Do I Have Body Dysmorphic Disorder or Body Image Concerns? And what’s the difference?

You find yourself constantly worrying about how you look, scrutinizing every detail in the mirror, taking multiple photos a day, checking your weight/size/measurements, looking at yourself in any reflective surface, or feeling like your appearance is never quite right…

You’ve done some Googling and are wondering “Do I have Body Dysmorphic Disorder (BDD), or are my body image concerns part of an eating disorder?”

We can help.

Many people struggle with these thoughts, and we see clients all the time with these concerns. Understanding the difference can help you find the right support.

What is Body Dysmorphic Disorder (BDD)?

BDD is a form of Obsessive-Compulsive Disorder (OCD) where a person becomes fixated on a perceived flaw in their appearance. This isn’t just general dissatisfaction—it’s an overwhelming, obsessive concern about something that might be barely noticeable (or even invisible) to others. The distress can feel all-consuming, leading to compulsive behaviors like mirror-checking, excessive grooming, comparing yourself to others, or constantly seeking reassurance. The thoughts are intrusive and persistent, and no matter how much you try to “fix” or hide the flaw, the distress doesn’t go away.

Living with BDD can feel exhausting. You might find yourself avoiding social situations, spending hours trying to camouflage the perceived flaw, or feeling completely preoccupied with how you look to the point that it interferes with work, relationships, and everyday life. Even when others reassure you that they don’t see the flaw, it doesn’t ease the anxiety—it still feels undeniably real to you.

Research suggests BDD affects around 2% of the population, often starting in adolescence. It can focus on anything—skin, nose, hair, body proportions—but unlike body dissatisfaction linked to diet culture, BDD isn’t about weight or size. It’s about a specific feature that feels unbearable (Phillips, 2005).

What About Body Image Concerns in Eating Disorders?

If your worries about your body are mostly about weight, size, or shape, and those worries affect your eating habits, they may be part of an eating disorder. People with eating disorders often struggle with overestimating their body size, extreme dissatisfaction with their weight, or a deep fear of gaining weight. These concerns are usually driven by a need for control, perfectionism, or coping with emotions, rather than an obsession with a specific “flaw.”

Someone with body image concerns related to an eating disorder might frequently check their reflection, feel a sense of panic around food, or change their eating and exercise habits to try to achieve a certain body shape. The distress often comes from feeling that they are “too big” or “not thin enough,” and their thoughts about their body fluctuate based on factors like mood, stress, or social situations.

Studies show that body dissatisfaction is one of the biggest risk factors for developing an eating disorder (Stice, 2002). Unlike BDD, which often involves a fixed belief that the flaw is severe and unbearable, body image concerns in eating disorders are influenced by societal pressures and diet culture, and the perception of one’s body can shift over time.

Can You Have Both?

Yes. BDD and eating disorders can overlap, and many people experience aspects of both. If you find yourself struggling with both obsessive concerns about a specific feature and deep distress about your weight or shape, it’s possible that both conditions are at play. In these cases, treatment may need to address both sets of symptoms.

Key Differences Between BDD and Eating Disorder-Related Body Image ConcernS:

  • Main Focus:

    • Body Dysmorphic Disorder (BDD): One specific perceived flaw (e.g., nose, skin, hair, muscle size)

    • Body Image Concerns in Eating Disorders: General dissatisfaction with body weight and shape

  • Underlying Cause:

    • Body Dysmorphic Disorder (BDD): Obsessive thoughts linked to OCD

    • Body Image Concerns in Eating Disorders: Fear of weight gain, control issues, or perfectionism

  • Compulsive Behaviors:

    • Body Dysmorphic Disorder (BDD): Mirror-checking, skin picking, excessive grooming

    • Body Image Concerns in Eating Disorders: Restricting food, purging, excessive exercise

  • Perception of Flaw:

    • Body Dysmorphic Disorder (BDD): Feels intensely real and distressing, even when others don’t see it

    • Body Image Concerns in Eating Disorders: Overvaluation of weight/shape, but perception may shift

  • Treatment Approach:

Getting the Right Support

If you’re reading this and recognizing yourself in both descriptions, that’s okay. You don’t have to fit neatly into one category. BDD and eating disorders share common ground in terms of distress and impact on daily life, and treatment can be tailored to your specific experiences.

The good news? Help is available. Cognitive Behavioral Therapy (CBT) is effective for both BDD and eating disorders, though the approach differs. For BDD, therapy focuses on reducing compulsive behaviors and addressing obsessive thoughts. For eating disorders, therapy helps change unhelpful beliefs about weight and food while restoring a healthy relationship with eating and your body.

If you’re finding yourself searching for a “psychologist near me”, “CBT for BDD”, or “eating disorder treatment”, reaching out to a clinical psychologist can be the first step. Online therapy in Australia is also an option if you prefer virtual support.

You’re Not Alone

Struggling with body image doesn’t mean you’re vain or shallow. These conditions are real mental health issues that can significantly impact your well-being, relationships, and confidence. If your concerns are taking up a lot of mental space and making life harder, it’s worth talking to someone who understands.

For extra support, organizations like the Butterfly Foundation Australia provide resources for those dealing with eating disorders and body image concerns.

If you’re wondering whether your body image struggles are just a phase or something more, know that you don’t have to figure it out alone.

Take the Next Step

If this article resonates with you, reaching out to one of our clinical psychologists in Sydney or exploring online therapy in Australia could be the first step toward feeling better. If you’re ready to take the next step, consider booking an appointment with our team at Brodie Earl Clinical Psychology. Contact us to find out more information, or to arrange an initial consultation.