Written by DiveThru Team
Reviewed by Hannah Fuhlendorf M.A, LPC
What's Body Dysmorphia? Signs, Symptoms and How To Treat It
Published Feb 2nd, 2022 & updated on Feb 7th, 2022
Body dysmorphia is one of those mental health disorders that can reeeeally trip you up. Your friends and family see your regular ol’ self, but you see a whole bunch of flaws that either aren’t there or are super minor. Those flaws feel extra noticeable—a huge problem that you need to change. It’s like your own personal Regina George inside your head, telling you awful things about yourself all the damn time. Greeeat.
Body dysmorphia can make even just seeing a picture of yourself a massive challenge. We want you to be able to be comfortable in your body and comfortable with looking at yourself! So strap in for a big dose of psychoeducation as we DiveThru body dysmorphia, its causes, the symptoms, and how it’s treated.
What Is Body Dysmorphia?
Alright, let’s get technical!
Body dysmorphia, or Body Dysmorphic Disorder (BDD), is defined in the DSM-V (the diagnostic tool for mental health professionals) as “preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.” It can relate to anywhere on your body, including your face.
Everyone feels insecure about their appearance from time to time. We know that icky feeling when you try your best to hide a massive zit that you’re convinced everyone else is staring at, even though they’re defs more concerned about their own stuff. But when your fixation on your flaws and appearance starts to dominate your thoughts to the point of interfering with your life, you maaay want to reach out for help.
What Causes Body Dysmorphic Disorder?
The causes of body dysmorphia are unknown, but there are some factors that can contribute.
Abuse and bullying can lead to the disorder, particularly if it’s related to one’s physical features. Low self-esteem is also a factor, as someone might excessively focus on “fixing” their appearance as a way to become confident. Fear of loneliness or isolation can contribute, especially if you think you need to look a certain way to be accepted by a partner, your friends, or society as a whole. Face filters give people unrealistic expectations of beauty. Perfectionism plays a part, too, as the desire to look “perfect” can lead to seriously damaging attitudes and beliefs about yourself.
There’s also a familial link—a person whose family struggles with BDD or disordered eating is more likely to also struggle with BDD, though there’s some debate on whether that link is learned or genetic. As well, if you struggle with depression, anxiety, or OCD, you’re more likely to have BDD, though it’s not clear whether or not these mental health conditions cause BDD or simply coincide.
Body Dysmorphia and Eating Disorders
Body dysmorphia is usually associated with eating disorders and disordered eating (yep, two different definitions), and they often co-occur, though having one does not necessarily mean you have the other. Someone who is dealing with an eating disorder may perceive themselves as looking much thinner or fatter than they actually are due to BDD, therefore continuing to struggle with the disordered eating behaviour in an effort to become more in alignment with their definition of what’s attractive.
But, as we’ll learn later in the article, body dysmorphia doesn’t go away when a certain look is achieved—it takes mental health help and a change in thought patterns and behaviours to truly deal with body dysmorphia.
If you’re looking for more info on eating disorders, disordered eating, and the many complex factors and causes, Hannah Fuhlendorf goes into more detail about all of this in her course “Disordered Eating: What Is It and How Does It Show Up?” in the DiveThru app. Suuuuper informative and super eye-opening!
Even though BDD and disordered eating/ eating disorders can be linked, body dysmorphia can also apply to things that have little or nothing to do with weight, like someone’s facial features, hair, nails, or any other physical feature.
Just to clear things up: facial dysmorphia is the same thing as body dysmorphia. Some experts believe having separate terms only creates unnecessary confusion, and possibly even delays treatment. Like we said above, body dysmorphia includes every part of your body, and your face is on your body. Ergo, BDD includes face. Make sense? Good.
The term facial dysmorphia refers to someone viewing their facial features as noticeably flawed or unattractive, to the point of it distressing them and affecting their everyday life. So if you’re feeling extremely insecure about your face, refuse to Zoom call with the camera on, or avoid looking in the mirror because it amps up your anxiety, you may want to talk to a mental health professional about BDD.
