Body Dysmorphic Disorder: Symptoms, Causes, and How It Is Treated
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Body dysmorphic disorder (BDD) is a mental health condition in which a person cannot stop thinking about one or more perceived flaws in their appearance. The flaw appears minor or invisible to others, yet it causes intense shame, anxiety, and social withdrawal. Treatment with cognitive behavioral therapy and medication can help people regain their daily lives.
Quick Answer
Body dysmorphic disorder is a mental health condition in which a person obsessively focuses on a perceived appearance flaw that seems minor or invisible to others, causing major distress. It is treated with cognitive behavioral therapy (CBT) and medications such as SSRIs. Seek help if appearance worries cause suicidal thoughts; in the U.S., call or text 988.
What the research says
Both medication and CBT show large effects. A systematic review and meta-analysis of 46 studies (2,227 participants) found that antidepressants, especially SSRIs, substantially reduced depressive symptoms in people with BDD (pooled standardized mean difference -0.96, with SSRIs at -1.16), and CBT showed comparable effects (-1.12, or -0.65 after bias correction). The authors noted that most studies were small and varied in design, and that combined approaches may give the best outcomes (Loewen et al., Curr Psychiatry Rep, 2026) [3].
Perfectionism travels with BDD. A meta-analysis of 34 studies (13,107 participants) found a moderate, significant correlation between BDD symptoms and perfectionism (r = 0.32, 95% CI 0.28 to 0.36), stable across age groups and genders. Part of the link may be explained by shared depressive symptoms, and heterogeneity was high (Stranz et al., BMC Psychiatry, 2026) [4].
Shame and low self-esteem are common. A systematic review of 26 studies (1,382 people with BDD) found that people with BDD report low self-esteem, high shame, rejection sensitivity, and social inhibition, and that avoidant personality disorder was the most common co-occurring personality disorder. Such overlap can contribute to misdiagnosis (Jenkins et al., J Psychiatr Res, 2026) [5].
How was this body dysmorphic disorder guide put together?
Our body dysmorphic disorder guide explains what the condition is, how it shows up, what raises the risk and how it is diagnosed and treated. The facts below are drawn from established clinical reference material and peer-reviewed research, with sources cited at the end of the article.
This article is educational and is not a substitute for professional medical advice, diagnosis, or treatment. If any of this describes you or someone you care about, please talk with a health care provider.
At a Glance: Body Dysmorphic Disorder in Numbers and Facts
Aspect | What the evidence shows |
Core problem | Obsessive focus on a perceived appearance flaw that appears minor or invisible to others |
Typical onset | Early teenage years, affecting both males and females |
Time spent on the flaw | Thoughts and behaviors can consume many hours each day |
Main treatments | Cognitive behavioral therapy combined with medication (often an SSRI) |
FDA-approved medication | None specifically for BDD; antidepressants used for depression and OCD can be effective |
Untreated course | Usually does not improve on its own and can worsen over time |
Muscle dysmorphia | Belief the body is too small or not muscular enough; occurs almost exclusively in males |
What Is Body Dysmorphic Disorder?
Body dysmorphic disorder is a mental health condition in which a person cannot stop thinking about one or more perceived defects or flaws in their appearance. The flaw appears minor or cannot be seen by others. Even so, the person may feel so embarrassed, ashamed, and anxious that they avoid many social situations [1].
When someone has BDD, they intensely focus on their appearance and body image. This means repeatedly checking the mirror, grooming, or seeking reassurance, sometimes for many hours each day [1]. The perceived flaw and these repetitive behaviors cause significant distress and impair the ability to function in daily life.
People with BDD may also seek out numerous cosmetic procedures to try to fix the perceived flaw. Relief is usually temporary. The anxiety often returns, and the person may resume searching for other ways to fix the flaw [1]. Treatment typically includes cognitive behavioral therapy and medication, which can break this cycle.
What Are the Symptoms of Body Dysmorphic Disorder?
Signs and symptoms vary from person to person, but they generally center on intrusive appearance-focused thoughts and hard-to-control repetitive behaviors. The following table summarizes the key symptoms recognized in clinical descriptions of the condition [1].
