Fiducia TogetherBody dysmorphic disorder
Also called BDD
A preoccupation with a perceived flaw others cannot see. Not vanity, and it carries a very high suicide risk.
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.
What it is
Body dysmorphic disorder is one of the most misjudged conditions in mental health, because from the outside it looks like vanity and from the inside it is closer to torture.
It is a preoccupation with one or more perceived defects in appearance that others either cannot see or consider trivial. The person spends hours a day on it: checking mirrors, comparing, grooming, seeking reassurance, or avoiding being seen at all.
It affects around 2% of people. Suicide rates in BDD are among the highest of any psychiatric condition, and that is the fact that should end any suggestion it is superficial.
Signs you might notice
Repeated mirror checking, or complete mirror avoidance. Both occur.
Camouflaging: hats, makeup, hair, posture, angles.
Comparing constantly with others, including strangers and images.
Seeking cosmetic procedures repeatedly, and rarely being satisfied by them.
Avoiding photographs, social events, work, or leaving the house in daylight.
Skin picking, which frequently accompanies it.
How it can affect day-to-day life
Cosmetic surgery is the trap. People pursue procedures, are dissatisfied, and pursue more. Ethical practitioners screen for BDD and decline; less scrupulous ones do not, and the industry has a real problem here.
Education, work and relationships all get abandoned rather than risked.
Shame keeps people silent for years. Many will not name the body part they are preoccupied with, even to a clinician.
Supporting someone well
Do not reassure about appearance. Reassurance is the compulsion, and it relieves for minutes and strengthens for months, exactly as in OCD.
Do not argue about whether the flaw exists. That conversation never ends well.
Discourage cosmetic procedures while BDD is untreated, and say why.
Focus on function and on what the person is missing out on, rather than on appearance.
Ask for CBT designed for BDD, and for SSRI medication at the doses used for OCD, which are higher than for depression.
Ask about suicide directly.
Where to get help
Ask a GP for referral, and for a specialist BDD or OCD service if it is severe. National specialist services exist.
The BDD Foundation provide support groups and information written by people who have had it.
In crisis, Samaritans are free on 116 123.
Last reviewed 2026-08-28 by Fiducia Together · Next review due 2027-08-28
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.