Body dysmorphic disorder (BDD) is a mental health condition that impacts a person’s beliefs and perceptions around their body image. Those suffering with BDD are overly concerned about what they perceive as flaws in their appearance and/or different parts of their body. These individuals often engage in extensive ritualistic or compulsive behaviors to mitigate the unhealthy beliefs regarding their body appearance.
Preoccupation with physical appearance
It is important to recognize that men and women who struggle with BDD have a very real preoccupation with a perceived deficit in their body appearance. Such preoccupation disrupts their day to day routine. Individuals will often ruminate over this preoccupation, evoking distress, which then impairs their social, relationship and even occupational experiences.
For example, a male may be overly preoccupied with his abdominal region. This individual may spend hours working out in an attempt to shape and “define” his abs despite already being quite fit. He may look at his body, struggling to see that he is in shape, and try to “camouflage” his perceived inadequacies through posing in different ways in an effort to achieve the “perfect look.”
In addition, he may frequently check himself in the mirror, excessively lift weights and exercise. His mind spirals into unfair comparisons of his body until he is left feeling disappointed and believing “I need to work harder.” He returns to the gym, excessively works out and may even miss important life responsibilities due to his fixation.
Like many other mental health disorders, Body Dysmorphic Disorder is likely developed due to a combination of biological, environmental, social and genetic factors. BDD occurs somewhat more often among women than men. However, most of its clinical features present similar in both genders. Onset is often early adolescence. The condition can become chronic if it is not treated.
Individuals with BDD may engage in the following:
- Avoiding mirrors and photo being taken
- Excessive grooming (combing of hair, applying excessive makeup, shaving)
- Comparing body parts with others and scrutinizing own appearance
- Seeking surgery to address or remove perceived flaws
- Changing clothes frequently
- Skin picking
- Questioning and seeking reassurance from others that perceived flaw is unattractive
- Avoiding social situations
- Excessive exercise and weight lifting
Many individuals struggling with BDD are at risk for co-occurring mental health concerns. Anxiety, depression, obsessive compulsive disorder, as well as eating disorders (Anorexia, Bulimia, and Binge Eating disorder) are common comorbidities.
Evidence-based treatment for BDD does exist.
Both cognitive behavioral therapy (CBT) with exposure response prevention as well as Acceptance Commitment Therapy have been useful for men and women struggling with BDD.
There is hope! With the help of therapy, a healthy support system, and a willingness to challenge and change negative thoughts and behavior patterns, those who struggle with body dysmorphic disorder can experience freedom and change.
Kelly Boprie, LMSW, is a clinician at the Pine Rest Southwest Clinic. She earned her Bachelor of Arts in Psychology and Sociology from Calvin College in 2005 and her Masters in Social Work from Grand Valley State University in 2009. Kelly aims to create a safe, supportive, empathic and validating environment for the clients that she sees. She utilizes cognitive behavioral therapy, trauma focused cognitive behavioral therapy, dialectical behavior therapy, acceptance commitment therapy, exposure response prevention therapy and supportive therapy.
She has particular interest working with individuals who are struggling with eating disorders, body image concerns, trauma, sexual abuse and spiritual issues. She is working on Certified Eating Disorders Specialist (CEDS) certification through the International Association of Eating Disorders Professionals.