Support for body dysmorphic disorder (BDD)

Body Dysmorphic Disorder (BDD) describes an intense, distressing preoccupation with parts of your appearance or body that feel flawed, often in ways others can't see.  As a result, people who experience BDD often feel anxious, distressed, ashamed and embarrassed about their appearance or body, and may do things that take up a lot of time and make daily life harder. Over time this can make life feel smaller, as a lot of time goes into body checking, looking into reflective surfaces, measuring body parts, picking skin and comparing yourself to others. The ongoing preoccupation with body and appearance adds to the person's distress, and this can lead to avoiding social situations, isolation, depression, low self-esteem and more compulsive behaviours.

What BDD is not.

Body dysmorphia is not about being vain or being self-obsessed. People who identify with BDD often experience an enormous amount of distress, humiliation and fear. Many seek reassurance as a way to ease their fears and cope with daily life. What helps most is being approached with compassion, understanding and support.

What Causes BDD?

BDD is likely caused by a combination of genetic, biological and environmental factors.

What Can BDD Look Like?

BDD can look different for each person and often starts in the early teenage years.

• Preoccupation with one or more parts of your body. Judging body parts as too big or too small, seeing body parts as asymmetrical, wrong shape or colour. These perceived differences can be so slight that others don't notice them.
• Believing the perceived flaw makes you unacceptable or unlovable.
• Believing that others are noticing your perceived flaw
• Spending a lot of time worrying about the perceived flaws, body checking, or looking in mirrors and reflective surfaces.
• Covering your appearance with make up or hiding your body with baggy clothing.
• Feeling anxious, ashamed and embarrassed about your appearance and body.
• Trying to change the perceived flaws, including through cosmetic procedures, and only feeling short-term relief or not feeling satisfied with the result, so the search for change keeps going.
• Comparing yourself to others.
• Avoiding social situations and isolating.
• Frequently needing reassurance from others and not believing them.
• Having obsessions and carrying out compulsions in secret

BDD vs OCD

BDD and OCD are not anxiety disorders, although anxiety is often part of both. The DSM-5 groups them together under obsessive-compulsive and related disorders, and they share similarities and differences. Some similarities are time-consuming behaviours, and intrusive, unwanted thoughts that are distressing and often feel uncontrollable. Both also involve repetitive compulsive behaviours. The main difference is that in BDD the focus is on appearance and the body, whereas in OCD it can include many other areas of life, such as fears about a loved one dying or contamination. BDD also often co-occurs with social anxiety, depression and eating disorders.

BDD Vs Eating disorders

BDD and eating disorders are similar in the strong preoccupation and distress people feel about their bodies. However, people with BDD tend to focus on particular body parts, whereas people who experience an eating disorder tend to be distressed about their body image more broadly.

What Support is Available for BDD?

The aim of support is to ease the distress around appearance and body concerns and to improve quality of daily life. This can involve  therapy and medication.  Research indicates that Cognitive Behaviour Therapy (CBT) is helpful in easing BDD. Other therapies are available such as Acceptance and Commitment Therapy and Compassion Focused Therapy.