How to Help Someone with Body Dysmorphia (2025)

Body dysmorphia, or body dysmorphic disorder (BDD), is a mental health condition where people become fixated on aspects of their appearance that others may not even notice. It affects both men and women and is more common in teens and young adults. Those with BDD often feel something is "wrong" or "ugly" about them, leading them to constantly check mirrors, avoid social events, or compare themselves to others. These thoughts can be tough to control and bring intense sadness, anxiety, and embarrassment.

While BDD can be managed, it may not fully go away for everyone. Therapy, especially cognitive-behavioral therapy (CBT), and sometimes medication, can help reduce symptoms. If you know someone with BDD, it’s important to listen without judging, encourage them to talk to a mental health professional, and avoid focusing on appearance. Support and understanding can help them feel less alone and may give them the confidence to seek help.

What Is Body Dysmorphia?

The "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" (DSM-5) defines body dysmorphic disorder (BDD) as a mental health condition involving an intense preoccupation with one or more perceived physical flaws.

Classified under obsessive-compulsive and related disorders, BDD involves both persistent, intrusive thoughts about appearance (obsessions), and repeated actions to reduce the anxiety these thoughts create (compulsions).

People with BDD often believe that others are noticing and judging their perceived flaws, even if these flaws are barely visible or invisible to others. This belief can make social situations overwhelming, leading to feelings of embarrassment, anxiety, or discomfort around others.

BDD is a complex and often misunderstood condition that can significantly impact a person’s well-being. The ongoing distress caused by these obsessive thoughts and compulsive behaviors can interfere with work, school, relationships, and everyday activities.

Symptoms

People with body dysmorphia worry excessively about minor or nonexistent flaws in their body and/or face. To "fix" those flaws, they may go to extreme lengths, such as drastically altering their looks with plastic surgery.

Research suggests that people with BDD often spend three to eight hours a day worrying about their perceived physical imperfections. Any body part may become a target for these worries. However, people with body dysmorphia are most likely to worry about their skin, nose, or hair.

Common symptoms of body dysmorphia include:

• Obsessive thoughts about perceived physical flaws
• Excessive mirror-checking or avoiding mirrors altogether
• Repeatedly comparing one's appearance to others
• Seeking reassurance about appearance from others
• Engaging in excessive grooming or skin picking
• Avoiding social situations due to fear of judgment
• Seeking cosmetic procedures or treatments to fix perceived flaws
• Spending long hours focused on appearance or body image
• Wearing clothing, makeup, or accessories to hide perceived imperfections
• Feelings of anxiety, embarrassment, or shame about appearance

Someone with body dysmorphia may feel so consumed with thoughts about their looks that they neglect other areas of their life. They may even avoid school, social events, dating, or work out of fear of being judged for their looks.

When left untreated, BDD can lead to serious negative consequences. Over half of people with BDD are unmarried, and over 20% of people with body dysmorphia are unemployed. Around 20% of people with BDD are so distressed by their appearance that they attempt suicide.

Examples

Body dysmorphia can look different from person to person, with some individuals showing more obvious signs than others. Examples of behaviors linked to body dysmorphia include:

• Obsessive focus on a perceived flaw: A person may become fixated on a minor imperfection, like a small mole or uneven skin, and believe it is noticeable to everyone.
• Excessive mirror-checking: A person may repeatedly check their reflection in mirrors or other reflective surfaces to inspect or "fix" the perceived flaw.
• Comparing appearance to others: They constantly compare their looks to those of others and feel inferior or flawed in comparison, even if the differences are insignificant.
• Avoiding social situations: The fear of being judged for their appearance may lead to avoiding social gatherings, work, or school.
• Seeking cosmetic procedures: In an attempt to fix perceived flaws, a person may seek frequent cosmetic surgery or other treatments that may not improve their self-esteem.
• Covering up flaws: People with BDD may wear heavy makeup, clothing, or accessories to hide or alter their perceived imperfections.
• Reassurance-seeking behaviors: They may ask others constantly if a perceived flaw is noticeable or seek constant reassurance about their appearance.
• Excessive grooming: They spend hours grooming or performing actions like skin picking, hair pulling, or other rituals aimed at "correcting" appearance concerns.
• Muscle dysmorphia: Believing that their body is too small or not muscular enough, this often leads to excessive exercise or dieting to try to achieve an ideal body image.

Body dysmorphic disorder (BDD) can vary in severity, from mild worries about a single feature to more extreme cases that significantly impact daily life.

For example, someone with mild BDD might obsess over the size of their nose, while someone with more severe BDD could become so fixated on their skin's appearance that they avoid leaving the house and spend hours applying makeup or engaging in skin treatments.

