Body dysmorphic disorder (BDD)

Body dysmorphic disorder (BDD) is a condition that causes an individual to become particularly self-conscious and believe that they have a problem with the appearance of a specific feature of their body. They become preoccupied with their perceived issue and therefore, this is all that they can think about. BDD is also sometimes referred to as 'body dysmorphia'.

Another term that is used to refer to BDD is 'dysmorphophobia', whilst the media sometimes refer to the condition as 'imagined ugliness syndrome'. This term can be particularly unhelpful as sufferers really do perceive themselves to be ugly.

BDD is more common in people with a history of depression and social phobia, with mild BDD being more common in women and young teenagers. It has been suggested that up to 1% of the population is affected by BDD.

What are the causes of BDD?

From what little research there is, causes of BDD are thought to be both psychological and biological. BDD may have a genetic influence, and it usually develops in the teens – a time when people are generally most sensitive about their appearance. They may have endured negative experiences like being teased or bullied. They will have developed a low self-esteem, may fear being alone and isolated and begin judging themselves by their appearance.

BDD symptoms 

People who suffer from BDD may spend several hours each day thinking about their appearance and what they believe is wrong with it. They are very self-conscious, and may have a picture in their mind of the impression that they give which no-one else can see, and a feeling of shame that others do not experience. Common characteristics of someone with BDD include:

  • Asking for constant reassurance about their image
  • Repeatedly checking their appearance in front of mirrors
  • Picking at their skin to make it smooth
  • Cutting or styling their hair until they think that it is perfect

Many people are concerned with some aspect of their appearance. Being diagnosed with BDD can be very distressing and have a serious effect on your life. This can lead to avoidance of social and public situations and hiding the part of your body that you are not happy with. This can include wearing heavy make-up, brushing your hair in a particular way or wearing loose clothes.

With the most severe cases, BDD symptoms can affect your ability to work or study as well as impact on your social and family life. Many sufferers are single or divorced, suggesting that they find it difficult to form relationships. Some sufferers may be housebound, in hospital or in severe cases, attempt suicide. 

BDD treatment

There has been limited research on the treatment of BDD. Two BDD treatments that have been shown to work include cognitive behavioural therapy (CBT) and antidepressant medication.

Contacting your GP is often the easiest way to get help and further treatment. He or she may refer you to a specialist for further assessment. This may lead to outpatient treatment or, if your condition is more serious, day or inpatient treatment. If you're worried about talking to your GP, consider writing down your concerns and questions. You can:

  • Take a friend or family member
  • See another doctor in the practice
  • Join a new GP practice 

The type of professional support offered will depend on the services that are available in your area and the arrangements that your primary care trust (PCT) have with other health authorities or private providers. Treatment for BDD is also available privately through Priory.


CBT can help those suffering from BDD. This treatment is based on a structured programme of self-help, enabling you to change the way that you think and act. During therapy, you will learn different ways of thinking about your problem and to refocus your attention away from yourself. You would learn to confront your fears and stop your rituals, such as checking mirrors and grooming yourself more than normal.

BDD medication

Certain types of prescribed antidepressants known as selective serotonin reuptake inhibitors (SSRIs) have been shown to be helpful in the treatment of BDD.

Long-term recovery from BDD

Treatment works effectively for many sufferers. However, some sufferers may feel reasonably well for a time then go back to old behaviour, while others remain chronically ill. Although there is currently limited research on the effects of medication combined with therapy, those with more severe symptoms are more likely to recover from BDD by combining the two.

For further details on how Priory can provide you with further assistance regarding Body dysmorphic disorder (BDD), please call 0800 840 3219. For professionals looking to make a referral, please click here