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The Causes, Effects, and Treatments of Body Dysmorphic Disorder

  • Chante Sy
  • Sep 23
  • 8 min read

Body dysmorphic disorder, also known as body dysmorphia, causes one to see their body as flawed. Many tend to think body dysmorphia and insecurity are the same and while they do have similar traits such as covering or hating the flaw, body dysmorphia is more than just disliking it. Body dysmorphia distorts the image of the body, they overexaggerate a part of their body that may be non-existent or unnoticeable to others.[1] It creates a stronger sense of insecurity, which comorbid with anxiety, depression, eating disorders or obsessive-compulsive disorder.[2] Those with body dysmorphia exhibit certain behaviors such as frequently avoiding using a mirror to reduce their concern over appearance.[2] [3] Some would try to hide it by using make-up, filters or self isolation.[2] [3] As for other people, they would undergo cosmetic surgery, unhealthy dieting or overuse of steroids.[2] [3] There are different forms of dysmorphia like body, facial, muscle, etc.[2] [3] It is not the same as insecurity, but insecurity is one of its symptoms. Many conclude those with body dysmorphia are attention-seeking and overreacting because they never understood why they see themselves differently compared to others perspectives. It is important for people to know that experiences in life can greatly contribute to the brain's activity, in order to properly support them.


There are multiple factors that could cause body dysmorphia, such as genetics, abuse, bullying or social standards.[4] There is a chance of inheriting body dysmorphia from a family member.[4] A study observed that 8% of people with body dysmorphia have first-degree relatives diagnosed with body dysmorphic disorder.[4] Other than genetics, it can also manifest through the abuse from a family member.[4] It causes the victim to feel insecure and neglected in the relationship. It is also possible to have body dysmorphia from bullying.[4] Social rejection causes embarrassment and fear, leading to  possession of psychopathologic behaviors such as change of eating habits or suicide ideation.[5] Some blame themselves for being weird or unpleasant to society. Body dysmorphia can be used as a defense mechanism as it redirects their attention to fixate on another problem; it helps avoid the problems in front of them.[6] It could also be a maladaptive coping mechanism to cope from shame and stress.[7] Shame is a powerful feeling, especially in a world where reputation is associated with social standards. Those who do not fit the social standard will be looked down upon. They are rules that influence people to believe they are flawed. A study[8] surveyed women, aged 18 and above, about their perspective on magazine industries and social media influencers, finding  that magazines and influencers can influence women that they must have specific body measurements to be healthy or sexually attractive. It is most affecting to younger women as they are trying to find their social identity. It is pressuring and toxic, it reduces women into eye candy. It does not only apply to women but men with the pressure of being manly. 


It is known that body dysmorphia lets the person see themselves differently compared to reality. There has been a study that shows the visual cortex and visual systems are hypoactive, hindering the ability to see and process as a whole.[4] On the other hand, the dysfunctional fusiform gyrus increases their attention and sensitivity in piecemeal processing.[7] [9] This may be the reason the symptoms of body dysmorphia are distorted or exaggerated views of the body. Another symptom of body dysmorphia is the harsh criticism due to the right parahippocampal gyrus[10], known for kind judgement towards the body, has the least activity. Other parts of the brain, such as the bilateral head of the caudate and left orbitofrontal cortex, are hyperactive when evaluating pictures of themselves in an experiment.[4] [11] Both of them are similar to the brain activity in obsessive-compulsive disorder[3] [12] [13], as if it was triggered. However, it is classified as an obsessive-compulsive and related disorder in the DSM-5.[3] Body dysmorphia is associated with the obsessive-compulsive disorder sub-types, many constantly check their appearance or ask for reassurance.[3] [7] They perform these acts repetitively for dopamine to reduce their anxiety.[7] Dopamine is a happy chemical for obtaining rewards, it is possible that rewards could be like this because they found relief after checking on themselves.[7] As well as anterior cingulate cortex, a part responsible for decision-making and reward processing, being hyperactive in body dysmorphia.[12] It is difficult to stop obsessions and compulsions because the hyperactivity of the orbitofrontal cortex is connected to obsessive thoughts, causing those with body dysmorphia to have trouble ignoring it.[7] [11] In addition, the default mode network is disrupted, causing the person to fixate and obsess about their flaws.[7] Most with body dysmorphia express extreme negative emotions whenever they are reminded of their flaws. This is from the amygdala that is utilized for processing emotions and assessing threats.[7] When heightened, the person becomes anxious. Usually, the gamma-aminobutyric acid is released to stabilize one’s anxiety or stress[14]; however, as the neurotransmitter is dysregulated during body dysmorphia, it causes one  to struggle to calm down[7]. As their thoughts bring down their self esteem, they may have a hard time accepting compliments[4] and assume people harbor anger towards them.[4] In an emotional stroop task[15], participants with body dysmorphia were tasked to focus on the words “attractive” and “beauty”, they were more likely to have difficulty than participants with no body dysmorphia. The results suggest they have strong beliefs about their appearance being flawed.[4] [15] They may also believe that people are angry at them due to their anxiety and low self-esteem. Based on multiple studies[16], many  with body dysmorphia have misunderstood reactions as anger towards them. This mindset results in self isolation to avoid potential judgement from people.[7] Body dysmorphia affects the way people see and react towards their body.


