Body dysmorphic disorder (BDD)

Body dysmorphic disorder (BDD) is an anxiety disorder which is related to the way in which you view your body. BDD can incorporate obsessive worrying about parts of your physical appearance or compulsive behaviours which are used to deal with your worries.

The symptoms and severity of BDD varies from day to day and between individuals. When these obsessions and behaviours begin to have an impact on your everyday life and cause you high levels of distress, professional help can make all the difference.

Common symptoms of BDD include:

Obsessive worries:

  • feeling you are too big or small
  • believing yourself to be disfigured
  • feeling out of proportion
  • believing you lack symmetry in your body
  • comparing yourself to models

Compulsive behaviours:

  • checking yourself in mirrors or avoiding them
  • using a lot of makeup or tanning products
  • attempting to disguise your shape
  • seeking reassurance from others
  • exercising excessively
  • picking your skin
  • seeking cosmetic surgery

Body dysmorpic disorder and eating problems:

BDD and eating problems share some common symptoms, however, they are not the same thing. People experiencing eating problems tend to focus solely on their weight an body shape, whereas those experiencing BDD tend to focus on a particular feature e.g. their nose, lips, hair etc. It is possible to experience an eating problem at the same time as BDD.

Other problems associated with BDD:

  • social isolation to avoid anxiety or discomfort
  • depression
  • anxiety
  • drug or alcohol misuse
  • eating problems
  • feelings of shame, guilt or loneliness
  • unnecessary medical procedures
  • self-harm
  • suicidal thoughts


NICE guidelines recommend that the approach taken is tailored to the particular difficulites that are being experienced and their severity. The guidelines state that Cognitive Behavioural Therapy (CBT) should be offered prior to medication.

Cognitive Behavioural Therapy  – CBT aims to identify the patterns of thoughts, feelings and behaviours and then develop skills in order to manage the obsessive thoughts and compulsions. In the case of BDD sessions would focus on improving your attitude towards your body image and reducing the compulsive behaviours. This may involve using elements of Exposure and Response Prevention (ERP) which is a technique used to get you to confront your obsessive worries and deal with them without exhibiting compulsive behaviours.

Medication – a psychiatrist or GP will be able to prescribe medication depending on the symptoms you are experiencing at the time, the severity of the symptoms, past experiences, physical health and how likely you are to consistently take your medication.