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What is body dysmorphic disorder?

Body dysmorphic disorder is a mental health condition in which children feel extreme worry about their physical appearance. Children with body dysmorphic disorder get very upset about a tiny flaw in the way they look. Sometimes the flaw doesn’t even exist. This disorder is sometimes called “imagined ugliness.” 

Kids with body dysmorphic disorder often feel a lot shame. They may not want to go to school or see friends because of the flaw in their appearance. They might try to cover up what bothers them with clothing or make-up, or even want to have surgery to correct it. However, physical changes don’t make kids with body dysmorphic disorder feel better. They find something to worry about no matter how they really look.  

Children who have obsessive-compulsive disorder (OCD) are more likely to develop body dysmorphic disorder. It shows up about the same amount in boys and girls.

What are the symptoms of body dysmorphic disorder?

Unlike an eating disorder, body dysmorphic disorder isn’t necessarily focused on weight or body fat. It usually begins around age 12 or 13. 

Kids with body dysmorphic disorder show symptoms including: 

  • Too much worry or shame over the way they look 
  • Believing that a minor flaw makes them ugly  
  • Fixating on worry about a specific part of the body, like the nose or the teeth 
  • A lot of time spent looking in the mirror, or avoiding mirrors completely 
  • Constantly looking for reassurance about the way they look 
  • Refusing to appear in photos 
  • Wanting cosmetic surgery 
  • Depression  
  • Social anxiety 
  • Worry that gets in the way of daily life

How is body dysmorphic disorder diagnosed?

It can be hard to diagnose body dysmorphic disorder, because it can look similar to other disorders like OCD and eating disorders. Sometimes children have a hard time telling anyone that they’re upset because of their appearance.

To be diagnosed with body dysmorphic disorder, a child has to be so upset about their appearance that it causes problems in their daily life. It is usually diagnosed through a combination of physical exams and psychological evaluations. 

How is body dysmorphic disorder treated?

The treatment for body dysmorphic disorder is usually a combination of cognitive behavioral therapy (CBT) and antidepressant medication. CBT helps children learn to change their negative thoughts and bad feelings about themselves. 

In severe cases, when a child or teen is in danger of hurting themselves, they may need to be hospitalized for a time. 

Cosmetic surgery is not used as a treatment for body dysmorphic disorder. That’s because children with this disorder are likely to start worrying about a new flaw in their appearance as soon as the old flaw changes.  

This guide was last reviewed or updated on September 7, 2021.