Body dysmorphia – also known as body dysmorphic disorder (BDD) –is a behavioral health condition that causes people to obsess over perceived flaws in their physical appearance that most others do not see. A body dysmorphia test and follow-up with a health care provider can help diagnose and ultimately treat the issue.
BDD is one of a spectrum of disorders that focus on the appearance of our bodies. It is related to obsessive compulsive disorder and other syndromes such as Munchausen’s disease.
People with body dysmorphia may go to extreme lengths to avoid social interactions out of embarrassment and anxiety stemming from minor or even nonexistent physical flaws. They may think they look “ugly” or even “deformed” and can spend hours obsessing over perceived physical flaws. In people with BDD, these often include:
  • Acne or other blemishes
  • Body type (muscle tone and size)
  • Breast and buttocks size
  • Hair (and lack thereof) 
  • Scars and wrinkles
  • Size or shape of certain facial features, like the nose and ears
  • Skin

Symptoms and complications of body dysmorphia

The characteristics of someone with body dysmorphia and/or signs and symptoms of the condition can include:
  • A constant need for reassurance, i.e., repeatedly asking others if they look OK.
  • Belief that others are acutely aware of one’s appearance, specifically the perceived physical flaw.
  • Comparing oneself to others.
  • Constantly checking the mirror or avoiding it altogether. 
  • Excessive grooming.
  • Excessive exercising.
  • Trying to hide perceived flaws under layers of clothing or with makeup.
Complications either caused or associated with body dysmorphia can range in severity from low self-esteem and social isolation to major depression, mood disorders and even suicidal thoughts and behavior. Shame about one’s appearance may prevent them from seeking treatment, but any person with these symptoms should reach out to their primary care provider or a mental health professional, especially those experiencing suicidal thoughts. Thoughtful, nonjudgmental approaches from a provider to their patient can help the patient disclose their developing body dysmorphia and in turn, seek treatment.
BDD is a condition that doesn’t tend to get better on its own and can worsen over time if left untreated, leading to some of the more serious symptoms mentioned here. Additionally, people will sometimes go to extreme lengths to alleviate the discomfort they feel, even to the point of surgery, which can still fail to relieve their symptoms and anxiety.

What is the difference between body dysmorphia and an eating disorder?

A distorted body image is a hallmark of both BDD and eating disorders, but they are not necessarily one in the same. The main difference between body dysmorphia or BDD and an eating disorder is that body weight and size isn’t always the concern of a person with BDD, whereas restricted eating in a person with an eating disorder usually stems from distorted ideas surrounding the idea food consumption. These distortions may in part be related to concerns about weight or distribution of muscle mass and subcutaneous fat, but the main focus is the process of eating itself. However, it is possible to have both BDD and an eating disorder. A trained medical professional needs to determine whether BDD or an eating disorder is the more accurate diagnosis in each individual case, marking another important reason to seek treatment if you are experiencing any of the aforementioned symptoms.

Body dysmorphia test: how to get tested

Standardized assessments – including brief questionnaires– are accessible online and could be useful for self-assessment purposes. The Body Dysmorphic Disorder Foundation offers a free test developed by BDD specialists in 2012 as an initial screening to understand whether someone might have the condition.
The questionnaire can also be used to measure the severity of symptoms, so a person can use it before and after any treatment and provide feedback on whether their symptoms have improved or not.
Only a trained health professional can make a diagnosis of BDD. Though it can be helpful as a guide, never let a self-assessment serve as a diagnosis. The questionnaire assumes that you do not have a disfigurement or a defect that is easily noticeable. The judgment on how noticeable your feature(s) can be made by a health professional. 
Specific treatment for BDD will be determined by your provider based on the magnitude of the issue, age, overall health and medical history and other factors. Treatment may include therapy, medication or a combination of both.
The most effective treatment is cognitive behavioral psychotherapy, which can be augmented with medication to control some of the more troubling symptoms. Visiting a specialist in this area of treatment yields the best outcomes, but everyone is unique, and combinations of interventions can be developed to gain control of the symptoms, improving their quality of life in the process.
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Photo credit: Getty Images

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