Body Dysmorphia: What It Is, Signs to Watch For, and How to Get Help

Body dysmorphia is often mistaken for low self-esteem, insecurity, or vanity. In reality, it's a mental health condition that can have a major impact on daily life.

Someone with body dysmorphia becomes intensely focused on perceived flaws in their appearance. These concerns can take up hours of the day, affect relationships and daily activities, and make it difficult to think about much else. Yet many people live with symptoms for years before receiving a diagnosis or treatment.

Body dysmorphia can feel challenging, both for the people experiencing it and the loved ones trying to help. Learning more about the condition is often the first step toward getting support.

What Is Body Dysmorphia?

Body dysmorphia, also known as body dysmorphic disorder (BDD), is a recognized mental health condition. It's classified as an obsessive-compulsive and related disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).

People with BDD become intensely focused on perceived flaws in their appearance. These flaws may be minor or invisible to others, but they feel very real and distressing to the person experiencing them.

These individuals may spend a significant amount of time checking, hiding, or trying to fix features they're concerned about. They may:

• Frequently check mirrors or avoid them altogether
• Compare their appearance to others
• Seek reassurance about how they look
• Groom excessively or pick their skin
• Use clothing, makeup, or hairstyles to camouflage a feature

Because feelings of shame and embarrassment often accompany BDD, many people struggle in silence and delay seeking help.

How Common Is Body Dysmorphia?

Body dysmorphic disorder affects an estimated 1.9% of adults, or roughly 1 in 50 people, according to a 2019 review. However, experts believe the condition is often underdiagnosed, meaning the true number of people affected may be higher.

BDD typically begins during adolescence, but it can take years for someone to receive appropriate treatment. Feelings of shame, embarrassment, or fear of being judged may prevent people from discussing their symptoms with healthcare providers.

What Does Body Dysmorphia Actually Feel Like?

A person with body dysmorphic disorder may find themselves thinking about the same feature over and over throughout the day. The concern can become so consuming that it's difficult to focus on work, school, relationships, or everyday activities.

BDD can bring up intense feelings of shame, anxiety, and self-consciousness. Some people avoid photos, dating, social events, or other situations that draw attention to their appearance. The fixation on the perceived flaw can start to affect how someone sees themselves as a whole.

Common Areas of Focus

BDD can involve any part of the body, but some concerns are more common than others, including:

• Skin (acne, scarring, wrinkles, or texture)
• Hair (thinning, hairline, or texture)
• Nose size or shape
• Teeth or smile
• Body shape or size
• Facial features such as the eyes, lips, or jawline
• Muscle size or definition (muscle dysmorphia)

The Cycle of Obsessive Thoughts and Behaviors

BDD often becomes a cycle that's hard to break. A thought about appearance triggers anxiety or distress. To try to feel better, a person may check mirrors, compare themselves to others, seek reassurance, or spend time researching cosmetic procedures. These behaviors may provide some relief in the moment, but the relief is usually short-lived.

Signs You Might Be Experiencing Body Dysmorphia

Most people have things they don't love about their appearance. With body dysmorphic disorder, those concerns become difficult to ignore. What matters is the overall pattern — how often the thoughts occur, how much distress they cause, and whether they interfere with work, school, relationships, or everyday activities.

You Spend Hours Each Day Thinking About Your Appearance

People with BDD often become preoccupied with a perceived flaw in their appearance. Unlike typical appearance concerns, these thoughts can feel difficult to control and may keep returning throughout the day.

You Avoid Social Situations or Activities Because of How You Look

Appearance concerns can become so overwhelming that they affect decisions about where to go and what to do. Some people avoid photos, dating, social events, presentations, or other situations where they feel exposed.

You Engage in Repetitive Behaviors to Check, Hide, or Fix Your Appearance

This might look like repeatedly checking mirrors, changing outfits, reapplying makeup, touching or measuring certain body parts, picking at skin, or using clothing to hide a feature. While these behaviors may help in the moment, the relief is usually temporary.

You Constantly Compare Your Appearance to Others

With BDD, comparisons can become frequent, distressing, and difficult to stop. You may find yourself comparing specific features to friends, strangers, celebrities, or people on social media and feeling like you don't measure up.

You've Sought or Are Considering Cosmetic Procedures

Seeking cosmetic treatments or procedures to improve a perceived flaw is common among people with BDD. In some cases, a treatment may provide temporary satisfaction, but the concern often remains or shifts to a different feature.

Body Dysmorphia vs. Normal Body Image Concerns: What's the Difference?

Most people have moments when they wish they could change something about their appearance. BDD is different because the concern doesn't easily fade — it can become a constant source of stress and take up a disproportionate amount of time and attention.

When Body Image Concerns Are Typical

Body image concerns are a normal part of life for many people. You might notice something you don't like about your appearance, think about it for a while, and then move on with your day. Even if the concern is frustrating, it usually doesn't stop you from participating in activities you enjoy.

When It Might Be Body Dysmorphia

With BDD, appearance concerns tend to feel all-consuming. Thoughts about a perceived flaw can keep resurfacing throughout the day, making it difficult to focus on other things. Another clue is how much the concern affects daily life — avoiding photos, social gatherings, dating, or presentations. The line between everyday insecurities and BDD isn't always clear-cut.