Body Dysmorphic Disorder is not beneficial in the long run. The condition may get worse as time goes by, so it is best to seek treatments such as Cognitive Behavior Therapy (CBT), Selective Serotonin Reuptake Inhibitors (SSRIs) or Transcranial Magnetic Stimulation (TMS).[7] [17] CBT is a psychotherapy that brings awareness to their behavior and emotions, properly processing them to find the cause and ways to regulate them.[18] They are encouraged to face their fears[18], like socializing or uncertainty of their appearance, as they have to learn on how to manage their stress. It is also recommended to practice a healthy balanced lifestyle to improve mental and physical health.[18] As a result, the default mode network's connectivity and the anterior cingulate cortex, showingdecreased activity, has improved, indicating that one's obsessive thoughts and compulsive actions could lessen over time.[19] Another method of treatment is SSRIs.[17] Serotonin is a neurotransmitter responsible for affecting our mood, especially happiness.[20] However, those with body dysmorphia have reduced levels of it.[7] Hence, the side effects being anxiety, depression, etc.[2] [7] SSRIs increase serotonin, which could decrease the obsessive thoughts and suicidal ideation.[7] [17] [21] Although the medicine's main purpose is to increase serotonin, the unusual changes to the brain and its chemistry can cause people to react differently or negatively to some drugs, so it is recommended to consult a doctor to determine which medicine is suitable for consumption.[21] To increase chances of recovery, SSRIs can be paired with CBT.[21] There are people who may experience no significant changes[21] or wish to quickly heal. The third method is TMS[7], the magnetic field conducts electricity towards the brain's neurons, which manipulates the brain activity.[7] [22] It is able to target depression, eating disorders, or other mental health conditions without needing to go through surgery.[22] It has temporary side effects like headaches, tinnitus or tingling sensation[22]; it may give seizures, though rare, examinations are required before the treatment to prevent such effects.[22] There are multiple ways to treat body dysmorphic disorder, it is within the person's mindset whether to heal or not.


Body dysmorphic disorder is caused by different factors and causes comorbidity with other health conditions.[2] People with body dysmorphia look at their body separately rather than as a whole[4] [7] [9], it is the reason why one can see their flaws even when it may not be significant or real.[2] [7] They can be preoccupied with their body while they go on with their daily life, despite the distress they are given.[7] They can seek reassurance or hide from others, which worsens the obsession-compulsive tendencies.[2] [7] Fortunately, cognitive behavioral therapy could reduce it as one would find alternative ways to manage their emotions.[18] Alongside selective serotonin reuptake inhibitors, it improves mood and decreases the severity of mental health conditions.[21] As for Transcranial Magnetic Stimulation, it focuses on a certain part of the brain to stimulate the neurons for proper activity.[22] Body dysmorphia can be self-destructive, so it is important to find support from family or friends. 