Symptom | What it looks like |
Preoccupation with a flaw | Extreme focus on a perceived defect that others cannot see or see as minor |
Belief of being deformed | Strong belief that a defect makes you ugly or deformed |
Belief others are mocking you | Feeling that others take special negative notice of your appearance |
Hard-to-control behaviors | Frequent mirror checking, grooming, or skin picking |
Hiding the flaw | Using styling, makeup, or clothes to conceal the perceived defect |
Constant comparison | Comparing your appearance with others on an ongoing basis |
Reassurance seeking | Frequently asking others about your appearance |
Perfectionism | Perfectionist tendencies tied to appearance |
Cosmetic procedures | Seeking procedures with little satisfaction afterward |
Social avoidance | Avoiding social situations because of appearance concerns |
This preoccupation is unwanted, difficult to control, and so time-consuming that it can cause major distress or problems in social life, work, school, or other areas of functioning [1].
Which Body Parts Do People Fixate On?
People with BDD usually focus excessively on one or more parts of the body, and the area of focus can change over time. The most common areas of fixation are listed below [1].
Body area | Specific concerns |
Face | Nose, complexion, wrinkles, acne, and other blemishes |
Hair | Appearance, thinning, and baldness |
Skin | Skin and vein appearance |
Body | Breast size, muscle size and tone, genitalia |
A related preoccupation called muscle dysmorphia involves the belief that the body build is too small or not muscular enough. It occurs almost exclusively in males [1].
Insight Varies From Person to Person
Insight about BDD varies. A person may recognize that their beliefs about the perceived flaws may be excessive or not true, think they probably are true, or be absolutely convinced they are true. The more convinced the person is of their beliefs, the more distress and disruption they may experience in life [1].
What Causes Body Dysmorphic Disorder?
The specific cause of body dysmorphic disorder is not known, though family history, negative body experiences and brain chemistry may contribute. Like many other mental health conditions, it may result from a combination of factors [1]. Researchers point to three broad contributors: a family history of the disorder, negative evaluations or experiences about the body or self-image, and abnormal brain function or abnormal levels of the brain chemical serotonin [1].
Risk Factors
BDD typically starts in the early teenage years and affects both males and females [1]. Certain factors appear to increase the risk of developing or triggering the disorder.
Risk factor | Details |
Family history | Blood relatives with body dysmorphic disorder or obsessive-compulsive disorder |
Negative life experiences | Childhood teasing, neglect, or abuse |
Personality traits | Perfectionism |
Societal pressure | Pressure or expectations of beauty |
Other conditions | Having another mental health condition, such as anxiety or depression |
What Complications Can Body Dysmorphic Disorder Cause?
Untreated body dysmorphic disorder (BDD) can damage many areas of life and may lead to a range of complications. The condition may cause or be associated with the following complications [1]:
Complication | Impact |
Low self-esteem | Ongoing negative self-view |
Social isolation | Withdrawing from friends, family, and activities |
Major depression | Depression and other mood disorders |
Suicidal thoughts or behavior | A serious and common risk |
Anxiety disorders | Including social anxiety disorder |
Obsessive-compulsive disorder | Related obsessive thoughts and rituals |
Eating disorders | Disordered eating patterns |
Substance misuse | Alcohol or drug use |
Skin-picking harm | Health problems from repeated picking |
Surgical risk | Pain or disfigurement from repeated cosmetic procedures |
Can Body Dysmorphic Disorder Be Prevented?
Body dysmorphic disorder has no known method of prevention, but early treatment and long-term care may still help. Because it often starts in the early teenage years, identifying the disorder early and starting treatment may be of some benefit [1]. Long-term maintenance treatment may also help prevent a relapse of symptoms [1].
When Should You See a Doctor?
Shame and embarrassment about appearance may keep people from seeking treatment. But if any signs or symptoms are present, it is important to see a health care provider or a mental health professional [1]. BDD usually does not get better on its own. If left untreated, it may worsen over time, leading to anxiety, extensive medical bills, severe depression, and even suicidal thoughts and behavior [1].
If you are having suicidal thoughts: suicidal thoughts and behavior are common with body dysmorphic disorder. In the U.S., call 911 or your local emergency number immediately, or call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. The Lifeline Chat is also free and confidential. You can also contact your mental health professional, your primary care provider, a close friend or loved one, or a trusted leader in your faith community [1].
How Is Body Dysmorphic Disorder Diagnosed?
