Body Dysmorphic Disorder (BDD): Risk Factors, Signs, Symptoms, and Treatment

Thrive • August 11, 2022

By Thrive Wellness Sacramento Clinical Director Gillian “Gillie” Francis, LCSW

A mental health diagnosis that affects up to 2.4% of people, body dysmorphic disorder (BDD) is characterized by a fixation on one’s own perceived body imperfections, which are generally imperceptible to others. Individuals with BDD typically engage in compulsive behaviors associated with their perceived flaws. While related to obsessive-compulsive disorder (OCD), eating disorders , and body image struggles, BDD is a separate and disabling condition that can interfere with one’s ability to participate and find enjoyment in everyday life.

WHAT IS BDD?

Experienced by men and women at relatively equal rates , BDD often involves obsessive distressing thoughts about a specific body part and related repetitive behaviors, such as mirror checking, excessive grooming, and skin picking.

BDD commonly develops in adolescents ages 12 to 13 , but frequently goes undiagnosed for years. While the causes of BDD are complex, the following factors can increase an individual’s risk for developing BDD:

Abuse
Anxiety
Bullying
Depression
Fear of being alone or isolated
Genetic predisposition
Low self-esteem
OCD
Perfectionist or competitive tendencies

Signs and symptoms of BDD include:

Extreme preoccupation with a perceived flaw in one’s appearance that others don’t notice or perceive as minor
A conviction that one has a defect in their appearance that makes them “ugly” or “deformed”
A belief that others take special notice of one’s appearance in a negative or mocking way
Engaging in behaviors aimed at fixing or hiding the perceived flaw that are difficult to resist or control, such as frequently checking the mirror, grooming, or picking at one’s skin
Attempting to hide perceived flaws with styling, makeup, or clothes
Constantly comparing one’s appearance with others
Repeatedly seeking reassurance about one’s appearance from others
Undergoing cosmetic procedures with little satisfaction
Avoiding social situations to hide one’s perceived flaw from observation or judgment

BDD often occurs with other mental and behavioral health conditions, including:

OCD: Co-occurring with OCD at rates varying from 3% to 43% , BDD shares the intrusive thoughts and compulsive behaviors that also manifest with OCD. Unlike OCD, however, the obsessive-compulsive focus of a person with BDD lies solely on their body and appearance.
Eating disorders : Research shows that 12% of those with anorexia nervosa or bulimia nervosa also struggle with BDD. Interestingly, however, the body dysmorphic concerns of the study participants were focused on skin, hair, teeth, nose, and height, rather than weight and shape. Even so, some individuals with BDD attempt to manipulate their perceived flaws through disordered eating behaviors including calorie restriction, over-exercising, and purging.

BDD VS. BODY IMAGE ISSUES

Individuals who experience poor body image often feel a general sense of displeasure about their overall appearance especially as it relates to weight or shape. Struggles with body image may arise from diet culture’s invasive narrative which prioritizes and celebrates certain body shapes over others. Although detrimental, body image issues brought on by diet culture are divergent from symptoms of BDD, which is a mental health diagnosis. Those with BDD experience intense preoccupation with specific body parts and cope with their distressing thoughts through disruptive, ritualized behaviors.

TREATMENT FOR BDD

Cognitive behavioral therapy (CBT) is one of the most effective treatment interventions for BDD, with a 77% to 84% success rate according to one study . A therapist applies CBT by uncovering the harmful thoughts and behaviors that are contributing to a person’s BDD. Then, the therapist guides the client in reframing their distressing thoughts and behaviors. Generally, CBT encourages mindfulness and relaxation strategies that can be beneficial in undermining disturbing thought and behavior patterns.

HEALING THE RELATIONSHIP WITH THE BODY AT THRIVE WELLNESS

For individuals struggling with body image concerns, BDD, OCD, disordered eating behaviors , and/or eating disorders , an integrated treatment approach involving an interdisciplinary team can help heal the root cause of their struggles and encourage lasting recovery. Drawing on evidence-based therapeutic interventions and a nutrition philosophy that emphasizes intuitive eating , Thrive Wellness’ team of psychiatrists, therapists, primary care providers, and mindful movement specialists collaborate to help individuals confidently connect with and embrace their bodies. Reach out to learn more about our treatment services .

