MENTAL HEALTH

Body Dysmorphic Disorder: What to know about this mental health condition

Actress Megan Fox recently shared in an interview with Sports Illustrated that she has body dysmorphia. In the video interview, Fox said, “I never see myself the way other people see me.” There has never been a moment in my life where I have loved my body.

Fox is not alone in her struggle. Many other celebrities have spoken out about having her condition, including singer Billie Eilish and actor Robert Pattinson. It is also estimated that around 2% of the population suffers from the condition.

Although body dysmorphia has been discussed more in recent years, many people confuse the condition with body image anxieties. The term body dysmorphic disorder is also outdated, with psychiatrists preferring the term body dysmorphic disorder or BDD.


Quarter life, a series of The Conversation

This article is part of Quarter Life, a series about the issues that affect those of us in our twenties and thirties. From the challenges of starting a career and taking care of our mental health to the excitement of starting a family, adopting a pet or just making friends as adults. Articles in this series explore questions and provide answers as we navigate this turbulent time in life.

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BDD is a serious mental health condition that causes extreme distress and interferes with a person’s ability to function on a daily basis. It also has one of the highest suicide rates of all mental health conditions, which is why it’s so important to raise awareness about what the condition is.

What is body dysmorphic disorder?

BDD is defined as a preoccupation or obsession with some aspect of that person’s body or appearance that feels grossly flawed when in fact no such flaw is apparent to others.

Many people are dissatisfied with some aspect of their appearance, but people with BDD are consumed for several hours a day by intrusive thoughts and feelings about their perceived flaws.

These perceived flaws cause extreme emotional distress and significant problems in daily life. People with BDD are overly self-aware, often believing that other people are noticing, judging, or talking about their perceived flaw. This can cause them to avoid intimate relationships and social situations, including work and school. Some may avoid leaving the house altogether.

People with BDD may also experience extreme feelings of disgust, anxiety, and low self-esteem, as well as suicidal thoughts because their perceived flaws are so upsetting. Excessive repetitive behaviors such as staring in the mirror, excessive grooming, skin picking, or seeking reassurance from others are also common in people with BDD.

While the skin, nose, teeth, and eyes are among the most common fixations for people with BDD, concerns about body weight or muscle size can also be concerns. It is also common for people with BDD to be concerned about multiple parts of their body.

The disorder tends to start in adolescence, but the causes of the condition are not fully understood. Childhood trauma, appearance-related bullying, genetics, and chemical imbalances in the brain have all been suggested as potential causes.

A woman looks at her reflection in a window.
People with BDD can often check their faults in mirrors during the day.
Paul Rushton/Shutterstock

While BDD is as common in men as it is in women, men may be more likely to develop muscle dysmorphia, a belief that their body is too small or not muscular enough. Men are also more likely to worry about their genitals than women.

Although BDD affects about 2% of people, the true prevalence is likely to be higher in reality. This is because people with BDD are often afraid to share their symptoms with healthcare professionals out of shame or fear of not being understood.

Get help

Many of us feel insecure about some aspect of our appearance. But for most of us, this doesn’t cause extreme discomfort or get in the way of daily life. You might consider talking to someone about BDD if you feel you:

  • Spend at least an hour a day thinking about perceived appearance defects
  • find that your worries about perceived flaws are interfering with your daily function
  • experience significant emotional distress as a result of these concerns.

It is important to know that help is available. If you’re not sure where to start, the best first step is to talk to your GP or mental health professional. They will ask you questions about your symptoms, how they affect your life and if you have any thoughts about harming yourself. There are also online mental health tools if you feel nervous about talking to someone in person.

Depending on the severity of your symptoms, you may be offered cognitive behavioral therapy (CBT), which involves working with therapists to help change intrusive thoughts about appearance and to eliminate problematic behaviors, such as looking in the mirror.

For more severe symptoms, medications such as fluoxetine may be offered, which will help reduce cognitive distortions, depression, and anxiety, making it easier to function in daily life. Both CBT and medications are effective for managing and reducing symptoms of BDD.

While many people with BDD undergo cosmetic surgery procedures to correct perceived flaws, this rarely manages the condition. Even if a person later feels better about that part of the body, he or she may still develop concerns about other parts of the body.

Having BDD doesn’t mean you’re vain or self-obsessed, and it’s not something you should be ashamed of. Body dysmorphic disorder is unlikely to go away without treatment, which is why it’s important to get help if you’re struggling.


If you are experiencing symptoms of body dysmorphic disorder or know someone who is, more information about symptoms and treatments is available through the National Health Service and the Body Dysmorphic Disorder Foundation.

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