressed about their appearance, rather than proud or self-absorbed.
BDD rarely improves without treatment. Cognitive Behavioural Therapy (CBT), sometimes combined with medication, is considered the most effective treatment. Early diagnosis and support can significantly improve outcomes.
