Body Dysmorphic Disorder: What It Is and Do You Have It?

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Exercise can be both bad and good for those with body dysmorphic disorder. Body Dysmorphic Disorder: What It Is and Do You Have It?


For some of us, running is a competitive sport. For others, it is a way to maintain a healthy lifestyle and relieve stress. For others, it is a social activity, a positive way to connect with like-minded people. But for some, it is an obsessive extension of a mental health issue known as body dysmorphic disorder.

What is body dysmorphic disorder?

Body dysmorphic disorder (BDD) is a mental condition in which a patient obsesses over a small—either imagined or real—flaw in his/her appearance.

Of course, many of us have physical characteristics that we might want to change or improve upon, but for those suffering from BDD, the obsession with his/her appearance is all-consuming and negatively impacts daily life and in extreme cases, their ability to function.

According to the International OCD Foundation, 1.7 to 2.9%—about 1 of every 50 people—have BDD. Based on our current population, that means that anywhere from 5 to 10 million people have varying degrees of the condition.

It impacts females and males fairly equally, with 2.2% and 2.5% respectively identifying themselves as having BDD, according to 2013 statistics from the American Psychiatric Association.

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What are the symptoms of BDD?

In addition to focusing on physical flaws, those with BDD also may have low self-esteem, have problems at work or school and may avoid social settings.

They also usually have some type of obsessive-compulsive behaviors related to their appearance such as:

  • Excessively exercising
  • Excessively grooming
  • Changing clothes frequently
  • Checking themselves in the mirror frequently or avoiding mirrors
  • Hiding their bodies with clothing, hair, hats, makeup, etc.
  • Frequently comparing themselves to others’ appearances
  • Undergoing unnecessary cosmetic or dermatological treatments

Patients who suffer from BDD are often housebound and have suicide rates that are up to 45% higher than the regular population.

Those with BDD often have other disorders such as depression, obsessive-compulsive disorder (OCD), eating disorders or social anxiety disorder.

Sometimes BDD is misdiagnosed because its symptoms and the symptoms of the disorders noted above often overlap.

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What causes BDD?

Signs and symptoms of BDD usually begin to manifest themselves during the adolescent and teenage years.

There is no one definitive cause but certain biological or environmental issues may contribute to the development of BDD. These factors may include things like genetics, a chemical imbalance in the brain, personality traits and negative life occurrences such as trauma or abuse.

Although not the root cause of BDD, some researchers have suggested that social media and the proliferation of selfies are correlated to an increase in body-image issues among teenage girls. This theory was put forth in the study, “Facebook Photo Activity Associated with Body Image Disturbance in Teenage Girls,” was published in the April 2014 issue of the journal Cyberpsychology, Behavior, and Social Networking.

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Exercise and BDD

Although one of the symptoms of BDD is excessive exercise (sometimes bordering on exercise addiction), some studies have shown that being involved in athletics nurtures a more positive body image as well as increases self-esteem.

A study, “The investigation of the relationship between body dysmorphic disorder and psychological problems and comprise it among female athletes and nonathletes students” followed 60 female university students between the ages of 19 and 25. Thirty study participants were athletes and the other 30 were not.

The study authors concluded that the athletes had a higher sense of self-esteem and a more positive body image. The researchers also noted that participation in athletics can improve overall fitness, increase confidence, help individuals achieve goals, foster social interaction and encourage other healthy behaviors such as better sleep and healthy eating.

The study was published in the journal Procedia – Social and Behavioral Sciences in 2010.

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How is BDD treated?

Although very little research has been conducted on BDD, the National Institute for Health and Care Excellence (NICE) has created guidelines to improve the diagnosis and treatment of BDD.

The NICE guidelines endorse two treatment options—BDD-specific cognitive behavior treatment and serotonergic anti-depressant medication, which affects serotonin transport in the brain.

Cognitive behavior treatment (CBT) is recommended in mild cases of BDD; either cognitive behavior treatment or medication in moderate cases; and possibly a combination of CBT and medication in severe, debilitating cases.

A feasibility study is currently underway in Australia that is exploring the use of a visual training program to lessen the symptoms of BDD. Study designers note that while CBT and medication can help in the treatment of BDD because they don’t often eliminate the perception among patients that they have a physical flaw, the rate of relapse can be high.

Parameters of the protocol, “Visual training program for body dysmorphic disorder: protocol for a novel intervention pilot and feasibility trial,” are found in Pilot and Feasibility Studies. The protocol’s designers plan a three-pronged approach—basic visual processing, face and emotion recognition, and self-perception.

Although there are online screening tests for BDD (, the disorder should be diagnosed by a trained professional.

Of course, the most important thing is that the patient is willing to discuss the issue with a health care provider, even just a general practitioner at first. Then, he or she can refer to a professional trained to deal with mental health problems.

Become proactive in dealing with BDD

In addition to seeking professional help, patients can do a number of things on their own to help manage BDD symptoms. Some of these include:

  • Learn to manage stress by using relaxation techniques such as meditation and controlled breathing exercises.
  • Maintain focus on recovery goals. Keeping goals foremost in a patient’s mind can help when he/she is distracted by the symptoms of BDD.
  • Keep a journal outlining goals as well as any thoughts or emotions that are important to recovery.
  • Read and research. There are a number of reputable online resources for information as well as thoughtfully written self-help books on BDD.
  • Seek out and join a support group. There is strength in numbers and having the support and guidance of others who have BDD can help in the recovery process.
  • Don’t isolate from family or friends. Although they may not struggle with BDD themselves, they can still support a patient in his/her recovery.
  • Patients should be aware of symptoms and the emotions they trigger and avoid making important decisions if they are really struggling. Chances are they aren’t thinking clearly and may make a rush to judgment that they may soon regret.


  1. Katharine Phillips, MD, Prevalence of BDD, website
  2. Evelyn P. Meier, James Gray, Facebook Photo Activity Associated with Body Image Disturbance in Teenage Girls, online journal
  3. Abdollah Ghasemi, Zahra Pooraghaei, Maryam Momeni, Mahdi, Falahati, Elham Azimzade, The investigation of the relationship between body dysmorphic disorder and psychological problems and comprise it among female athletes and nonathlete students, online journal
  4. Francesca Beilharz, David J. Castle, Andrea Phillipou, Susan L. Rossell, Visual training program for body dysmorphic disorder: protocol for a novel intervention pilot and feasibility trial, online journal