While all Thrive Wellness locations offer interdisciplinary clinical teams who collaborate to treat eating disorders, perinatal mood and anxiety disorders (PMADs), and additional mental and behavioral health conditions, programs and services may vary by location.

About the Author

Thrive Wellness Sacramento Clinical Director Gillian “Gillie” Francis, LCSW

Gillie Francis received her master’s degree in Social Work at the University of Nevada and is a fully licensed LCSW in both Nevada and California. Her experience spans a variety of settings and levels of care including inpatient, residential, and outpatient and crisis services. Gillie has experience working with adults and adolescents with severe mental illness, eating disorders, mood and anxiety disorders, suicidal ideation, personality disorders and other co-occurring disorders. Gillian is passionate about honoring each individual’s journey and utilizes approaches that emphasize empowerment with clients. Approaching her work with integrated modalities, she works with individuals to find their voice and engage in pivoting towards their values. She believes that each individual has the capacity for meaningful change in their lives. When she is not working with clients, she enjoys time outdoors with her spouse and dog, Charlie.

The post Body Dysmorphic Disorder (BDD): Risk Factors, Signs, Symptoms, and Treatment first appeared on Thrive Wellness.

< Older Post

Newer Post >

3 Adolescent Mental Health Red Flags Providers Should Watch for During Summer

June 27, 2025

How school breaks can mask or amplify eating disorders, anxiety, and OCD symptoms and how to intervene

Navigating Coming Out: Emotional Wellness Tips for Every Stage

June 4, 2025

Coming out is a deeply personal, courageous, and in many cases, life-changing act. Whether you're sharing your sexual orientation or gender identity, coming out is about embracing authenticity and sharing an essential part of who you are. During the process of coming out, prioritizing your mental health at every stage is crucial. In this blog, we'll discuss insights and strategies to support your mental health before, during, and after coming out. Wherever you are in your journey, know that your experience is valid and you are not alone. Understanding the Mental Impact of Coming Out Coming out can bring about a lot of big feelings, including fear, relief, joy, anxiety, grief, and hope, sometimes all at once. Know that heightened emotions during this time are completely normal. Sharing such an integral part of yourself with the world can feel intense, but even with the ups and downs, being authentically you is worth it. Because LGBTQIA+ individuals face added mental health burdens due to stigma and discrimination, taking care of yourself during this time is more important than ever. You might experience increased anxiety, mental exhaustion, or avoidance ahead of coming out, so don’t be afraid to reach out for support. At its core, coming out is about authentic self-expression and showing your truest self, which can feel both exciting and scary at the same time . The self-acceptance and community gained from coming out is a vital part of finding long-term strength and joy. Still, it’s okay if you feel uncertain or conflicted, and these feelings are just part of the process. Before Coming Out: Emotional Preparation Coming out starts with reflection. Remember that there’s no rush when it comes to figuring out who you are. It’s okay to take time to understand your identity and what coming out might mean for you. Here are a few questions to consider: What do I hope to gain by coming out? Who feels emotionally safe to talk to? What are my fears, and how can I manage them? Mental wellness tips before coming out: Journaling can help you better understand your feelings and fears and explore different ways to share your truth. Talking through your feelings and different scenarios with a therapist , especially one who is LGBTQIA+ affirming, can help you to feel more supported and ready to come out. Practice grounding techniques like deep breathing, meditation, or visualization to ease anxiety ahead of sharing your identity. Helpful resources for coming out include: Trevor Project Lifeline (1-866-488-7386) TrevorSpace (an online community for LGBTQIA+ youth) OurCenter (a local community center for the LGBTQIA+ community in Reno) During the Coming Out Process: Staying Grounded The act of coming out can feel intimidating, as you’re sharing such a vital part of who you are. You might experience fear, panic, or doubt. While these feelings are real, know that you don’t have to navigate them alone. Tips for emotional resilience: Practice conversations ahead of time with a therapist or supportive friend so you feel ready when the time comes to share. Choose a time and place where you feel safe and in control. Use affirming statements, like, “I deserve to be loved for who I am.” Coping with negative responses: Set emotional boundaries with people who aren’t supportive. Create an emotional safety plan: know who you can call, where you can go, and what can help soothe you in moments of distress. After Coming Out: Processing and Healing Coming out, no matter how it went, deserves to be celebrated. An act of strength and authenticity like coming out is no small feat, so be proud of yourself for sharing who you are. Even so, the emotional aftermath can be complicated. You might feel joy and empowerment or loss and grief, especially if relationships shift. Healing strategies: Acknowledge your courage . Even difficult conversations are acts of strength. Rebuild your safety if you've experienced rejection. This might mean changing your environment or seeking new support systems. Release guilt or shame. Being who you are is never something you should feel ashamed or guilty for. Support networks can make a huge difference. Seek out different forms of support like: LGBTQIA+ support groups (in-person or online) Peer mentors or community leaders Allies, friends, or family who affirm and respect your identity Therapeutic options to deal with stress, grief, or isolation associated with coming out: EMDR (Eye Movement Desensitization and Reprocessing) can help process trauma. Narrative therapy helps you rewrite your story in your own empowering voice. Coming Out More Than Once: Navigating the Long Game Coming out isn’t just a single milestone, it’s a recurring process. You might come out again and again: to a healthcare provider, a neighbor, a partner, or a friend. It can feel exhausting or unfair to have to come out more than once, but each time, you’ll continue to find more strength, confidence, and understanding for yourself. Other tips for coming out: Focus on cultivating a strong inner identity that doesn’t rely on external validation. You know who you are, and you don’t need to prove yourself to anyone. Create a personal toolkit of coping and grounding strategies to deal with stress or burn-out associated with coming out. Thrive Wellness offers a free breathing exercise guide to help relieve anxiety and calm the nervous system. Download it here . Find affirmation and support through community. This can look like finding a chosen family, looking up to queer role models, attending events that celebrate the LGBTQIA+ community and its history, and working on embracing authenticity and having pride in who you are. Remember, there’s no one-size-fits-all approach to coming out, and it’s never too late to share who you are. Whether you're preparing to come out, in the midst of sharing your truth, or processing what came after, know that you are worthy of love, safety, and joy. Your truth is worth celebrating, today and everyday! For support during the coming out process and beyond, reach out to our team of affirming, inclusive, and compassionate mental and physical health care providers. We're here for you.

