Body Dysmorphic Disorder: Condition & Treatment

Author: Elizabeth Milburn, CRNP

What is Body Dysmorphic Disorder?

Most people occasionally feel dissatisfied with parts of their appearance. Body dysmorphic disorder (BDD), however, is a psychiatric condition characterized by an intense and persistent preoccupation with perceived flaws in one’s appearance. These concerns go far beyond typical body image dissatisfaction and can consume significant time and emotional energy.

Body dysmorphic disorder is closely related to obsessive-compulsive disorder (OCD). Individuals may experience intrusive thoughts about their appearance and feel compelled to perform repetitive behaviors or mental rituals in response to these concerns.

Individuals with body dysmorphic disorder experience intrusive thoughts about perceived flaws in their appearance. These perceived defects are often minor or not noticeable to others, yet they can feel extremely distressing to the individual experiencing them.

People with BDD frequently engage in repetitive behaviors or mental rituals related to their concerns. These may include mirror checking, excessive grooming, seeking reassurance, comparing their appearance to others, or avoiding social situations. These patterns can occupy several hours each day and significantly interfere with work, relationships, and daily functioning.

Insight into these beliefs can vary. Some individuals recognize that their concerns about appearance may be exaggerated, while others feel completely convinced that their perceived flaws are real or noticeable to others.

Elizabeth Milburn, CRNP treats students & adults (18+) w/ Body Dysmorphic Disorder (BDD).

Examples of Body Dysmorphic Disorder Symptoms

Example 1: A patient becomes intensely focused on the belief that a dermatological procedure left visible scars on their face. Although others do not see any scarring, the patient feels certain the marks are obvious and unattractive.

They repeatedly check mirrors or their phone camera throughout the day and experience severe anxiety in social situations, fearing that others are staring at their perceived flaw. This distress can become so overwhelming that the individual occasionally avoids work or social interaction.

Example 2: Another patient believes their thighs are unusually large or deformed, even though others perceive them as typical. Before leaving the house, the individual spends hours trying on clothing combinations in an attempt to hide the perceived flaw.

They frequently check their appearance in mirrors, send photos to friends for reassurance, and ask others for repeated opinions about how their body looks. In some cases the anxiety becomes so intense that the person cancels plans or avoids situations where their body may be visible.

While out with friends, the individual may continue checking their body in mirrors or reflective surfaces. They may also avoid activities such as swimming or exercise because these situations feel too exposing or distressing.

Who Gets Body Dysmorphic Disorder (BDD)?

Body dysmorphic disorder affects both men and women and often begins during adolescence. Research estimates that approximately 2–3 percent of people in the United States may experience BDD.

Symptoms frequently begin before age 18, and individuals with a family history of obsessive-compulsive disorder or related conditions may have a higher risk of developing body dysmorphic disorder.

Why Treat Body Dysmorphic Disorder (BDD)?

Body dysmorphic disorder can significantly interfere with daily life. Individuals may avoid social situations, struggle academically or professionally, or withdraw from activities they previously enjoyed. In severe cases, people may become increasingly isolated or unable to leave their home.

Research also shows that individuals with BDD experience higher rates of depression, anxiety, and suicidal thoughts compared to the general population. Seeking appropriate body dysmorphic disorder treatment can help reduce symptoms and restore functioning.

Body Dysmorphic Disorder Treatments

Several evidence-based body dysmorphic disorder treatments are available. Medication management is often similar to treatment approaches used for obsessive-compulsive disorder.

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed and may help reduce obsessive thoughts and compulsive behaviors related to appearance concerns. In some cases, additional medications may be recommended depending on the severity of symptoms, level of insight, or the presence of co-occurring depression or anxiety disorders.

Effective body dysmorphic disorder treatments typically combine medication with psychotherapy. Cognitive behavioral therapy (CBT) is widely considered the most effective therapeutic approach for BDD.

Treatment may include:

• Identifying and challenging distorted thoughts about appearance
• Learning healthier ways to interpret and respond to appearance-related triggers
• Reducing repetitive behaviors such as mirror checking or reassurance seeking
• Gradual exposure to feared situations while resisting compulsive behaviors

Additional techniques such as psychoeducation, motivational interviewing, and perceptual retraining may also be incorporated depending on the individual’s needs.

If you or someone you care about may be experiencing symptoms of body dysmorphic disorder, professional evaluation can help clarify the diagnosis and identify appropriate treatment options.

Rittenhouse Psychiatric Associates offers comprehensive evaluation and body dysmorphic disorder treatment for adults through individualized medication management and coordinated care. Contact our office to schedule an appointment.