Body Dysmorphia In Teens: Symptoms And Causes

Body dysmorphia is a mental health disorder in which a person obsessively focuses on perceived flaws in one’s physical appearance to the point it affects their quality of life.

Symptoms of body dysmorphia include extreme focus on looks, being upset about unfavorable changes in physical appearance, persistent examination or fixing of the body part, hiding from others, and holding on to false views about one’s physical appearance.

Causes of body dysmorphia are low self-esteem, genetics, perfectionism or comparison, traumatic experiences like abuse and bullying, and fear of rejection.

Despite being a severe and common disorder, body dysmorphia is still underdiagnosed and under-recognized. If you notice you or any of your loved ones are battling with body dysmorphia, seek professional help to get the required diagnosis and treatment.

What Is Body Dysmorphia?

Body dysmorphia, medically termed body dysmorphic disorder, also called dysmorphophobia, is a mental health condition or a psychiatric disorder that has to do with a preoccupation with a perceived fault in one’s appearance. 

It is characterized by the unfair judgment of one’s physical appearance. Even with small differences in appearance, individuals struggling with body dysmorphia become extremely concerned and worried about it.

According to Bjornsson, Andri S. et al.’s 2013 study ‘Age at Onset and Clinical Correlates in Body Dysmorphic Disorder,’ symptoms of BDD usually start in adolescence, often around the ages of 12 to 13. This condition is also closely related to obsessive-compulsive disorder (OCD).

What Are The Symptoms Of Body Dysmorphia?

Most symptoms of body dysmorphia show in their thought patterns. Teenagers who have this mental illness worry about their looks, and it translates to a lack of confidence. 

The following are some of the symptoms of body dysmorphia in teens: 

  • Extreme focus on looks: They find it difficult to stop thinking about their looks and the part of their body that they don’t like. They focus and worry about everything about their bodies, like a pimple or the shape or look of their nose, eyes, lips, ears, teeth, or hands. 
  • Obsessing about changes in their physical appearance: They feel upset about any unfavorable change in their physical appearance. These kids feel stressed and anxious every time they notice a change they imagined to be flawed in their bodies or physical appearance, like pimples, hair, skin color, and breast size, among others.
  • Attempt to fix their body part: Teens suffering from body dysmorphia can’t stop examining or fixing their body parts. Mortada et al.’s 2020 study, ‘Screening for body dysmorphic disorder among patients pursuing cosmetic surgeries in Saudi Arabia,’ claims that one-fifth of patients requesting cosmetic procedures are potential cases of BDD requiring psychiatric evaluation and treatment. 
  • Not wanting to be seen: Some teens feel so bad about their physical appearance that they prefer staying indoors to avoid others seeing them. Sometimes, they use makeup or dress to cover up their look from others. At an extreme rate, they avoid looking in the mirrors or taking pictures because they believe that it is going to portray an ugly version of themselves. 
  • Distorted perception of their appearance: Teenagers with body dysmorphia hold a false view of their appearance. They don’t feel they look as good as others see them to be, and it is often hard to convince them otherwise. They hold on to the perceived flaws in their look and exaggerate them to make them seem worse in their mind. 

What Causes Body Dysmorphia?

Body dysmorphia stems from a combination of biological, psychological, and environmental factors. The following are some of the known causes of body dysmorphia:

  • Low Self-Esteem: Teens with low self-esteem often become fixated on the parts of their appearance they wish to improve. They feel their appearance is the most valuable thing about them and attach more importance to working on it.
  • Genetics: Body dysmorphia is common among people whose relatives or family members also suffer from the disorder. According to Wei Li, B. S. et al.’s 2013 study, ‘Body Dysmorphic Disorder: Neurobiological Features and an Updated Model,’ 8% of individuals with BDD have a family member who is also diagnosed with the disorder.
  • Perfectionism Or Comparison: Information about body image and appearance that teens often access in movies, social media, advertisements, or magazines typically exerts a negative influence on their perception of their own bodies. This exposure makes them develop unrealistic expectations about their appearance, contributing to dissatisfaction and negative feelings towards their body image.
  • Traumatic Experiences: Teens who experienced abuse or bullying are more likely to develop a negative image of themselves, which in turn causes them to hold a negative and false perfection about their appearance. 
  • Fear Of Rejection: Teens who worry a lot about fitting in a group or being rejected often develop thought patterns of body dysmorphia. For instance, kids who believe they need to look a certain way to be accepted by a certain circle usually worry a lot about their physical appearance. 

What Are The Two Types Of Body Dysmorphia?

The following are two common types of body dysmorphia:

1. Muscle Dysmorphia

This type of dysmorphia affects both males and females. It is characterized by an intense fear of one’s body build being too weak or small. Individuals who suffer from this type of dysmorphia often spend a lot of time gyming to bulk up. Even with good muscle mass, individuals battling with this dysmorphia may still think they are undeveloped and inadequate, always obsessing about how to get larger.

Although males and females struggle with muscle dysmorphia, it is more common in males. This is because culture defines the ideal male to be strong and big while the female counterfeit is thin and small. More so, most of the people battling with muscle dysmorphia also suffer from depression.

