Body dysmorphic disorder is a type of obsessive-compulsive disorder. An individual with body dysmorphic disorder is overly preoccupied with what are perceived as gross imperfections in their appearance and spends an hour or more every day thinking about the way they look. In reality, the imperfections are imagined or only slight and barely noticed by others, if at all. The affected person may be obsessed with certain body parts, particularly related to their face or head, or with their weight or body shape.
The symptoms of body dysmorphic disorder often begin in the early teens or even childhood, and are all related to the person’s appearance.
According to DSM-5, the symptoms of body dysmorphic disorder include;
- Preoccupation with one or more perceived defects in physical appearance that are not observable to others
- Performance of repetitive behaviors—such as mirror-checking, excessive grooming, skin picking, reassurance-seeking—or such mental acts as comparing one's appearance with that of others in response to appearance concerns
- Clinically significant distress or impairment in functioning caused by the preoccupation.
Individuals with body dymorphic disorder are constantly checking their look in the mirror, excessive grooming, over-exercising, skin picking, or hair plucking — and comparing themselves to others. In addition to an extreme obsession with their looks, people with body dysmorphic disorder try to hide their perceived flaws by holding their body in certain ways, covering up with make-up or clothing, or trying to improve their imagined defects, sometimes with multiple plastic surgeries or other cosmetic practices.
Even when steps are taken to make improvements, the person is still unhappy with their appearance. The obsession, repetitive behavior, and the constant covering up create stress for the affected individual and can have a negative impact on daily functioning and quality of life. Major depression is common in those with body dysmorphic disorder, as are suicidal thoughts and behavior.
Individuals with body dysmorphic disorder often have a history of child abuse, neglect, or some other childhood trauma and may also have a parent or sibling with an anxiety disorder. Those with the condition may also have an anxiety disorder, such as obsessive-compulsive disorder or social anxiety, a personality disorder, or issues with substance abuse. Body dysmorphic disorder is not an eating disorder, though both conditions exhibit similarly severe and abnormal body image concerns and self-esteem issues. Men and women are equally affected by this disorder.
Cognitive-behavioral therapy and antidepressant medication—particularly selective serotonin reuptake inhibitors, or SSRIs—are the primary treatments used to relieve symptoms of body dysmorphic disorder. Often, both therapies are employed in combination. The goal of treatment is to reduce or eliminate obsessive and compulsive behaviors, to foster recognition of triggers, and to improve management of the stress associated with the behavior. In addition, a major goal of therapy is to help patients learn to view themselves in a non-judgmental fashion. To control symptoms and prevent relapse, treatment may continue for years.