Different Types of Body Dysmorphia

Body dysmorphic disorder doesn't look the same for everyone. While the underlying pattern is similar, the specific focus can vary from person to person.

Muscle Dysmorphia (Sometimes Called "Bigorexia")

Muscle dysmorphia is a form of BDD centered on the belief that your body isn't muscular enough. Someone may appear strong, fit, or highly muscular to others, yet still feel small, weak, or inadequate. This can show up as an intense focus on building muscle, strict eating habits, and lengthy workout routines. Muscle dysmorphia is most common among males, though it can affect people of any gender.

Snapchat Dysmorphia and Social Media Influence

'Snapchat dysmorphia' materialized after plastic surgeons noticed patients bringing in filtered selfies and asking to look like the edited version of themselves. Filters can smooth skin, reshape facial features, and remove imperfections in seconds. When those edited images become the standard, real-life appearance can feel harder to accept.

While social media isn't considered a cause of BDD, it may worsen existing appearance concerns in some people.

The Connection Between Body Dysmorphia and Eating Disorders

Body dysmorphia and eating disorders are separate conditions, but they often occur together. Research suggests that about 12% of people with BDD also have an eating disorder.

BDD and eating disorders may focus on different appearance concerns, but they can have a lot in common. The main difference is where that attention gets directed — eating disorders often center on body weight, shape, or food, while BDD is more likely to focus on a specific feature.

When BDD and an eating disorder overlap, it can create a cycle that's difficult to break. Therapy can help address the thoughts and behaviors driving the condition, while a registered dietitian can help with eating patterns, nutrition, and recovery from disordered eating.

How Body Dysmorphia Is Treated

Body dysmorphia is treatable, and recovery is possible. Treatment focuses on reducing the thoughts and behaviors that keep appearance concerns at the center of daily life. The most effective treatment plans include therapy, medication, or both.

Cognitive Behavioral Therapy (CBT) for BDD

Cognitive behavioral therapy (CBT) is usually the first treatment recommended for body dysmorphic disorder. The National Institute for Health and Clinical Excellence guidelines recommend that CBT is specific for BDD, often over a course of 16 to 24 sessions. Rather than focusing on appearance, CBT addresses the thoughts and behaviors that perpetuate the distress.

Medication Options

Some people benefit from medication, particularly when BDD is accompanied by significant anxiety, obsessive thoughts, or depression. The medications most commonly used are selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant also used to treat anxiety disorders and OCD. These decisions should be made with a psychiatrist or other qualified healthcare provider.

The Role of Nutrition and Overall Health

Nutrition isn't a treatment for BDD, but it can support overall mental and physical health. For some people, appearance concerns affect eating habits or lead to patterns of restriction, dieting, or other disordered eating behaviors. When that happens, working with a registered dietitian can help support a healthier relationship with food while ensuring nutritional needs are being met.

Supporting Someone with Body Dysmorphia

It can be hard to know what to say when someone you care about is struggling with BDD. As caregivers, you may want to reassure them or talk them out of their concerns. While those reactions come from a good place, they're not always what the person needs most.

What Helps

Start by listening. BDD can be incredibly isolating, and simply having someone who's willing to listen without judgment can make a difference. It can also help to encourage professional support — BDD is a treatable condition, but recovery often requires more than reassurance from friends and family. Helpful responses might include:

• "That sounds really hard."
• "I can tell this has been weighing on you."
• "I'm glad you told me."
• "You don't have to deal with this on your own."
• "Have you talked to anyone about how much this has been bothering you?"

What Doesn't Help

Repeatedly telling someone they look fine may seem reassuring, but it often doesn't provide lasting relief. Other responses that are usually unhelpful include brushing concerns off as vanity, telling someone to "just stop worrying about it," or suggesting cosmetic procedures as a solution.

When to Seek Professional Help for Body Dysmorphia

A good rule of thumb is to pay attention to how much space these concerns are taking up in your life. If thoughts about your appearance are showing up throughout the day, causing significant distress, or changing the way you live your life, it's worth reaching out for help.

Consider talking with a mental health professional if appearance concerns are making it difficult to focus on work or school, you're avoiding social events or activities, you spend significant time checking mirrors or comparing yourself to others, or friends and family have expressed concern.

If you're having thoughts of self-harm or suicide, seek immediate help from a mental health professional, healthcare provider, emergency service, or crisis resource.

How a Nutritionist or Dietitian Can Help with Body Dysmorphia

Body dysmorphia is a mental health condition, and treatment typically involves therapy, medication, or both. That said, appearance concerns can sometimes spill over into eating habits, exercise routines, and food choices.

A registered dietitian and eating disorder specialist can help untangle some of the eating habits that often develop alongside body image concerns. The focus should be on supporting health and building a more balanced relationship with food — not changing appearance.

Nutrition support is often most helpful when it's part of a larger treatment plan that may also include a therapist, psychiatrist, or physician.

How Top Nutrition Coaching Can Connect You with a Registered Dietitian

If body image concerns have started affecting your eating habits, relationship with food, or overall well-being, Top Nutrition Coaching can help.

Top Nutrition Coaching matches clients with registered dietitians based on their individual needs and goals, including challenges related to body image, disordered eating, and mental health. Appointments are conducted virtually, making it easy to access support from home.

Taking the first step can feel intimidating, but you don't have to figure everything out on your own. Check if your insurance covers a registered dietitian — it takes less than a minute.