Diagnosis

If you think you may have BDD, talk to your healthcare provider. They can refer you to a mental health specialist who can make a diagnosis using the criteria in the DSM-5. If your worries about your looks are focused more on your body weight or size, you may be diagnosed with an eating disorder instead.

To be diagnosed with body dysmorphia, the preoccupation with your appearance must negatively affect your life and/or cause significant emotional distress. Your healthcare provider may also specify whether you have muscle dysmorphia, a type of body dysmorphia that involves worrying about appearing “too small” or not muscular enough.

During the diagnostic process, your mental health specialist may specify whether you have good, fair, or poor insight into your BDD symptoms.

According to the DSM-5, some people with body dysmorphic disorder have “good” insight, which means they are aware that their beliefs about their body are not true. People with “fair” or “poor” insight aren’t aware that their worries are excessive or not based in reality.

Causes

The exact cause of body dysmorphia is unknown. Researchers believe that several factors may contribute to the development of BDD, including:

• Genetics: In some cases, BDD may be inherited. According to twin studies, genetic factors account for about 44% of the variance in body dysmorphic disorder symptoms.
• Trauma: People with a history of trauma have a higher chance of developing body dysmorphia. Many people with BDD report having been bullied by peers at school, and up to 79% of people with body dysmorphia experienced childhood abuse.
• Personality traits: People with certain personality traits, such as perfectionism and sensitivity to aesthetics, are more likely to develop body dysmorphia.
• Comorbid conditions: Many people with BDD have at least one other mental health condition at the same time. It’s especially common for someone with body dysmorphia to have obsessive-compulsive disorder (OCD), social anxiety disorder (SAD), or an eating disorder, such as anorexia nervosa (AN).
  

Can It Be Cured?

Body dysmorphic disorder (BDD) cannot be cured and will not go away on its own. However, effective treatments can help people manage symptoms and improve quality of life.

The most effective approach typically combines talk therapy and medication:

• Cognitive behavioral therapy (CBT): As the primary therapy for BDD, CBT involves working with a mental health professional to identify and replace negative thought patterns with more positive, realistic ones. CBT also helps individuals manage their anxiety and depression and reduce compulsive behaviors tied to BDD.
• Selective serotonin reuptake inhibitors (SSRIs): SSRIs, a type of antidepressant, have been shown to be effective for 53% to 70% of people with BDD. These medications, often used alongside CBT, can help manage symptoms, with many individuals benefiting from long-term SSRI use.

Leaving BDD untreated can lead to severe depression and even suicidal thoughts. Seeking treatment early is essential to avoid the more severe effects of the disorder.

Coping

If you have BDD, it’s important to build your self-esteem and reach out to others for support. In addition to seeking professional treatment, here are some ways to cope with the symptoms of body dysmorphia:

• Joining an online or in-person peer support group for people with BDD
• Spending time with loved ones
• Practicing mindfulness techniques, such as meditation
• Managing stress with relaxation techniques, such as deep breathing exercises
• Writing your thoughts in a journal
• Using positive affirmation statements to build your confidence
• Participating in a new hobby or learning a new skill

Helping Someone With BDD

Supporting someone with body dysmorphic disorder (BDD) can be challenging, but your understanding and encouragement can make a difference. Here are some ways to help:

• Listen without judgment: Offer a safe space for them to talk about their feelings. Avoid dismissing their concerns, even if the flaws they see aren't noticeable to others.
• Encourage professional help: Gently suggest they talk to a mental health professional, as therapy and medications have been shown to help manage BDD symptoms.
• Focus on non-appearance-based strengths: Compliment their skills, talents, or positive qualities unrelated to appearance to help boost self-esteem.
• Avoid participating in reassurance-seeking behaviors: It can be tempting to reassure them about their appearance, but try to avoid feeding into their need for constant validation. Instead, redirect the conversation to activities or qualities unrelated to appearance.
• Be patient and supportive: Recovery can take time, and setbacks are normal. Remind them that they don’t have to face BDD alone and that you’re there to support them through their journey.
• Educate yourself about BDD: Learning more about the disorder can help you understand what they’re going through and provide more effective support.

Remember to set boundaries and prioritize self-care to keep your communication healthy and effective. Supporting someone with BDD can be challenging, so taking care of your own well-being helps you offer consistent, positive support without becoming overwhelmed.

Summary

Body dysmorphic disorder (BDD), is a mental health disorder that involves an extreme preoccupation with minor or imagined flaws in one’s physical appearance. People with BDD feel overwhelmed by negative thoughts about their body or face. They may spend excessive amounts of time and/or money in attempts to conceal their imperfections or “fix” the way they look.

Researchers believe that BDD is caused by a combination of genetic and environmental factors. Many people with BDD have been bullied about their looks. A history of trauma, such as child abuse, also increases the likelihood of developing BDD. Treatment for BDD typically involves psychotherapy, medication, or both.