Often, those with eating disorders have ideas about how their bodies look that are not accurate. When this phenomenon stands on its own, without the presence of an eating disorder, it is known as body dysmorphic disorder, or BDD.
Symptoms of Body Dysmorphic Disorder
Body dysmorphic disorder involves a preoccupation with some defect in the person's appearance. This defect becomes so important that the person feels a great deal of stress. In some cases, there is no defect present--only the idea that one is there. In either case, stress about the "defect" becomes powerful enough to keep the person from functioning normally.
Many times, the person with body dysmorphic disorder perceives a problem with a part of the face--nose, eyebrows, mouth, lips, teeth, or any facial feature--but it can be associated with other body parts. Regardless, a person with symptoms of BDD will often check his or her appearance in a mirror or any other reflective surface. This activity can consume hours of the person's day (American Psychiatric Association, 1994).
A study of women and men with body dysmorphic disorder (Phillips and Diaz, 1997) suggested that women with BDD are more likely to be concerned about their hips and to use makeup to cover up what they perceive as facial flaws. Men, on the other hand, seem to be more concerned with body build, a lack of hair, or their genitals.
Similarities Between Body Dysmorphic Disorder and Eating Disorders
Those with BDD share certain traits with persons who struggle with eating disorders. In both cases there is anxiety about the body. A person with anorexia, for example, will not believe someone who tells her that she isn't fat. Similarly, a person with BDD who believes that his ears are too large will not believe someone who tells him that they look normal.
Like those with eating disorders, a person with body dysmorphic disorder will often compare his "defective" body part to that of others. If the anxiety is strong enough, the person may avoid everyday activities and become isolated.
Differences Between Body Dysmorphic Disorder and Eating Disorders
Body dysmorphic disorder is not dependent on the person's body weight or eating habits. If the person has all the symptoms of an eating disorder, her preoccupation with her body shape is not a sign of BDD. It is a part of the eating disorder. However, a person could have both an eating disorder and BDD.
For example, a person who binges and purges and maintains a fairly normal weight could be diagnosed with bulimia nervosa. If at the same time she experiences a high level of stress because of the shape of her nose (which is not related to her body shape and size), then body dysmorphic disorder may be an additional diagnosis.
A Word of Caution, and Next Steps
As always, it is important not to assume that a person suffers from a mental disorder just by observing certain behaviors. A diagnosis must come from a trained professional. If you are concerned about being preoccupied with a body part, call your physician, counselor, or psychiatrist for an evaluation. BDD is normally treated with talk therapy and, if appropriate, medication (Mayo Clinic 2006).
American Psychiatric Association. 1994. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, D.C.: American Psychiatric Association.
Mayo Clinic. “Body Dysmorphic Disorder.” <http://www.mayoclinic.com/health/body-dysmorphic-disorder/DS00559>. Accessed 10 October 2006.
Phillips, Katharine A. and Susan F. Diaz. 1997. "Gender Differences in Body Dysmorphic Disorder." Journal of Nervous & Mental Disease 185: 570-577.