10 Simple Actions to Improve Your Mental Health

May 15, 2025

Taking steps to protect and maintain good mental health is key to living your best life. Whether it's managing stress, building emotional resilience, or simply finding a moment of peace during your busy day, developing a set of strategies to protect your mental health is essential. This Mental Health Awareness Month is all about turning action into awareness, so why not take action today to care for yourself and improve your mental health? This guide outlines ten impactful activities you can incorporate into your daily routine to boost your mental health starting today. By incorporating these activities into your days, you can take control of your mental health journey, grow personally, and improve your relationship with yourself and others. Why is Taking Action for Your Mental Health Important? Understanding the significance of proactive mental health care can change how we treat ourselves and move through our everyday lives. Taking action for yourself not only improves your overall well-being but also helps prevent existing or potential issues from becoming more severe. When you prioritize your mental health, you’ll feel a greater sense of happiness and productivity, paving the way for stronger relationships and a fuller, more enjoyable life. Focusing on your mental health is not just about problem-solving, but about living in a balanced and fulfilling way that supports your overall well-being and ability to thrive. 10 Effective Activities for Improving Your Mental Health It’s essential to have a repertoire of activities on hand that can boost your mental health. Simple activities like sleeping enough, meditating, spending time with a friend, or seeing a therapist can have huge impacts on your overall mental wellness. Prioritizing your mental health doesn’t have to be complicated or difficult, it’s just about doing activities that make you feel joyful, relaxed, or energized, fueling a better outlook on life overall. Here are 10 activities you can do today to help your brain and body to feel their best: 1. Mindful Practices Practicing mindfulness is a simple yet impactful step you can take in improving and protecting your mental health. Mindfulness practices include activities like meditating and mindful breathing to calm the mind and reconnect with the body. Meditation and breathing exercises are shown to reduce stress, improve focus, and grow your self-awareness. For more breathing exercises for anxiety relief, download our free guide “Breathe Easy” . 2. Eating Intuitively Eating intuitively is a powerful way to boost your energy and mood and reduce stress around food, helping to improve your overall mental health. This approach encourages a healthy relationship with food by promoting balance, variety, and pleasure without guilt. Intuitive eating helps you recognize and respond to your body's signals, leading to more mindful and satisfying eating experiences. By focusing on how foods make you feel, both physically and emotionally, you can make healthier choices that nourish your body and mind. Adequate nutrition has been shown to support brain function, improve mood, and reduce the risk of mental health conditions. 3. Sleep Hygiene Practicing good sleep hygiene is essential for maintaining overall health and wellbeing. Establishing a consistent bedtime routine helps regulate your sleep patterns, ensuring you get the deep sleep your body needs. Aim to go to bed and wake up at the same time each day if possible. Quality sleep is vital for cognitive function, emotional stability, and physical health, making good sleep hygiene a key component of wellness. 4. Mindful Movement Doing movement that you enjoy can have massive impacts on your mental health. Exercise reduces stress by triggering the release of endorphins, which have mood-lifting and pain-relieving effects. It also helps regulate hormones like cortisol, improving the body's ability to handle stress. By simply incorporating enjoyable movement into your routine a few times a week, you’ll see improvements in both your mental and physical health. 