Understanding and Defeating Body Dysmorphic Disorder (BDD)

By Carol Goh

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It is normal for people to have little things they dislike about their appearance. While many may fret about their imperfections, it typically does not interfere with day-to-day life.

However, individuals who suffer from body dysmorphic disorder (BDD) are consumed by negative thoughts of their appearance. These thoughts may cause emotional distress and even make it difficult for them to function healthily.

Understanding body dysmorphic disorder

Body dysmorphic disorder is a mental health disorder characterised by preoccupations with flaws in one’s appearance that are persistent and invasive.

Individuals suffering from BDD can find fault with any part of their body, with the most common being their skin, nose, stomach, and overall physique. In reality, the perceived flaw might be a minor flaw or even imagined. Despite that, someone with BDD may repeatedly check their appearance, constantly seek reassurance from others, or spend hours trying to conceal perceived flaws. In severe cases, they may feel too conscious or anxious to interact socially.

For related reads, see Conquering Low Self-esteem Through Psychotherapy and Anxiety Counselling.

Causes of body dysmorphic disorder

Research has shown that BDD affects men and women almost equally. The exact causes are unclear, but environmental factors can contribute to its development.

In an increasingly digital world, comparing oneself to others on social media can influence one’s perception and image of their appearance. Self-perception may also be shaped by the concepts and values of family, friends, education and religion.

When trauma, criticism, or shame are part of one’s history, these experiences can also reinforce self-critical beliefs (see Psychotherapy and Schema Therapy).

Signs and symptoms

Individuals suffering from BDD are constantly trying to correct or conceal their perceived imperfections. This obsession can persist for hours or even the entire day. These thoughts and urges are difficult to resist or control, making it challenging to focus on anything else.

Common signs include:

Negative body image; constantly putting oneself down or comparing appearance to others
Constantly checking one’s appearance in the mirror
Avoiding mirrors
Camouflaging (hiding body parts under clothing or makeup)
Frequently seeking reassurance from others but not believing them
Feeling anxious, depressed, or ashamed
Avoiding social situations

Left untreated, BDD may contribute to low self-esteem, mood disorders, eating disorders, and social anxiety.

Treatment for body dysmorphic disorder

BDD is serious but treatable. It is important to receive help from a qualified professional. If left untreated, symptoms may worsen over time and result in other severe mental health disorders such as depression or thoughts of self-harm.

Multiple studies support psychotherapy as an effective treatment. A suite of approaches—such as Schema Therapy, Eye Movement Desensitisation and Reprocessing (EMDR), Gestalt, and visualisation—can help a person revise self-critical language and restructure negative, irrational thoughts about their appearance.
Learn more: EMDR · Schema Therapy.

Our work often includes gentle exposure to avoided situations, skills for managing reassurance-seeking and checking, and building compassionate, values-driven routines.

Take the next step

Here at Emotional Wellness Counselling Singapore, we offer therapy and counselling services in Singapore and online. Our psychotherapist has over 18 years of experience and will work alongside you to address BDD, body image distress, and self-esteem—drawing on Schema Therapy, EMDR, Gestalt, visualisation, and more to help you reduce distress and relate to your appearance with kindness.