Overview

Body dysmorphic disorder is a mental disorder in which you can't stop thinking about one or more perceived defects or flaws in your appearance — a flaw that, to others, is either minor or not observable. But you may feel so ashamed and anxious that you may avoid many social situations.

When you have body dysmorphic disorder, you intensely obsess over your appearance and body image, repeatedly checking the mirror, grooming or seeking reassurance, sometimes for many hours each day. Your perceived flaw and the repetitive behaviors cause you significant distress, and impact your ability to function in your daily life.

You may seek out numerous cosmetic procedures to try to "fix" your perceived flaw. Afterward, you may feel a temporary satisfaction, but often the anxiety returns and you may resume searching for a way to fix your perceived flaw.

Treatment of body dysmorphic disorder may include cognitive behavioral therapy and medication.

Symptoms

Signs and symptoms of body dysmorphic disorder include:

  • Being extremely preoccupied with a perceived flaw in appearance that to others can't be seen or appears minor
  • Strong belief that you have a defect in your appearance that makes you ugly or deformed
  • Belief that others take special notice of your appearance in a negative way or mock you
  • Engaging in behaviors aimed at fixing or hiding the perceived flaw that are difficult to resist or control, such as frequently checking the mirror, grooming or skin picking
  • Attempting to hide perceived flaws with styling, makeup or clothes
  • Constantly comparing your appearance with others
  • Always seeking reassurance about your appearance from others
  • Having perfectionist tendencies
  • Seeking frequent cosmetic procedures with little satisfaction
  • Avoiding social situations
  • Being so preoccupied with appearance that it causes major distress or problems in your social life, work, school or other areas of functioning

You may obsess over one or more parts of your body. The feature that you focus on may change over time. The most common features people obsess about include:

  • Face, such as nose, complexion, wrinkles, acne and other blemishes
  • Hair, such as appearance, thinning and baldness
  • Skin and vein appearance
  • Breast size
  • Muscle size and tone
  • Genitalia

Insight about body dysmorphic disorder varies. You may recognize that your beliefs about your perceived flaws may not be true, or think that they probably are true, or be absolutely convinced that they're true.

Body dysmorphic disorder typically starts in the early teenage years and it affects both males and females. An obsession that body build is too small or not muscular enough (muscle dysmorphia) occurs almost exclusively in males.

When to see a doctor

Shame and embarrassment about your appearance may keep you from seeking treatment for body dysmorphic disorder. But if you have any signs or symptoms, see your health care provider or a mental health professional.

Body dysmorphic disorder usually doesn't get better on its own, and if untreated, it may get worse over time, leading to severe depression, anxiety and extensive medical bills, and may lead to suicidal thoughts and behavior.

Causes

It's not known specifically what causes body dysmorphic disorder. Like many other mental illnesses, body dysmorphic disorder may result from a combination of causes, such as:

  • Brain differences. Abnormalities in brain structure or neurochemistry may play a role in causing body dysmorphic disorder.
  • Genes. Some studies show that body dysmorphic disorder is more common in people whose blood relatives also have this condition or obsessive-compulsive disorder.
  • Environment. Your environment, life experiences and culture may contribute to body dysmorphic disorder, especially if they involve negative social evaluations about your body or self-image, or even childhood neglect or abuse.

Risk factors

Certain factors seem to increase the risk of developing or triggering body dysmorphic disorder, including:

  • Having blood relatives with body dysmorphic disorder or obsessive-compulsive disorder
  • Negative life experiences, such as childhood teasing and trauma
  • Certain personality traits, such as perfectionism
  • Societal pressure or expectations of beauty
  • Having another psychiatric disorder, such as anxiety or depression

Complications

Complications that may be caused by or associated with body dysmorphic disorder include, for example:

  • Major depression or other mood disorders
  • Suicidal thoughts or behavior
  • Anxiety disorders
  • Health problems from behaviors such as skin picking
  • Obsessive-compulsive disorder
  • Eating disorders
  • Substance abuse

Prevention

There's no known way to prevent body dysmorphic disorder. However, because body dysmorphic disorder often starts in the early teenage years, identifying the disorder early and starting treatment may be of some benefit.

Long-term maintenance treatment also may help prevent a relapse of body dysmorphic disorder symptoms.