As something of a latecomer to the Diagnostic and Statistical Manual of psychiatric disorders, Body Dysmorphic Disorder  (BDD) is not as well understood as it should be. Sufferers become obsessed with one or more perceived body flaws.

This obsession can become so strong that it interferes with regular daily life, and very often co-occurs with depression, anxiety, eating disorders, self-harm, substance abuse or social withdrawal.

In our modern world, where people are fed a steady diet of makeover reality shows and magazines that idealise youth and beauty, it’s understandable that people should be a little self-conscious about features or body parts that they wish they could improve on. After all, the cosmetic surgery industry would not exist without our desire to tweak and adjust our physical appearance.

Body Dysmorphic Disorder sufferers, however, take this to extremes. The defect is assumed to be a huge disfigurement, causing sufferers to hide away indoors for years, consider wasting life savings on dangerous surgeries or even suicide. Usually, just one body part is focused on, very often the skin, hair or face, and the rest of the body is ignored or not a primary focus. While BDD has some similarities with anorexia nervosa, the obsession is not on weight specifically.

At the core, people with BDD believe that they are deeply hideous and naturally, this makes employment or romantic relationships extremely difficult. Because those with BDD bear such intense shame, they seldom seek out help, and this can sometimes look like social phobia or depression.

Help for Body Dysmorphic Disorder

Part of the delusion for those with BDD is that the only way they can be whole and normal is to “fix” the flaw. Of course, since the problem is never the flaw in question, attempts to fix it are never successful. People can argue all they want – the BDD person will never agree that they are not hideous monsters. And sadly, repeated cosmetic surgery can leave sufferers financially compromised and with
an even deeper belief that their flaw cannot be fixed.

BDD is a complex problem, but there is help available. Cognitive Behaviour Therapy in particular can help combat harmful thoughts and the stream of emotions that follow. In some cases, BDD results in part from childhood abuse, bullying and exposure to environments that promote toxic beliefs about appearance.

Treatment then focuses on developing and strengthening the sense of self, learning to moderate negative self-talk and ways to manage and cope with strong emotions. Certain medications can also help with the more obsessive and compulsive aspect of the disorder. A psychiatrist can prescribe this medication if necessary.

If you know someone who you suspect suffers from this disorder, remember that shame is the underlying emotion, and that it is useless to try and debate the truth of their beliefs. Instead, lovingly encourage them to seek help and where you can, try to emphasise your understanding and acceptance of them, regardless of their appearance.

Do you know someone who is suffering from dysmorphia? Australia Counselling can help you. Click here to look for a specialist that you can speak with.

photo credit: lined up (license)


  1. I have suffered from this since adolescence and it is terrible! There are times when I have said I would rather swap a limb for the Illness because at least then I could live a life where there isn’t constant worrying and shame with looking abnormal.

    I am a nursing student and completing my mental health subject. I have noticed an area in the literature that could be helpful in researching to understand how to assess people with BDD.

    Through my own experience and times of deterioration I have been assessed as having a good appearance so therefore I must be functioning for a Mental state examination. This is certainly is not the case in my experience with this illness. I will actually look more well presented in my appearance when I am more unwell due to wanting to look as normal as I can and cover up any flaws. I’m starting to wonder if this is the case with others who have this and whether the MSE may be affected by being inaccurate to around this.

    Just a point I thought would be insightful and maybe to consider when accessing those with this disorder.

    Kind regards


  2. I’m a 29 year old male and this Disorder is ruining my life. I’m exhausted from trying to look ok and nothing I do ever seems to make it better. In fact things are getting a lot worse

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