Muscle dysmorphic individuals may also become intensely focused on eating some foods while completely avoiding others that are believed to be detrimental to muscle gain. This often includes high protein intake, sometimes far exceeding nutritional recommendations, and the excessive use of protein powders and supplements.

2. Body Dysmorphia By Proxy

Teens who suffer from body dysmorphia by proxy tend to be hyper-focused on what they perceive to be flaws in others’ appearance. It could be a stranger or someone close to them. This leads to distress, affects their functioning, and causes them to spend time performing the act of “fixing” others’ appearance in order to alleviate distress.

Individuals with Body Dysmorphia, by proxy, feel impairment in their daily lives because of their intrusive concerns about others’ appearances. In many cases, these teenagers spend excessive time scrutinizing others’ appearances or comparing their appearances to those of others.

How Is Body Dysmorphia Treated?

Though body dysmorphia isn’t curable, it is treatable. Just like many other mental health disorders, there are different ways to treat body dysmorphia. 

The following are the treatment options available for teens with body dysmorphia:

1. Psychotherapy 

The technique used for psychotherapy is to make the teenager who has body dysmorphia speak to a psychotherapist about what they are feeling or experiencing. This treatment is common in two forms: 

  • Cognitive behavioral therapy (CBT): CBT helps teens with body dysmorphia understand the thoughts and behaviors that lead to their distressing feelings about their body image. This technique changes their negative thoughts and behaviors into more positive ones, improves their self-esteem, and reduces the urge to seek reassurance.
  • Family therapy: Family relationships can greatly influence a teen’s mental health. Family therapy is an important part of treatment because it helps family members understand the disorder and learn the best ways to support their teen without encouraging unhealthy behaviors related to BDD.

2. Medications

Medications like antidepressants are commonly used for the treatment of body dysmorphia. Medications help in reducing the symptoms of body dysmorphia, making it easier for the teen battling with the illness to manage their thoughts and behaviors. 

Is Body Dysmorphia A Bad Thing?

Body dysmorphia is a serious mental health disorder that often doesn’t get better without treatment. It gets worse over time, without treatment, and can lead to other mental health disorders like anxiety, severe depression, and even suicidal thoughts. 

How does social media influence body dysmorphia in teens?

Social media can significantly impact body image and contribute to body dysmorphia in teens. Constant exposure to curated images of unrealistic beauty standards can lead to feelings of inadequacy and comparison. Teens may develop a distorted perception of their own bodies, striving for unattainable ideals promoted on social media platforms. Likes, comments, and followers can become measures of self-worth, exacerbating feelings of insecurity and dissatisfaction with physical appearance. Engaging in frequent social media use, particularly platforms focused on appearance and validation, may increase the risk of developing or exacerbating body dysmorphia in susceptible individuals.

Is body dysmorphia in teens linked to other mental health conditions?

Body dysmorphia in teens often coexists with other mental health conditions, such as anxiety disorders, depression, and eating disorders. The preoccupation with perceived flaws or defects in appearance can lead to significant distress and impairment in daily functioning, impacting various aspects of mental well-being. Teens with body dysmorphia may experience heightened levels of anxiety and social withdrawal, as well as symptoms of depression, including low self-esteem and hopelessness. Additionally, body dysmorphia shares similarities with obsessive-compulsive disorder (OCD), as individuals may engage in repetitive behaviors or rituals to alleviate distress related to their appearance concerns.

Can body dysmorphia in teens lead to panic attacks?

While body dysmorphia primarily revolves around preoccupations with perceived flaws in appearance, the distress and anxiety associated with these concerns can trigger panic attacks in some teens. The intense fear and discomfort experienced during panic attacks may be exacerbated by feelings of shame, embarrassment, or perceived judgment related to body image issues. Teens with body dysmorphia may develop avoidance behaviors or social isolation to cope with their distress, which can further contribute to the onset or exacerbation of panic attacks.

What Do Teens With Body Dysmorphia See in Themselves??

Teens with body dysmorphia hardly see their body as others see it. They focus on their perceived flaws, which are not noticeable to others. They exaggerate the flaws and make them seem worse in their minds.

What Is The Opposite Of Body Dysmorphia?

Reverse body dysmorphia is the opposite of body dysmorphia. It happens when individuals have a delusional belief that they are more fit and muscular than they actually are. People with reverse BDD see themselves as thin despite having a larger body.

How Do People With Body Dysmorphia Act?

People with body dysmorphia usually worry about how they look. They frequently check the mirror, ask people for reassurance about their appearance, or compare it with others. 

Author: Shantel Sullivan Ed.D., LCSW
Dr. Shantel Sullivan, Ed.D., LCSW, serves as the CEO of Bright Path with a rich background in residential adolescent treatment, adult outpatient services, and academia, leveraging over a decade of licensed social work experience in New York and North Carolina. Her academic credentials include a BA in Sociology, an MSW and a graduate certificate in addictions counseling from the University of New England, culminating in a doctoral degree in Educational Leadership focused on transformational leadership. Beyond her clinical expertise, Dr. Sullivan contributes to the field as a national speaker, educator, and editor of the Bright Path Teen Mental Health Blog, committed to enhancing access to evidence-based mental health care for adolescents and their families.
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