Body Dysmorphic Disorder (BDD)

The primary distinguishing feature of BDD is an obsessive preoccupation with a perceived defect in one’s physical appearance. BDD obsessions may manifest as excessive, disproportionate concerns about a non-existent or minor flaw, or as recurrent, anxiety-provoking thoughts about an entirely imagined defect with a particular body part that the person considers unattractive. The individual persistently seeks medical attention to fix the minimal cosmetic defect (e.g., nose, cleft chin, blemish, breast size). Many remain persistently dissatisfied despite having performed cosmetic surgery on the particular body part. Consequently, individuals with BDD tend to end up having repeated surgeries on the same body part to correct the perceived defect. About 2% of the general population has BDD, and it tends to occur in adolescence and early adulthood.

Associated Features

Obsessions

• Moles and freckles being too large or noticeable
• Acne
• Minor scars or skin aberrations
• Too much facial or body hair
• Too little hair on head
• Size and/or shape of genitalia
• Breast size
• Muscles being too small
• Overall size/shape/symmetry of the face or another body part

Compulsions

• Repetitive checking of a minor or imagined flaw in mirrors
• Avoidance of mirrors
• Avoidance of having pictures taken
• Repetitive grooming activities (e.g., shaving, combing hair, etc.)
• Repetitive checking/touching/measuring of a minor or imagined defect
• Wearing excessive make-up to camouflage a minor or imagined flaw
• Wearing certain clothes to camouflage a minor or imagined defect
• Multiple medical visits, especially to dermatologists
• Multiple medical/cosmetic procedures in an effort to eradicate a minor or imagined flaw