Body dysmorphic disorder (BDD)

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This page was clinically reviewed by Dr Anne Perry (MBBS, MRCPsych), Consultant Psychiatrist at Priory Hospital Ticehurst House, in January 2022.

Body dysmorphic disorder (BDD) is a common anxiety disorder that causes you to become particularly self-conscious and believe you have a problem with the appearance of a specific feature of your body. You may become preoccupied with this perceived issue and struggle to think about anything else on a daily basis. Obsessive worries and compulsive behaviours are at the core of the mental health condition.

These obsessions and behaviours can cause significant emotional distress, and impact on your ability to function and focus on other tasks either at home or at work. BDD is closely related to obsessive-compulsive disorder (OCD) in its link between intrusive thoughts and behaviours.

If you believe you may have BDD or have recently been diagnosed, Priory has the UK’s largest network of mental healthcare hospitals and wellbeing centres, which allows for flexible outpatient and inpatient treatment programmes for BDD. We use a combination of talking therapies and medication, depending on the severity of your condition, which can help you reduce your symptoms and work towards freeing your mind of obsessions.

What is BDD?

BDD is sometimes portrayed as the ‘imagined ugliness’ disorder, although this label only highlights how other people without the condition interpret BDD. If you're living with BDD, even a slight imperfection in your physical appearance can occupy your mind in the form of obsessions and unwanted intrusive thoughts, for hours each day.

While everyone feels unhappy about their appearance from time to time, these concerns are often considered small and may be forgotten in time. If you have BDD, you may spend a lot of time in front of a mirror, trying to conceal what you believe is a defect, regularly compare yourself with others, and even avoid going to locations where social interaction is likely, due to the stress and anxiety it causes.

Obsessive thoughts can lead to compulsive behaviours such as repeatedly checking how you look in the mirror, requesting reassurance about how you look and repeatedly grooming your hair or adjusting your make-up. These behaviours are usually focused on the head and face, although any body part can be involved if you have BDD.

The disorder affects people of any age and gender, although it's more common in teenagers and young adults, primarily due to bodily changes during this time and a feeling of ‘growing into’ your body. This can lead you to focus more on your appearance than usual, especially when coupled with the rising use of social media and images of the ‘perfect’ body image portrayed in the media.

BDD is believed to affect about 1 in 50 people, or around 1.7% to 2.4% of the general population. However, due to many people being reluctant to seek help for the disorder, the actual number of people with the condition may be higher. If you have BDD, it can be difficult to focus on everyday life, including completing tasks at work or school, while relationship problems in older people with the condition are also common due to the preoccupation with appearance and self-consciousness in many social situations.

It can be especially difficult to help someone you know experiencing symptoms of BDD as it's a condition that many want to keep from others to avoid feeling embarrassed or believing they'll experience negative feedback when seeking support. It's important to remember that with a treatment programme delivered by experienced therapists and consultants at Priory, you can reduce the severity of symptoms and ultimately improve quality of life.

Causes of BDD

While there's no definitive cause for BBD, it's thought that both psychological and biological factors may play a part in how likely you are to develop the disorder. BDD may have a genetic influence, and it usually develops in the teens, a time when young people are generally most sensitive about their appearance and going through a series of bodily changes.

Abuse, bullying and low self-esteem

If you developed BDD in your teenage years or early twenties, it may have been partially due to negative experiences at school or college, like being teased or bullied for your weight or physical appearance. This can cause low self-esteem, and make you judge yourself on your appearance and overanalyse what other people would perceive as minor skin blemishes or slight imperfections.

Associated anxiety disorders

The chances of developing BDD are believed to increase if you have associated anxiety disorders, including social anxiety disorder (social phobia) or OCD. Some studies also indicate that people who attend certain healthcare settings, including plastic surgery and cosmetic environments, are more likely than the general population to be affected.


There's some evidence to suggest that if your immediate family members have been diagnosed with BDD, there's an increased chance that you'll develop the condition too. However, it's currently unclear whether this is due to inherited traits which make you more conscious of your appearance, or that it's picked up from repeated behaviours you observe in your parents, such as excessive mirror checking or going to great lengths to cover up perceived flaws.

Signs and symptoms of BDD

If you have BDD, you may spend several hours each day thinking about your appearance and what you believe is wrong with it. You'll often feel distressed and very self-conscious, and may have a picture in your mind of the impression that you think other people are seeing, although in reality it's highly unlikely anyone will perceive you in this way.

The exact symptoms of BDD can vary from person to person, although the obsessive thoughts you have about a minor or imagined flaw in your body, will often result in compulsive behaviours in an attempt to conceal or remove the imperfection. In extreme cases, this can lead people with BDD to pursue plastic surgery, although this is unlikely to be an effective treatment and isn't recommended.

The common signs of someone with BDD include:

  • Asking for constant reassurance about your image
  • Repeatedly checking your appearance in front of mirrors
  • Picking at your skin to make it smooth
  • Cutting or styling your hair or adjusting make-up until it's perfect
  • Weighing yourself frequently
  • Making constant comparisons with other people or models in magazines
  • Exercising excessively to try and change the problem area

Many of these symptoms are dependent on the area of the body that you perceive to have a flaw. While the face and skin are the most common areas leading to obsessive thoughts about bodily imperfections in BDD, you may have a fixation on weight, muscle mass definition or the size and shape of certain body parts.

If you have BDD, common body parts that can cause distress include:

  • Skin complaints, including acne
  • Minor scars or cuts
  • Moles and freckles
  • Size of breasts
  • Size and shape of genitalia
  • Muscle size or belief they are too small (also called muscle dysmorphia)
  • Size, shape or symmetry of the face or other body parts

Being diagnosed with BDD can be very distressing and have a serious impact on your ability to function in daily life, making it difficult to go out in public and be near other people. The severity of your symptoms may change from day-to-day. You might feel as though your obsessive thoughts have calmed down on one day, and become extreme and debilitating the next.

The difficulties associated with BDD can also cause other mental health issues. These can include feelings of loneliness, depression, anxiety, self-harm, suicidal thoughts, misuse of alcohol or drugs, and eating disorders. All of these concerns can be treated at your nearest Priory wellbeing centre or hospital.

Seven tips for dealing with the initial stages of BDD

  • Understand and admit that you have a problem - this is a crucial first step towards beating BDD
  • Accept that your behaviours are damaging your self-confidence which will have a knock-on effect on your relationships
  • Accept help from family, friends and professionals who only want the best for you
  • Surround yourself with positive influences and remove any negativity, as well as any temptations to relapse
  • Make a step-by-step plan for tackling your condition with a health professional
  • Be honest with yourself and with family and friends about your condition, and avoid cosmetic surgery
  • Don’t put pressure on yourself to be perfect - everyone is different in a variety of ways

For more information, resources and support when it comes to living with BDD, you can also visit the BDD Foundation website.

Body dysmorphic disorder (BDD) treatment near me

We have BDD treatment centres located throughout the country, meaning that you can access the support you need in a location that’s convenient for you. To find your nearest BDD treatment centre, please use the search form below.

Contact us to make an enquiry or for more information

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