Body Image Difficulties & Body Dysmorphic Disorder

 While most people experience dissatisfaction with aspects of their appearance from time to time, Body Dysmorphic Disorder (BDD) involves an individual becoming overly preoccupied with a real or imagined flaw in their appearance, such that they perceive it to be far more noticeable or serious than is actually the case. This preoccupation may relate to any body part, but often revolves around the skin (e.g., acne, blemishes, wrinkles, scars, moles), hair (e.g., thinning or excessive), facial features (e.g., nose, eyebrows, lips, ears, jaw, chin, teeth, smile), physique (e.g., muscles, height, shape of legs, buttocks, breast, stomach) or genitals. BDD involves more than individuals simply seeing parts of their body in a negative light and is not “vanity” – it is a very real and distressing condition. People with BDD engage in ritualistic behaviours such as:

• excessively checking the perceived flaw/s in mirrors and other reflective surfaces (or alternatively avoiding reflective surfaces)
• comparing the area to others
• going to great lengths to hide or disguise the flaw (e.g., with clothing or hair styles, by sitting a certain way)
• poring over pictures in magazines, e.g., of models
• taking an excessive number of “selfies” (or alternatively avoiding being photographed)
• seeking reassurance from others about the severity of the flaw.

These activities may take up significant amounts of time, thereby interfering with the individual’s life. People with BDD are often very distressed by their thoughts about the perceived flaw. BDD is associated with depression, social anxiety and shame. Body image difficulties which are less severe than BDD may still impact an individual’s confidence and self-esteem, eliciting anxiety and resulting in avoidance of certain situations.