Body Dysmorphic Disorder (colloquially called BDD) is an obsessive-compulsive related disorder in which individuals see themselves differently than the world sees them.
Those who live with BDD (which is about 2% of the general population) tend to be obsessively preoccupied with nonexistent or very small perceived flaws in their appearances. They also have repetitive compulsive behaviors around these perceived flaws in an attempt to correct the problem. BDD is different from eating disorders in that it is not food-focused. Though unhealthy and compulsive eating habits may be a symptom of BDD, the focus of the illness is on the body and not on food intake.
Similar to other appearance-related disorders, people with BDD often have very low self-esteem and are at a high risk of suicide, about 80% of people with BDD have reported suicidal thoughts. BDD affects both men and women equally although men often have specific dysmorphia related to their muscles while women are more likely to be focused on their weight or specific body parts.
BDD can manifest in many ways, from compulsively tweezing to regular cosmetic surgery.
I spoke to two women living with BDD about their experiences. The first, Bailey, is a nanny in her late twenties and has BDD since she was a teenager.
“My mother put me on a diet when I was 14 years old,” Bailey told me. “Now, I look in the mirror everyday and draw circles around the parts of my body that are fat and huge. I’m [currently] the thinnest I’ve ever been in my life and I [still] spend a lot of time sucking in my stomach in front of the mirror wondering when I’ll see someone thin.”
BDD affects every part of Bailey’s life, from her socializing to her sex life.
“I didn’t let my partners see me completely naked until I was 25,” explains Bailey. “I only stopped sucking in my stomach during sex last year. My parents took me to a doctor when I was 14 because I was literally cutting the calluses off my feet with scissors. Whenever I go into a room I look around and see if I’m the biggest woman in it. Then if I am, or am not, I rank myself. How far away I am from being the heaviest. Every day I live in a body that looks different to everyone else.”
Audrey, a teacher also in her late twenties, has had a similar experience with BDD.
“I got made fun of a lot when I was younger, for being chubby, nerdy, “goth,” states Audrey. “I was a picky eater and vegetarian and my dad told me I had to watch what I ate. Now, if I eat some sort of junk food, I feel really guilty about it. And I always, always look at menus and have an idea of what I’m going to order beforehand. I once had a panic attack because the thing I thought I wanted to eat had a TON of butter and cream and I knew I couldn’t/shouldn’t eat it. I still have an irrational fear of butter, I never keep it in the house.”
Audrey and Bailey both go to therapy. For Audrey it comes up, but it’s not the focus of her sessions. She’s always known that this way of thinking was disordered. Bailey on the other hand had a different experience. “I’ve been in treatment in the past but never considered BDD a part of my mental illnesses until the last couple years,” Bailey explains. “I thought dieting and concerns about the body were something ALL women experienced and obsessed over. It wasn’t until I was in therapy 2 years ago that my therapist pointed out to me that I had a skewed view of myself.”
As I wrapped up both interviews, the two women summed up their experience with the disorder in almost the exact same way, “Every day I live in a body that looks different to everyone else.”
If you struggle with or think you might have BDD, you can find help here.