Co-morbid Conditions:

Body Dysmorphic Disorder

About Body Dysmorphic Disorder (BDD)

Body dysmorphic disorder (BDD) is a mental health condition characterized by a persistent preoccupation with perceived flaws in appearance that are not observable or appear minor to others.

Individuals with body dysmorphic disorder often engage in repetitive behaviors—such as mirror checking, excessive grooming, reassurance seeking, or avoidance of social situations—in an effort to reduce distress related to appearance concerns.

BDD does not surround vanity; rather, it is driven by intrusive, often obsessive thoughts that can impair daily functioning, self-esteem, and quality of life.

Comorbidity with OCD

Obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) are closely related conditions within the obsessive-compulsive and related disorders spectrum, characterized by intrusive thoughts and repetitive behaviors associated with significant distress and functional impairment.

BDD, defined by a persistent preoccupation with perceived flaws in appearance, shares core features with OCD, including intrusive obsessions and compulsive rituals such as checking and reassurance-seeking.

Individuals with body dysmorphic disorder (BDD) may experience:

  • Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others
  • Repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (e.g., comparing appearance with that of others) in response to their appearance concerns
  • Preoccupation causing clinically significant distress or impairment in social, occupational or other areas of functioning

Treating BDD

Evidence-based treatment for body dysmorphic disorder involves a combination of cognitive behavioral therapy (CBT), exposure and response prevention (ERP), and perceptual retraining.

Cognitive behavioral therapy (CBT) for body dysmorphic disorder (BDD) focuses on identifying and challenging thoughts about appearance while developing more balanced perspectives. Individuals learn to recognize cognitive distortions, evaluate the evidence for their beliefs, and reduce focus on perceived flaws.

Exposure and response prevention (ERP) for body dysmorphic disorder (BDD) helps individuals gradually face situations that trigger appearance-related distress while reducing compulsive behaviors, such as mirror checking or avoidance.

Treatment involves creating a hierarchy of feared situations and engaging in exposures that are manageable yet meaningful, with the goal of building tolerance to anxiety. Over time, individuals learn to reduce rituals, challenge predictions, and develop increased flexibility with the relationship with their appearance.

Perceptual retraining for body dysmorphic disorder (BDD) helps individuals develop a more objective view of their appearance. In effort to reduce focus on perceived flaws, individuals are guided to observe their whole body from a natural distance and describe features in neutral, nonjudgmental terms.

For more information on the treatment of body dysmorphic disorder, please visit:

BDD.IOCDF.org

Resources

BDD Foundation: https://bddfoundation.org 

IOCDF BDD Special Interest Group: https://iocdf.org/special-interest-groups/bdd/

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