5. Go Outside Spending time outside can support physical, mental, and emotional well-being. It allows you to disconnect from everyday stressors, reconnect with the natural world, and experience a sense of tranquility and peace. Spending time in nature has been linked to reduced anxiety, improved mood, and increased mindfulness. Make time to explore outdoor environments such as parks, forests, beaches, or gardens. Practice mindfulness while in nature, focusing on the scenery and sounds that surround you. Incorporating nature into your daily routine can provide a refreshing break from everyday life, improving your mental health. 6. Make Time for Creative Pursuits Creative activities can be a great outlet for self-expression and reducing stress. Creativity allows you to explore new ideas, solve problems, and connect with your inner self. Even dedicating just 10 minutes a day to creative pursuits can have a positive impact on your mental health. Activities like drawing, painting, journaling, or crafting can help you unwind and stimulate your mind. Creative expression can also improve mood, enhance cognitive function, and foster a sense of accomplishment. 7. Practice Positive Self-talk Positive self-talk is a powerful habit that involves speaking to yourself in a kind, supportive, and encouraging manner. It's about cultivating a positive mindset and nurturing self-compassion. By shifting negative thoughts and beliefs to positive affirmations, you can boost your self-esteem and overall well-being. Practice acknowledging your strengths, accomplishments, and perseverance, even in challenging situations. 8. Practice Social Wellness Social wellness is about nurturing meaningful connections with others and fostering a supportive network of relationships. It involves engaging in positive interactions, building trust, and offering and receiving support. Cultivating social wellness contributes to emotional resilience, reduces feelings of isolation, and promotes overall happiness. Take time to connect with friends and family members regularly, whether through phone calls, video chats, or in-person gatherings. 9. Do Something for You Making time for yourself is crucial for maintaining life balance and preventing burnout. This involves setting boundaries, practicing self-care, and prioritizing activities that bring you joy and relaxation. Taking time for yourself allows you to recharge, reflect, and reconnect with your inner needs and desires. Self-care can take many forms, from indulging in a hobby to simply enjoying a quiet moment alone. Regularly dedicating time to yourself helps reduce stress, improve mental clarity, and enhance overall well-being. 10. Visit a Mental Health Professional Sometimes, we need professional support for our mental health, and that’s okay! Knowing when it’s time to see a therapist shows strength and self-awareness. No matter where you are in your mental health journey, getting guidance from a therapist can be a helpful tool in living your best life. Our team of mental health professionals are ready to support you now, don’t be afraid to reach out and open up. When Should I Seek Professional Help for My Mental Health? It's important to know when it's time to reach out to a mental health professional. Persistent feelings of sadness, anxiety, or emotional distress that interfere with your daily life are clear indicators for seeking professional help. If your coping mechanisms and self-care activities fail to alleviate your mental health concerns, reaching out can offer valuable support and interventions. Nurturing Your Mental Well-being Through Action Investing time and effort in your mental health can make positive differences in your everyday life. By understanding the importance of mental health practices and incorporating proactive strategies, you lay the groundwork for feeling better and staying mentally strong over time. Whether through improved sleep hygiene, mindful practices, or seeking professional help when needed, these efforts can bring more joy, emotional stability, and peace into your life. Make these activities a regular part of your day with a focus on self-growth, and you'll be on your way to a healthier mind and a fuller life.