Get Out of the Mirror - Understanding Body Dysmorphic Disorder (BDD)

Jonathan Hoffman, PhD, ABPP 

Imagine looking in the mirror and seeing something completely different from what others see. This is a daily reality for people with Body Dysmorphic Disorder (BDD).

BDD is an obsessive-compulsive related disorder. In BDD, individuals become excessively preoccupied with perceived “flaws” in their appearance— “flaws” that often go unnoticed or seem trivial to others.

While many people have certain insecurities about their looks, those with BDD experience extreme distress, spending hours obsessing over minor imperfections. They may fixate on specific features such as their nose, skin, hairline, or jaw. Unlike eating disorders, which typically involve concerns about overall body shape and weight, BDD is more about intensely focusing on one or more specific body parts.

BDD is often thought of being mainly an issue for females. However, this is inaccurate. One BDD subtype, Muscle Dysmorphic Disorder (MDD), which involves an obsessive focus on muscularity seems to be a growing problem among men. Social pressures to achieve unrealistic beauty standards can feed into BDD for all genders.

The Impact of BDD

As BDD worsens, life often becomes consumed by compulsions like mirror-checking and persistent negative comparisons to how others look. Some people with BDD seek cosmetic procedures repeatedly, hoping for a “fix” that usually doesn’t work.

Meanwhile, the personal and professional lives of people with BDD suffer, and in severe cases, depression and suicidal thoughts emerge. It is a dangerous misconception that people with BDD who talk about suicide won’t act on it. If someone expresses suicidal thoughts, it’s best to take them seriously and seek immediate professional help.

It's important to understand that BDD is not about vanity, but perfectionism, and an exaggerated belief that appearance defines self-worth. Research suggests that people with BDD may have perceptual distortions, making their concerns feel undeniably real to them. Unfortunately, many people with BDD resist treatment, convinced that their issue is physical rather than psychological.

Treatment and Recovery

Despite its challenges, the good news is that BDD is treatable. Cognitive Behavioral Therapy (CBT) is considered one of the most effective treatments for BDD, helping individuals to shift their focus away from obsessive thoughts while teaching them to develop healthier ways of thinking about their appearance.

Seeking treatment for BDD may feel overwhelming, but it is a crucial step toward reclaiming one’s life. With the right support, people with BDD can move beyond self-defeating fixations on appearance.

Supporting a loved one with BDD can be challenging. Family members may struggle to understand or respond in a helpful way. Learning how to offer support for a loved one while maintaining healthy boundaries is an essential part of the recovery process.

No person should be reduced to body parts. If BDD is ruining your life—or the life of someone you care about—remember, help is available, and recovery is possible. If you think you might have BDD, it may be a good idea to consult with an experienced mental health professional about this diagnosis.