Body Dysmorphia

Many of us will feel concerned about aspects of our appearance from time-to-time. However, the worries of people experiencing body dysmorphia are distressing and impact their ability to go about their everyday activities. The worries often focus on aspects of appearance that others wouldn’t notice or would consider minor, or on imagined flaws in appearance.

What is body dysmorphia?

Body dysmorphia is a clinical term for a condition where a person worries excessively about their appearance.

People of any age, gender, or sex can be affected by body dysmorphia. The focus of concern varies, but often includes skin, hair, facial features (such as the nose), or other body parts.

Prevalence of body dysmorphia

Body dysmorphia is considered relatively common, and both men and women can experience symptoms.

According to one study:

  • 2.2% of men and 2.5% of women are affected (1)

However, the true prevalence may be even higher. The shame associated with body dysmorphia means that some people do not discuss their concerns with a mental health professional.

Symptoms of body dysmorphia

Body dysmorphia can affect people in different ways. Common signs include:

  • Feeling driven to repeatedly check your body in the mirror. Or, avoiding looking at yourself in the mirror altogether.
  • Thinking that other people are looking at the aspect of your appearance, or criticizing you based on your appearance.
  • Avoiding social situations (including school or work) because you feel people are judging you negatively because of your appearance.
  • Trying to disguise the part of your body that you worry about - wearing a hat, or oversized clothing, for example.
  • Having trouble concentrating because worries about your appearance get in the way.
  • Picking at your skin to try to change your appearance.
  • Considering cosmetic procedures to address the aspect of your appearance.
  • Excessively exercising to try to change the aspect of your appearance.

Body dysmorphic disorder (BDD) is a mental health condition listed in the DSM-5; this is the manual that mental health professionals use for diagnosing mental health challenges.

It is classified in the category of obsessive-compulsive and related disorders. This reflects the obsessive nature of the concern about appearance, and the often excessive compulsions that go along with BDD.

Challenges associated with body dysmorphia

Body dysmorphia is distressing and can affect a person’s wellbeing and quality of life in diverse ways. Some examples of associated challenges include:

What to do if you are struggling with body dysmorphia

If you are struggling with body dysmorphia, consider a combination of the following actions:

  • See your physician: In some cases, medication can form a helpful part of a treatment plan for body dysmorphia. You might like to discuss this with your physician, or seek out a psychiatrist for specialized assessment and advice.
  • Therapy: Talking therapies in both individual and group contexts can help people learn how to overcome body dysmorphia. Types of therapy to consider are discussed further, below.
  • Support groups: Many people find that support groups are helpful sources of information, advice and support for coping with body dysmorphia. You can search for local body dysmorphia support groups in your area on the International OCD Foundation page.
  • Social supports: Talk to a trusted family member or friend about how you feel. They may be able to offer a different perspective that changes how you feel or think about your appearance.
  • Helplines: If you need immediate support, call 1-800-273-8255, or go the National Suicide Prevention Lifeline website.

Therapy types to consider for body dysmorphia

Cognitive behavior therapy currently has the strongest evidence base for treating body dysmorphia, but you might find that another type of therapy feels like a better personal fit. Some therapy types to consider include:

  • Cognitive Behavioral Therapy (CBT): CBT can help change unhelpful behaviors and develop more balanced thoughts and beliefs. Exposure and response prevention (ERP) is a particular CBT technique that is helpful for body dysmorphia. This therapy has a strong evidence-base supporting its efficacy for treating body dysmorphia.
  • Mindfulness Practices: Mindfulness may help if you are feeling anxious or low and can help people to learn self-compassion.
  • Acceptance and Commitment Therapy (ACT): ACT involves components of both CBT and mindfulness as well as other strategies to help people take an acceptance approach.

What to look for in a therapist for body dysmorphia

The best-fitting type of therapist for you will depend on individual factors, symptoms, your location and finances. When selecting a mental health professional, it can be helpful to consider the following factors:

Personal fit: As is the case when you are seeking therapy for any reason, it’s important to consider the potential for developing a strong working relationship with your therapist. The trusting working relationship with a therapist is called the therapeutic alliance, and it’s the number one indicator of treatment efficacy.

Qualifications and experience: It is important to look for a licensed mental health professional. This ensures that the therapist you work with has undertaken the appropriate education and training. Also, ask your prospective therapist ahead of time whether they have training and experience in treating body dysmorphia or obsessive-compulsive disorder, which is closely related.

Talk in advance: The best way to judge how you feel about your prospective therapist is to ask for a preliminary phone call. Most therapists will be happy to oblige. This enables you to ask about:

  • Their qualifications
  • Their experience working with people with body dysmorphia
  • Ongoing training in body dysmorphia, obsessive-compulsive disorder and related therapies
  • What type of therapy they suggest, and what that will be like
  • Their participation in insurance plans and cost of therapy

Try to speak to a few different therapists before making your mind up.

Zencare can help you to find a therapist who is a good personal fit. You can browse the videos of our vetted therapists and book a free phone call. This can help you to figure out whether you feel comfortable discussing difficult issues with the therapist, and gives a sense of what the therapist’s approach is like.

Sources and references