Learn about body dysmorphic disorder

Key points:

  • Body dysmorphic disorder (BDD) is a serious mental illness characterised by a preoccupation with a perceived flaw in appearance
  • BDD is often very difficult to diagnose
  • Recovery is possible

The way we feel about our appearance can have a big impact on our self-esteem and mental health. For some people, a perceived flaw in their appearance becomes such a significant fixation that it causes extreme distress. Body Dysmorphic Disorder (BDD) is a mental illness characterised by a preoccupation with a perceived defect in appearance, and people with BDD see a non-existent or minor imperfection as a major flaw. This perceived flaw can be in any part of their body, but the most common areas are:

  • facial features (often the nose, but also eyes, mouth or lips)
  • skin imperfections (acne, scars, wrinkles)
  • hair (head or body hair, or lack of hair)
  • body shape (muscles, body size)

People with BDD are not vain; they believe themselves to be “ugly” and their desire is to simply have a normal appearance.

Symptoms of body dysmorphic disorder

  • Being preoccupied with or avoiding mirrors
  • trying to hide the “flaw” with makeup or clothing
  • negative talk about their body, and needing constant reassurance about the “flaw”
  • repeatedly touching the “defect”
  • avoiding social situations or being seen in public

Often people with BDD will see dermatologists or plastic surgeons in an effort to change the area they are worried about. Even if a surgeon is willing to operate, the procedure rarely works as the underlying issues have not been addressed.

BDD causes extreme distress, and can affect someone’s ability to function at school, work or in social situations. Suicide is also a great risk, so it’s important to seek help as soon as possible.

The causes of BDD

It’s not known what causes BDD. It may have a biological basis. It shares features with obsessive compulsive disorder (OCD), and often occurs with depression, anxiety and social anxiety disorder.

A tendency towards perfectionism, a negative body image, childhood abuse or neglect, bullying or teasing about appearance in childhood are all factors that can affect someone’s body image in a negative way, but not necessarily cause BDD.

BDD is under-diagnosed due to a number of reasons. Often people will seek help from cosmetic surgeons or dermatologists rather than mental health professionals. They may be ashamed and worried that people will think they are vain. It’s also not a well-known illness, so may not be diagnosed correctly by health professionals.


Recovery from BDD is possible with help from professionals. Cognitive-behavioural therapy (CBT) is the most common treatment method. Anti-depressants may be prescribed, and group or family therapy may also be of benefit. Call EDV on 1300 550 236 or email help@eatingdisorders.org.au for advice.