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WHAT IS BODY DYSMORPHIA?
Definition
Body dysmorphia is a mental health condition where a person becomes intensely preoccupied with perceived flaws in their appearance—flaws that are either very small or not noticeable to others at all. This isn’t vanity or insecurity. It’s a deeply distressing experience that can interfere with daily life, relationships, and self-esteem.
Common Signs & Symptoms
BDD can revolve around any body part, but common areas include the face (skin, nose, hair), stomach, chest, or overall body shape. Many people with BDD spend hours a day thinking about these perceived imperfections.
People often describe:
- Feeling “distorted” or convinced something looks “wrong”
- Constantly checking or examining the perceived flaw
- Comparing themselves to others
- Seeking reassurance that they “don’t look bad”
- Avoiding mirrors, photos, or social situations
- Feeling ashamed, disgusted, or hopeless about their appearance
- Using makeup, clothing, angles, or filters to hide the “flaw”
- Thinking about cosmetic procedures or having a history of pursuing them
Even when others reassure them, the distress doesn’t go away — because it’s the anxiety (not the appearance) that needs support.
Associated Experiences
People with BDD may also experience:
- Depression
- Anxiety or panic
- Suicidal thoughts or hopelessness
- Social withdrawal
- Difficulty dating or forming relationships
- Eating disorder symptoms (restriction, over-exercising, fixation on weight/shape)
- Low self-worth
BDD is highly connected to eating disorders because both involve perfectionism, body-based fears, and attempts to control or change one’s appearance to feel safer or more acceptable.
WHAT BDD TREATMENT LOOKS LIKE WITH ME
When we begin, I’m interested in how your appearance-based worries developed—not to challenge them right away, but to understand the emotional weight they carry. You’ll never be asked to justify why your concerns feel so distressing; instead, we explore when these thoughts started, how much time they take from your life, and how they impact your self-worth, your social experiences, your relationships, and even the way you move through your day. Together, we begin identifying the moments when your mind becomes most self-critical and what those moments are protecting you from or bracing you for. We create goals rooted in relief and empowerment: reducing mirror-checking, softening the intensity of appearance-based fears, expanding the parts of your identity that exist beyond how you look, and helping you build more flexible, compassionate ways of relating to your body. During sessions, we gently practice shifting your attention, challenging assumptions your brain jumps to, and building new habits that don’t revolve around avoidance or self-surveillance. As therapy moves forward, you’ll notice you spend less time analyzing your appearance, the thoughts feel less urgent, and your days begin to open up again. We revisit your goals frequently to ensure the process continues to feel supportive and aligned with what you need.
EVIDENCE- BASED TREATMENTS
Cognitive Behavioral Therapy (CBT-BDD)
Exposure and Response Prevention (ERP)
- Identifies the distorted beliefs about appearance (“I look deformed,” “People are staring at me”).
- Helps you examine where those beliefs come from and how they get reinforced.
- Challenges the mental rituals (checking mirrors, comparing, seeking reassurance) that keep the distress going.
- Builds new, flexible ways of thinking about your appearance and your worth.
- Reduces the time and energy spent fixating on perceived flaws.
Exposure and Response Prevention (ERP)
Exposure and Response Prevention (ERP)
- Teaches your brain that feared situations aren’t actually dangerous.
- Breaks the cycle of anxiety → checking → temporary relief → more anxiety.
- Helps you become less reactive to body-related triggers.
- Reduces avoidance so your world can expand again.
Mindfulness-Based Approaches
Mindfulness-Based Approaches
- Decrease the urge to analyze or “fix” perceived flaws.
- Increase tolerance for distress and uncertainty around appearance.
- Support stepping out of the mental loop of scanning, comparing, or judging.
- Build a gentler, more compassionate relationship with your body.