After a medical evaluation to rule out other conditions, a health care provider may refer the patient to a mental health professional for further evaluation [2]. Diagnosis is typically based on three components [2]:
Component | What it covers |
Psychological evaluation | Assesses risk factors and thoughts, feelings, and behaviors related to negative self-image |
Personal history | Personal, social, family, and medical history |
Signs and symptoms | The appearance-related preoccupation and repetitive behaviors described above |
How Is Body Dysmorphic Disorder Treated?
Treatment often includes a combination of cognitive behavioral therapy and medication [2]. The combination addresses both the thoughts and the behaviors that keep the disorder going.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy for BDD focuses on several goals [2]:
CBT goal | How it helps |
Understand the cycle | Learn how negative thoughts, emotional reactions, and behaviors maintain problems over time |
Challenge negative thoughts | Test automatic negative thoughts about body image and learn more flexible thinking |
Manage urges and rituals | Learn alternate ways to handle urges to reduce mirror checking, reassurance seeking, or excess use of medical services |
Rebuild social life | Address social avoidance and increase engagement with healthy supports and activities |
You and your mental health provider can set goals for therapy and develop a personalized treatment plan to learn and strengthen coping skills. Involving family members in treatment may be particularly important, especially for teenagers [2].
Medications
No medication is specifically approved by the U.S. Food and Drug Administration (FDA) to treat body dysmorphic disorder. However, medications used for other mental health conditions, such as depression and obsessive-compulsive disorder, can be effective [2].
Selective serotonin reuptake inhibitors (SSRIs) are often prescribed because BDD could be caused in part by problems related to serotonin, the brain chemical. SSRIs appear more effective for BDD than other antidepressants and may help control negative thoughts and repetitive behaviors [2]. In some cases, other medications may be added to an SSRI depending on symptoms [2].
Hospitalization
In some cases, symptoms may be severe enough to require psychiatric hospitalization. This is generally recommended only when a person cannot keep up with day-to-day responsibilities or is in immediate danger of harming themselves [2].
What lifestyle changes and home remedies help with body dysmorphic disorder?
BDD warrants treatment from a mental health professional, but several home practices build on a treatment plan [2]. Sticking to the plan matters most: do not skip therapy sessions, and continue medications even when feeling well, because stopping suddenly can cause withdrawal-like symptoms and symptom return [2].
Learning about the disorder can empower you and motivate you to stay with the plan. Working with your provider to identify warning signs and triggers, then making a plan for symptom return, helps you respond quickly if symptoms reappear [2]. Regularly practicing the skills learned in therapy at home strengthens them into habits [2].
Alcohol and recreational drugs can worsen symptoms or interact with medications, so avoiding them is important [2]. Physical activity, such as walking, jogging, swimming, or gardening, can help manage depression, stress, and anxiety. However, excessive exercise should be avoided as a way to fix a perceived flaw [2].
How can people cope with body dysmorphic disorder and find support?
Coping skills improve alongside treatment. A provider can help you identify, monitor, and change the negative thoughts and behaviors about your appearance [2].
Coping strategy | How to practice it |
Journaling | Write to better identify negative thoughts, emotions, and behaviors |
Stay connected | Join social activities; get together regularly with friends and family who offer healthy support |
Self-care | Eat well, stay physically active, and get sufficient sleep |
Support groups | Connect with others facing similar challenges |
Recovery goals | Keep recovery goals in mind; recovery is an ongoing process |
Stress management | Practice relaxation techniques such as meditation or deep breathing |
Pause big decisions | Avoid important decisions during distress or despair, when thinking may not be clear |
How should you prepare for a body dysmorphic disorder appointment?
Although you may start by talking with your health care provider, you will likely be referred to a mental health professional, such as a psychiatrist or psychologist, for further evaluation and specialized treatment [2]. Preparing in advance makes the most of the appointment time.
What You Can Do Before the Visit
Before the appointment, make a list of the following [2]:
Preparation item | What to include |
Symptoms | Any symptoms you or your family noticed, and for how long; ask family what behaviors concerned them |
Personal history | Traumatic events, current major stressors, and family mental health history including BDD and OCD |
Medical information | Other physical or mental health conditions you have been diagnosed with |
Medications | All medications plus herbs, vitamins, and supplements, with names and doses |
Questions | Questions you want to ask your provider |
Useful questions to ask include: what is most likely causing my symptoms; could behavioral therapy help; are there medications that might help; how long will treatment take; and what can I do to help myself [2].
