What is body dysmorphic disorder?

Body dysmorphic disorder (BDD) involves a preoccupation with one or more perceived flaws in physical appearance that are not visible to others or appear slight. The preoccupation is intrusive, distressing, time-consuming (typically more than an hour a day), and leads to repetitive behaviours (mirror checking, seeking reassurance, excessive grooming, skin picking) or avoidance. BDD causes significant impairment in social, occupational, and daily functioning. It affects approximately 2% of the population equally across genders and is associated with high rates of depression and suicidal ideation.

How is BDD different from normal appearance concerns?

Most people have aspects of their appearance they would prefer to change. BDD is distinguished by: the preoccupation being intrusive and consuming significant mental energy; the flaw being undetectable or minimal to outside observers; the distress being disproportionate and persistent; and the behaviour patterns (checking, comparing, camouflaging, seeking reassurance) that impair functioning. People with BDD typically feel that others notice and judge their perceived flaw, and may significantly restrict activities — avoiding mirrors, public settings, or intimacy — because of it.

What treatments work for BDD?

CBT specifically adapted for BDD (CBT-BDD) is the most evidence-supported psychological treatment — involving exposure and response prevention for BDD-related checking and avoidance, perceptual retraining, and cognitive restructuring of appearance beliefs. SSRIs at appropriate doses (higher than standard depression doses) are the most evidence-supported medication option. BDD is often undertreated because people present to cosmetic surgeons rather than mental health services — cosmetic procedures almost universally fail to resolve BDD and often worsen it. Identifying and referring to appropriate specialist services is critical.

Can someone with BDD get better?

Yes — with appropriate evidence-based treatment, most people with BDD experience significant symptom reduction. However, BDD is often chronic if untreated, and the average person experiences BDD for years before receiving appropriate treatment. Misidentification as depression, OCD, social anxiety, or eating disorder can delay correct treatment. BDD has a high rate of suicidal ideation (up to 80% in clinical samples) and completed suicide — early identification and specialist referral are genuinely important. Good outcomes are achievable, particularly when evidence-based CBT-BDD is accessible.

Mental Healthelevated Risk

Body dysmorphic disorder

Body dysmorphic disorder involves intrusive preoccupation with a perceived flaw in appearance that is not visible or appears minor to others, causing significant distress and avoidance. Specialist talking therapy (partic

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Reviewed by Dr. Ava Gardner · Integrative Medicine Researcher26 March 2026Evidence varies

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Do any of these feel familiar?

Body dysmorphic disorder is experienced as a preoccupying, distressing focus on a perceived flaw in one's appearance that others typically cannot see or regard as very minor
Many people describe spending hours each day thinking about the perceived flaw, checking mirrors, seeking reassurance, or attempting to conceal the area
Despite these efforts, the distress rarely resolves
Common areas of concern include skin, hair, nose, and body weight or symmetry
Many people avoid social situations, photographs, or any circumstance in which they might be observed
The condition is poorly understood, frequently mistaken for vanity, and carries significant stigma

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