Body Dysmorphia

Body dysmorphia, also known as body dysmorphic disorder (BDD), is a mental health condition that leads to significant distress and preoccupation with perceived flaws in one's appearance. These flaws are often not noticeable or exaggerated to others, but they cause immense psychological distress to the individual affected. This condition is related to obsessive-compulsive disorder (OCD) but is distinct in its focus on appearance-related concerns. Body dysmorphia can severely impact an individual's daily life, leading to disruptions in relationships, work, and social activities.
The onset of body dysmorphia typically occurs during adolescence or early adulthood, and it can affect people of all genders. It is estimated that around 2.4% of adults in the United States experience body dysmorphia, with slightly more individuals assigned female at birth being affected compared to those assigned male at birth.
It is essential to differentiate between body dysmorphia and gender dysphoria. While the terms may sound similar, they refer to different experiences. Gender dysphoria is the distress that some individuals may feel when their gender identity does not align with the sex assigned at birth. It is not a mental disorder, but it can cause challenges in mental health. On the other hand, body dysmorphia is centered around distress related to perceived physical flaws and is not related to gender identity.
What Does Body Dysmorphia Feel Like?

Body dysmorphia, also known as body dysmorphic disorder (BDD), is a mental health condition characterized by a persistent preoccupation with perceived flaws or defects in one's appearance. These flaws are often imagined or exaggerated and cause significant distress, leading to impairment in daily functioning and quality of life. People with body dysmorphia are unable to see themselves objectively and may believe that their appearance is ugly, abnormal, or deformed, despite reassurance from others.
The appearance concerns in body dysmorphia can focus on any part of the body, but some common areas include the face (e.g., nose, complexion, wrinkles), hair (e.g., thinning or baldness), skin and veins, breast size or appearance, muscle size and tone, and genitalia. Individuals with body dysmorphia may obsess over one or multiple body parts, spending excessive amounts of time examining them in mirrors, touching or measuring them, or trying to hide or cover them up.
The symptoms of body dysmorphia can vary in intensity and may become more severe over time. Some of the common signs and behaviors associated with body dysmorphia include:
  • Excessive mirror checking: Spending long periods looking at oneself in mirrors, often trying to find flaws or comparing specific body parts with perceived ideal standards.
  • Avoidance behaviors: Avoiding mirrors altogether, or avoiding certain situations or social interactions due to anxiety about one's appearance.
  • Compulsive grooming or skin picking: Engaging in repetitive behaviors, such as picking at the skin or hair, to try to fix or improve the perceived flaws.
  • Seeking reassurance: Constantly seeking reassurance from others about one's appearance, but not fully believing or accepting their compliments.
  • Excessive grooming or makeup application: Spending hours trying to perfect one's appearance through grooming, makeup, or other means.
  • Comparing oneself to others: Constantly comparing one's appearance to others, often feeling inadequate or envious of perceived more attractive individuals.
  • Frequent plastic surgery or cosmetic procedures: Seeking out multiple cosmetic procedures to correct perceived flaws, often with little satisfaction from the results.
  • Emotional distress and impaired functioning: Feeling distressed, anxious, or depressed about one's appearance, which can interfere with work, social life, and relationships.
It's essential to note that body dysmorphia is a mental health disorder, and the perceived flaws are not based on objective reality. Even if others may not see any issues with the person's appearance, the distress and preoccupation are very real to the individual experiencing body dysmorphia.
Body dysmorphia can significantly impact an individual's life, leading to social isolation, difficulties at work or school, and a reduced quality of life. The condition often coexists with other mental health disorders, such as depression, anxiety, and obsessive-compulsive disorder (OCD).
What Are The Different Forms of Body Dysmorphia?
There are two subtypes of body dysmorphia:
  • Muscle Dysmorphia: Individuals with muscle dysmorphia believe that their bodies are not muscular or big enough. They may engage in excessive exercise, monitor their diet rigidly, and wear clothing to appear bulkier. This subtype is sometimes referred to as "bigorexia" or "reverse anorexia" and may overlap with eating disorders.
  • Body Dysmorphia by Proxy: In this subtype, individuals become overly focused on perceived flaws in other people's appearances, causing distress and affecting their daily functioning. They may engage in repetitive behaviors to alleviate anxiety or feelings of guilt.
The exact cause of body dysmorphia is not fully understood, but several factors may contribute to its development. Some theories suggest that certain brain areas responsible for processing body appearance information may be involved. Genetic factors also play a role in predisposing individuals to the disorder. Additionally, childhood experiences, such as traumatic events, emotional conflict, or critical comments about one's appearance, may influence the development of body dysmorphia.
Identifying the symptoms of body dysmorphia can be challenging due to the shame and secrecy that often accompany the condition. Some warning signs include engaging in repetitive behaviors like mirror-checking, skin-picking, or attempts to hide the perceived defect. Individuals may constantly seek reassurance from others that the flaw is not visible or obvious, even when others assure them otherwise. Body dysmorphia can lead to difficulties at work, school, or in relationships due to the overwhelming focus on the perceived flaw.

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