What to Expect From Your Provider
Your provider may ask questions such as whether you are concerned about your appearance, when the worry began, how daily life is affected, and how much time each day is spent thinking about your appearance [2]. Expect questions about previous treatments, cosmetic procedures, things that make symptoms worse, family comments on mood or behavior, and family mental health history [2]. Being ready with answers helps the provider tailor the evaluation to your needs.
What is the bottom line on body dysmorphic disorder?
Body dysmorphic disorder is more than vanity or self-consciousness. It is a recognized mental health condition in which intrusive thoughts about a perceived flaw consume hours each day, drive repetitive behaviors, and steadily shrink a person's social life. The distress is real, and it deserves real treatment.
The encouraging news is that BDD responds to evidence-based care. Cognitive behavioral therapy directly targets the negative thought patterns and mirror-checking rituals that sustain the disorder, while SSRIs can calm the intrusive thoughts and compulsive behaviors from a biological angle. Most people benefit most from combining the two approaches.
The most common obstacle to recovery is shame. Feeling embarrassed about the preoccupation keeps many people from seeking help. But because the condition rarely improves on its own and can worsen over time, reaching out early matters. A single conversation with a health care provider is the starting point.
The best next step depends on your situation. If appearance thoughts occupy hours of your day, cause you to avoid people, or trigger suicidal thoughts, contact a health care or mental health professional as soon as possible. If you are in the U.S. and in crisis, call or text 988 for immediate, free, and confidential support.
Take the next step: If appearance thoughts occupy hours of your day or lead you to avoid people, book a conversation with a health care or mental health professional. If you are in the U.S. and in crisis, call or text 988.
FAQ
What is the main symptom of body dysmorphic disorder?
The main symptom is an intense, hard-to-control preoccupation with one or more perceived flaws in appearance that appear minor or cannot be seen by others. This preoccupation is unwanted, time-consuming, and causes major distress or problems in social life, work, or school.
Is body dysmorphic disorder a form of OCD?
Body dysmorphic disorder is not OCD, but the two are related. BDD belongs to the same family of obsessive-compulsive and related disorders, and it shares features such as intrusive thoughts and repetitive rituals like mirror checking. Family history of OCD also raises the risk of BDD.
Can body dysmorphic disorder be cured?
BDD is highly treatable, especially with cognitive behavioral therapy combined with SSRI medication. Because the condition rarely improves on its own and can relapse, long-term maintenance treatment may be needed to prevent symptoms from returning.
What age does body dysmorphic disorder usually start?
Body dysmorphic disorder typically starts in the early teenage years and affects both males and females. Starting treatment early, when the condition is first identified, may be of benefit.
What should I do if someone with body dysmorphic disorder is suicidal?
Take it seriously and get help immediately. In the U.S., call 911 or your local emergency number, or call or text 988 to reach the Suicide & Crisis Lifeline, which is free, confidential, and available 24/7. You can also contact the person's mental health professional, primary care provider, or a trusted loved one.
Disclaimer: This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for questions about a medical condition.
References
Mayo Clinic Staff. Body dysmorphic disorder - Symptoms and causes. Mayo Clinic. December 13, 2022. https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/symptoms-causes/syc-20353938
Mayo Clinic Staff. Body dysmorphic disorder - Diagnosis and treatment. Mayo Clinic. December 13, 2022. https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/diagnosis-treatment/drc-20353944
Loewen A, et al. Effects of Pharmacological and Psychological Treatments on Depressive Symptoms in Body Dysmorphic Disorder: A Systematic Review and Meta-Analysis. Curr Psychiatry Rep. 2026;28(1). PMID 42274855. https://doi.org/10.1007/s11920-026-01688-y
Stranz R, et al. The cross-sectional relationship between body dysmorphic disorder and perfectionism: a meta-analysis. BMC Psychiatry. 2026;26(1). PMID 42015133. https://doi.org/10.1186/s12888-026-08044-7
Jenkins ZM, et al. Personality traits and disorders in people with body dysmorphic disorder (BDD): A systematic review. J Psychiatr Res. 2026;199:358-384. PMID 42127601. https://doi.org/10.1016/j.jpsychires.2026.04.020
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