Body dysmorphic disorder

Do you…

  • Worry a lot about your appearance?
  • Spend large amounts of time repeatedly checking your appearance, or trying to cover up or change aspects of your appearance?
  • Avoid situations and activities because of your appearance worries?

What is Body Dysmorphic Disorder (BDD)?

Most people worry about their appearance from time-to-time, but for some people appearance concerns dominate their life. Body dysmorphic disorder (BDD) involves preoccupying concerns about appearance that cause a lot of distress and/or get in the way of day-to-day activities. Often people with BDD worry most about facial features, such as their skin, hair, or nose. However, appearance concerns in BDD can relate to any body part and often relate to more than one body part. Sometimes people with BDD say that their appearance worries are general, not specific, such as a general feeling of being unattractive.

BDD usually also involves time-consuming repetitive behaviours, such as:

  • checking appearance (e.g. in mirrors or other reflective surfaces),
  • concealing aspects of appearance (e.g. with clothing or makeup) or
  • trying to change aspects of appearance (e.g. with cosmetic products and procedures).
  • comparing appearance to other people (e.g. on social media)

Some people with BDD also feel compelled to pull their hair or pick their skin in an attempt to improve their appearance. For details on habit problems, please click here.

How common is it?

Research shows that BDD usually develops during adolescence and is a relatively common problem, affecting about 2% of adults, but it often goes undetected and undiagnosed. This is partly because people with BDD often feel too embarrassed to tell someone about their difficulties. Even when they do, awareness of BDD is quite limited so other people may not recognise the problems as being symptoms of this disorder.

What can I do about it?

The National Institute for Health and Care Excellence (NICE) recommends two main treatments for BDD: Cognitive Behavioural Therapy that is specific to BDD, and SSRI medications.

Cognitive Behavioural Therapy
Cognitive Behavioural Therapy (CBT) is a psychological therapy and is one of the most effective types of treatment for BDD. Generally, CBT for BDD helps you build your confidence by learning to identify unhelpful beliefs and behavioural patterns. You and your therapist work together to change your behaviour and replace unhelpful beliefs with more realistic and balanced ones. CBT teaches you new skills and helps you understand how to manage situations that would usually cause you anxiety or distress.

If you would like to get help from our service or know more about Cognitive Behavioural Therapy, you can request an appointment with our service. Alternatively, you may wish to speak to your GP about a referral to our service.

Testimonials

“It has felt like a giant weight off my chest being able to go on with my life without thinking negatively about my body and appearance constantly. I feel like I have developed more appreciation for myself and have been able to practice body neutrality. I am very grateful for all the tools I’ve been able to learn and use everyday.”

“For a long time, I thought that maybe being miserable all the time about my body was normal, but I have now learnt I can do something about it. People think they have to live their life without being happy in their body, but to me, if people are living this way, they are not living life to the fullest. I would encourage anyone starting CBT for BDD to lean into therapy, embrace it, and be truthful.”

How can I help myself?

The BDD Foundation is a UK charity that aims to increase awareness and understanding of dysmorphic disorder (BDD): https://bddfoundation.org/

The BDD Foundation has a wealth of resources on their website and runs online and in person support groups, free of charge.

These two books are helpful resources, written by leading experts in BDD and CBT:

  • Overcoming Body Image Problems including Body Dysmorphic Disorder: a Self-help Guide Using Cognitive Behavioural Techniques by David Veale, Rob Wilson and Alex Clarke.
  • Feeling Good about the Way You Look: A Program for Overcoming Body Image Problems by Sabine Wilhelm.