The Adonis Complex and Muscle Dysmorphia
This is when a man believes he doesn’t have enough muscle on his body. He sees himself as weak or small, regardless of his actual size and muscle mass. The godly term comes from a book of the same name, written at Harvard in 2000. Men face societal pressure to reduce fat and build muscle in order to be perceived as attractive and healthy. This is also known as muscle dysmorphia. Just like facial dysmorphia, it’s already part of Body Dysmorphic Disorder.
Muscle dysmorphia can lead to steroid use, excessive exercising, and disordered eating and eating disorders to try to build muscle and lose fat. Competitive athletes, bodybuilders, and people who lift weights are at higher risk of developing muscle dysmorphia.
Look at all the viral Marvel superhero body transformations (think Kumail Nanjiani). It’s not just movie stars—everyday men are often praised for their “gains” and “cuts.” It’s pretty easy to see how the Adonis Complex can become an issue.
The Adonis Complex is only recently being recognized as a serious and pressing problem. DiveThru therapist Hannah Fuhlendorf believes that it may be added to the next DSM under Body Dysmorphic Disorder.
Symptoms of Body Dysmorphic Disorder
Not sure if it’s Body Dysmorphic Disorder or regular ol’ insecurity? Here are some symptoms of body dysmorphia:
- Preoccupation with a perceived flaw that others don’t notice or see as minor
- Belief you are ugly or deformed
- Belief that others mock or make fun of you for your looks
- Frequently doing things to fix or address the flaw, like excessive grooming or fixing yourself in a mirror
- Trying to hide perceived flaws with clothes or makeup
- Constantly comparing how you look to other people
- Frequently looking for reassurance about your appearance from other people
- Getting cosmetic procedures, with very little satisfaction
- Avoiding social situations
You’ve likely seen some version of these behaviours in people you know. Almost everyone has a friend who runs from the camera because they say they don’t look good. You might even see some of the behaviours in yourself!
Insecurity about your physical appearance is totally normal—even though we want you to be your most body-loving self possible! It goes from regular insecurity to mental health disorder when it causes you serious distress and disrupts everyday life.
We’re here to educate, not diagnose! If you think you, or someone close to you, may be struggling with BDD based on the stuff we’ve told you so far, seeking advice from a mental health professional would be a good next step.
If you were to reach out for help, what would treatment look like for BDD??
Treatment for Body Dysmorphic Disorder
Currently, the main treatment is Cognitive Behavioural Therapy, or CBT. The idea is to change your thought patterns and behaviours around something. So if you hate the way you look, CBT can help reframe the way you think about yourself and how you behave with regards to your looks.
CBT for body dysmorphia can sometimes include Exposure and Response Prevention (ERP). It’s safe and monitored exposure to whatever is causing stress or anxiety. Patients learn coping skills and how to prevent unwanted behaviours in the face of their fears. If you feel uncomfortable looking in a mirror, your therapist may get you to do just that in short, controlled bursts. And don’t worry, exposure therapy is definitely something that would be talked about beforehand.
Medication can help with the symptoms of BDD. Selective serotonin reuptake inhibitors (SSRIs) may be prescribed, as it’s thought that BDD is related to serotonin levels in your brain. This, along with CBT, can help you make great progress over time!
If someone is a danger to themselves, or can’t function in their everyday life because of BDD, they may need inpatient treatment. Don’t worry—the medical staff are there to help people go through whatever they’re feeling. We all need a little extra help sometimes. Reaching out can be the first step towards accepting yourself, and leading a more self-loving life.
There is no cure for Body Dysmorphic Disorder, but that DOES NOT mean that the symptoms can’t be reduced or improved. You deserve to live a happy, fulfilled, and confident life. With help from a mental health professional, medication (if recommended and prescribed), time, effort, and some positive affirmations, you can get that much closer to self-acceptance. You’re worth it!