Works Cited


  1. American College of Family Medicine Writers (ACFMW). Insecurity vs. body dysmorphia: everything you need to know. American College of Family Medicine. Accessed August 30, 2025. https://www.acfmw.com/insecurity-vs-body-dysmorphia-everything-you-need-to-know


  1. Phillips KA. What is BDD (Body Dysmorphic Disorder)?. International OCD Foundation. Accessed August 13, 2025. https://bdd.iocdf.org/about-bdd/


  1. Schieber K, Kollei I, De Zwaan M, Martin A. Classification of body dysmorphic disorder — What is the advantage of the new DSM-5 criteria? Journal of Psychosomatic Research. 2015;78(3):223-227. doi:10.1016/j.jpsychores.2015.01.002


  1. Feusner JD, Neziroglu F, Wilhelm S, Mancusi L, Bohon C. What causes BDD: research findings and a proposed model. Psychiatric Annals. 2010;40(7):349-355. doi:10.3928/00485713-20100701-08



  1. Sissons C. Defense mechanisms in psychology: What are they? MedicalNewsToday. Published July 31, 2020. https://www.medicalnewstoday.com/articles/defense-mechanisms#related-conditions 


  1. Çınaroğlu M. Neural Mechanisms and Cognitive-Behavioral Interventions in Body Dysmorphic Disorder: A Neurobehavioral Perspective, J Neurobehav Sci 2025; 12: 32-42


  1. Monks H, Costello L, Dare J, Boyd ER. “We’re Continually Comparing Ourselves to Something”: Navigating Body Image, Media, and Social Media Ideals at the Nexus of Appearance, Health, and Wellness. Sex Roles. 2020;84(3-4):221-237. doi:10.1007/s11199-020-01162-w


  1. Shahid, S. Fusiform gyrus. Kenhub. Published May 25, 2023. https://www.kenhub.com/en/library/anatomy/fusiform-gyrus 


  1. Feusner JD, Yaryura-Tobias J, Saxena S. The pathophysiology of body dysmorphic disorder. Body Image. 2008;5(1):3-12. doi:10.1016/j.bodyim.2007.11.002


  1. Feusner JD, Moody T, Hembacher E, et al. Abnormalities of visual processing and frontostriatal systems in body dysmorphic disorder. Archives of General Psychiatry. 2010;67(2):197. doi:10.1001/archgenpsychiatry.2009.190


  1. Elisavet Machremi, Christos Bakirtzis, Maria-Valeria Karakasi, Marina-Kleopatra Boziki, Vasileios Siokas, Athina-Maria Aloizou, Efthimios Dardiotis, Nikolaos Grigoriadis. What scans see when patients see defects: neuroimaging findings in body dysmorphic disorder. J. Integr. Neurosci. 2022, 21(2), 45. https://doi.org/10.31083/j.jin2102045 


  1. Maia TV, Cooney RE, Peterson BS. The neural bases of obsessive–compulsive disorder in children and adults. Development and Psychopathology. 2008;20(4):1251-1283. doi:10.1017/s0954579408000606


  1. N/A. Gamma-Aminobutyric Acid (GABA). Cleveland Clinic. Published March 19, 2025. https://my.clevelandclinic.org/health/articles/22857-gamma-aminobutyric-acid-gaba


  1. Buhlmann U, McNally RJ, Wilhelm S, Florin I. Selective processing of emotional information in body dysmorphic disorder. J Anxiety Disord. 2002;16(3):289-298. doi:10.1016/s0887-6185(02)00100-7


  1. Wheeler GL, Steinman SA. Emotion recognition in generalized anxiety disorder, panic disorder, body dysmorphic disorder, skin picking disorder, trichotillomania, and posttraumatic stress disorder: a systematic review. Front Psychol. 2025;16:1486765. Published 2025 Jul 4. doi:10.3389/fpsyg.2025.1486765




  1. Yuan S, Wu H, Wu Y, et al. Neural Effects of Cognitive Behavioral Therapy in Psychiatric Disorders: A Systematic Review and Activation Likelihood Estimation Meta-Analysis. Frontiers in Psychology. 2022;13. doi:10.3389/fpsyg.2022.853804


  1. N/A. Serotonin. Cleveland Clinic. Published May 7, 2025. https://my.clevelandclinic.org/health/articles/22572-serotonin 


  1. N/A. Medication. Body Dysmorphic Disorder Foundation. Published August 1, 2024. https://bddfoundation.org/support/getting-treatment/medication/ 


  1. N/A. Transcranial magnetic stimulation (TMS). Cleveland Clinic. Published June 30, 2025. https://my.clevelandclinic.org/health/treatments/17827-transcranial-magnetic-stimulation-tms#risks-benefits 

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