What is Body Dysmorphia?
Body image struggles are something almost all of us experience at some point in our lives — but when those concerns become persistent, distressing, and interfere with daily functioning, we may be looking at something deeper: Body Dysmorphic Disorder (BDD), often referred to as body dysmorphia.
At The Current we often work closely with individuals navigating eating disorders and body image issues and we want to shed some light on what body dysmorphia is — and what it isn’t.
Body Dysmorphia Is More Than Disliking How You Look
Body dysmorphia is a mental health condition characterized by obsessive focus on a perceived flaw in appearance — a flaw that might be minor or even invisible to others. This isn’t about vanity or a lack of confidence. It’s a distressing, often debilitating experience that can take over a person’s life.
People struggling with BDD may:
Spend hours each day worrying about their appearance
Engage in repetitive behaviors like mirror checking, skin picking, or excessive grooming
Avoid social situations due to appearance-related anxiety
Constantly seek reassurance about their looks, or conversely, isolate due to shame
Importantly, the focus of concern varies from person to person. It might be weight or body shape, but just as often it’s something like skin, hair, facial features, or other areas not related to weight at all.
How BDD Is Connected to OCD
One of the lesser-known facts about BDD is how closely it relates to Obsessive Compulsive Disorder (OCD). In fact, BDD is classified within the obsessive-compulsive and related disorders category in the DSM-5. That’s because the cycle of obsessive thoughts and compulsive behaviors is central to both conditions.
In BDD:
The obsession is often a belief that a specific body part is deformed or ugly.
The compulsions are the behaviors meant to reduce that distress — like checking mirrors, comparing to others, or camouflaging the perceived flaw.
This OCD-like pattern often creates a powerful and painful loop that reinforces the belief and deepens the anxiety.
There Is Hope — and Treatment That Works
With the right support, body dysmorphia can be treated. At The Current, we offer a range of evidence-based therapies including:
Inference-Based CBT (I-CBT) to target obsessive reasoning patterns and to reduce compulsive behaviors
Radically Open DBT (RO-DBT) for clients with perfectionism, emotional overcontrol, or rigid coping patterns
We also take a trauma-informed approach, recognizing that many people with BDD have histories of bullying, trauma, or invalidating environments that contributed to their struggles.
We also understand that Body Dysmorphic Disorder (and its close connection to OCD) often benefits from a combination of therapeutic and medical support. That’s why we work collaboratively with psychiatrists who are experienced in treating BDD and related conditions. When appropriate, medication can help reduce the intensity of obsessive thoughts and compulsive urges, making it easier to engage in therapy and benefit from skills like those taught in RO-DBT. Our team approach ensures that you’re supported holistically — addressing both the emotional and biological aspects of what you're experiencing, and tailoring care to meet your unique needs.
How We Treat BDD (and OCD):
Inference-Based Cognitive Behavioral Therapy (I-CBT)
A promising approach for treating BDD is Inference-Based CBT (I-CBT).
I-CBT is especially helpful for people who have highly detailed and convincing beliefs about their appearance. Instead of focusing solely on the content of the belief (e.g., “my nose is crooked”), I-CBT helps clients examine how that belief formed in the first place — usually through faulty reasoning or “inferential confusion.”
Through this approach, clients learn to:
Identify when they’ve shifted from sensory reality into imagination-based belief
Rebuild trust in their direct perception rather than internal “stories”
Disrupt the obsessive-compulsive reasoning patterns that drive BDD
This approach teaches you to recognize when your mind is pulling you away from reality and helps you reconnect with what’s actually true. Many people with BDD find that I-CBT gives them a powerful way to break free from obsessive doubts and begin to trust their perception again.
At our practice, we’ve found I-CBT to be a powerful intervention, especially for clients who have insight into their distorted thoughts but still feel stuck in them. Our I-CBT trained clinician, Shayna Irvin, LMSW, often combines this approach with mindfulness and social safety activation skills, to address both the cognitive and somatic symptoms of BDD and OCD.
Radically Open Dialectical Behavioral Therapy (RO-DBT)
If you’re living with body dysmorphic disorder (BDD), you might find yourself also stuck in rigid thoughts and behaviors, perfectionism, harsh self-judgment, and a constant effort to appear “in control” — even when you’re feeling overwhelmed inside. Radically Open Dialectical Behavior Therapy (RO-DBT) is especially helpful for people who cope through overcontrol, a common trait in BDD and OCD. This treatment helps by teaching specific skills like self-enquiry (learning to question your own rigid beliefs with curiosity) and social signaling (practicing openness and nonverbal connection to build safety and trust within yourself and others). For someone with BDD, these strategies can loosen the hold of appearance-focused thoughts and behaviors, reduce isolation, and build more authentic, compassionate relationships — including the one you have with yourself.
All of the therapists at The Current are trained in RO-DBT and have found it to be an effective approach for many symptoms associated with BDD and OCD.
BDD and Eating Disorders: The Overlap
In our work at The Current, we often see body dysmorphia co-occurring with eating disorders. While they are separate diagnoses, they frequently interact — especially when the BDD centers on weight, shape, or body size. Many individuals with anorexia nervosa or bulimia nervosa, for example, exhibit a type of body dysmorphia specific to their body image and weight.
That said, BDD can exist without disordered eating. Someone might have significant BDD related to their skin, hairline, or face and never engage in disordered eating behaviors.
Don’t Wait To Reach Out For Help
Body dysmorphia thrives in secrecy and silence. Talking about it — naming it — is the first step toward healing. If you or someone you care about feels consumed by appearance-related thoughts or behaviors, know that you are not alone and that help is available.
You don’t need to wait for a formal diagnosis or a crisis moment to get support. If you’re wondering whether therapy might help, reach out. You deserve to live a life not dictated by the mirror. Contact us today.