Body Dysmorphic Disorder

What is Body Dysmorphic Disorder?

Body dysmorphic disorder (also known as BDD or body dysmorphia) this is a disorder that involves belief that one's own appearance is unusually defective and is worthy of being hidden or fixed. Thoughts related to the body, self-image and one’s own appearance are persistent and intrusive. The distress that accompanies BDD can affect quality of life by impairing social, occupational, and academic functioning and social isolation. While BDD is not categorised as an eating disorder it can be closely related and lead to the onset of disordered eating behaviours.

One of the main characteristics of BDD is the belief in unreal imperfections and the preoccupation or even obsession with them; you may many times wish to change or improve the aspects of your physical appearance that you find troublesome and may engage with disordered eating or other cosmetic modification to fix these ‘flaws’. The outcome usually does not resolve the symptoms of the disorder itself. BDD sufferers are often prone to compulsive or repetitive behavior to try to conceal what they are insecure about, a solution that often gives only momentary relief. These repetitive actions usually stem from a sense of shame about the perceived imperfection and an insecurity about it being seen. A few examples of repetitive behaviors that have been seen in patients with BDD are camouflaging (clothing, makeup, hair, hats, etc.), comparing themselves to others in terms of appearance, seeking surgery, constantly checking in a mirror, and skin pickings.

BDD has also generally been referenced as paralleling Obsessive Compulsive Disorder (OCD) and many of its characteristics.

It may also cause other problems such as:

  • feelings of shame, guilt and loneliness
  • isolating yourself to avoid situations that cause you anxiety or discomfort
  • depression or anxiety
  • misuse of alcohol or other drugs
  • self-harm
  • suicidal thoughts

Many people with BDD do not seek help as they are worried that people will judge them, or think they are vain. This means that many people are likely to experience BDD for a long time before seeking help.

Treatment is available for BDD through CBT and counselling.

More information can be found at

Muscle Dysmorphia

A subtype of body dysmorphic disorder, which in itself is a variant of obsessive-compulsive disorder, muscle dysmorphia refers to an obession characterized by a fear of being too small, and perceiving oneself as small and weak even when one is actually large and muscular. Muscle dysmorphia is a very specific type of  BDD, and  is sometimes called bigorexia or reverse anorexia. People with this disorder obsess about being small and undeveloped, they worry that they are too little and too frail. Even if they have good muscle mass, they believe their muscles are inadequate. In this disorder a person is preoccupied with thoughts concerning appearance, especially musculature. As with other forms of body dysmorphic disorder, muscle dysmorphia is strictly connected with selective attention: individuals selectively focus their attention on perceived defect (too skinny body, underweight etc.). They are hypervigilant to even small deviations from perceived ideal and they ignore information that their body image is not consistent with reality.

While this is not an eating disorder categorym muscle dysmorphia has been closely linked to male eating disorders and the growing poor body image experienced by males enagaging with disordered eating, and as a result has been dubbed by the media as 'manorexia'. It must be noted however that muscle dysmorphia can and does affect women as well as men. 

In efforts to fix their perceived smallness, people with muscle dysmorphia may engage in disordered behaviours such as obsessively lifting weights, do resistance training, and exercising compulsively. They may also take steroids or other muscle-building drugs, a practice with potentially lethal consequences. This type of eating disorder must therefore be taken just as seriously as other eating disorders types.

Eating Disorder Association NI
28 Bedford Street,
Belfast, BT2 7FE
Phone: 028 9023 5959