Body Dysmorphic Disorder or BDD is characterized by a person’s perception that they are flawed in their physical appearance. They may believe that they look ugly, are unattractive, abnormal or deformed. Their perceptions are not supported by others or only supported in the average range as slight.

The person suffering BDD can experience distress ranging from mild to severe. From looking unattractive to ugly to a sense that they are look awful or hideous. The focus of concern with appearance can be anywhere on the body but is often focused on the skin including acne, wrinkles, lines, scars or paleness.

The focus can also be on the hair or nose with concerns of thinning hair or excessive facial hair or concerns with the shape and/or size of their nose. Other concerns include perception of asymmetry of body areas, concerns about their eyes, teeth, weight, stomach, chest, breast, legs, face size or shape, lips, chin, eyebrows or genitals. The person experiencing BDD finds their preoccupations intrusive, unwanted and can consume from 3-8 hours of their time per day. The sufferer finds the symptoms difficult to control or manage successfully.

There are many ways in which the individual tries to manage the anxiety produced by their BDD. Rituals are a primary focus and can include both excessive and repetitive behaviors and mental acts. These acts in and of themselves can create anxiety and sadness.

The rituals can include:

  • Comparing one’s appearance with the appearance of others.
  • Repeatedly checking perceived defects in mirrors or reflective surfaces or examining them directly.
  • Examining perceived defect directly.
  • Excessively grooming, shaving, combing, plucking, styling, pulling out of place or unwanted hair, repeated cutting of hair to achieve symmetry.
  • Camouflaging with makeup, or using hats, scarfs or other clothing for the purpose or hiding the perceived defect.
  • Reassurance seeking about how the perceived flaw looks.
  • Touching areas to check.
  • Excessive exercise or body building.
  • Tanning to “fix” perception of pale skin.
  • Seeking repeated cosmetic procedures.
  • Possible compulsive shopping for cosmetics.
  • Skin picking in order to smooth out perceived flaw.

While we all may find ourselves on this list to one degree or another a person suffering BDD will be affected in such a way as to cause noticeable and painful impairment in social, occupational or other important life attachments.

Muscle Dysmorphia is a form of BDD that is generally seen in males in which the individual suffers a preoccupation with the idea that one’s body is too small or not lean or muscular enough. This condition is often characterized by excessive weight lifting, excessive dieting or potentially dangerous anabolic-androgenic steroids and other substance use to make their body bigger and more muscular.

Prevalence 2.5% in women and 2.2% men

Onset most common age 12-13, mean 16-17, median 15.

Low insight is not uncommon and suicide rates for attempts and suicide are high in adults/children and adolescents. Consult an expert if you or someone you know or care about fits the above symptom profile.

Some of the areas that we work in include Philadelphia, the Main Line, Montgomery County, as well as the surrounding areas.