Treatment Options for Body Dysmorphic Disorder

Living with body dysmorphic disorder can feel overwhelming, as persistent thoughts about perceived flaws in appearance can take control of daily life. Although many people struggle silently with appearance-related distress, effective solutions exist. Through therapy for body image concerns, medications, and other proven treatments, people can learn to challenge distorted thoughts, develop healthy coping skills, and rediscover joy in their daily activities.

What Is Body Dysmorphic Disorder?

Diagnosed in roughly 2.4% of U.S. adults, body dysmorphic disorder is a mental health condition characterized by an intense preoccupation with perceived flaws in appearance that are either minimal or not observable to others. These preoccupations can involve one or several body parts, such as the skin, hair, nose, breasts, etc., and they can range in severity, with perceived self-perceptions ranging from “unattractive” to “hideous” ^[1]. 

Thoughts associated with body dysmorphic disorder are often intrusive, unwanted, time-consuming, and difficult to resist and control ^[1]. Furthermore, these preoccupations can lead to repetitive behaviors such as mirror checking, excessive grooming, seeking reassurance about appearance, or attempting to hide perceived flaws with makeup, clothing, or specific body positions ^[2]. 

Beyond behavior and emotional concerns, however, people with body dysmorphic disorder often experience significant distress and impairment in social, occupational, and other important areas of functioning. In fact, the condition can lead to severe emotional pain, social isolation, and difficulty maintaining relationships or employment. Most concerning, however, is its strong association with suicidal thoughts and behaviors. Studies indicate that approximately 80% of people with body dysmorphic disorder experience suicidal ideation at some point in their lives, and about one-quarter attempt suicide ^[3]. Additionally, many people with the condition experience depression, anxiety, and social isolation, which can further compound their struggles and impact their quality of life ^[4]. 

If you or someone you know is experiencing thoughts of suicide, reach out immediately for help. Call or text 988 to reach the 988 Suicide and Crisis Lifeline, which provides free, confidential support 24 hours a day, 7 days a week. Trained counselors can provide immediate assistance, emotional support, and connections to local resources. 

Diagnosis and Symptoms

Body dysmorphic disorder signs and symptoms can easily be confused with other mental health conditions. Thus, mental health professionals use specific diagnostic criteria to identify and differentiate body dysmorphic disorder. A thorough evaluation typically includes a detailed assessment of symptoms, their severity, and their impact on daily functioning. 

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, provides the following diagnostic criteria for body dysmorphic disorder ^[1]: 

• Appearance Preoccupation: The person experiences persistent preoccupation with one or more perceived defects in physical appearance that are not observable or appear slight to others.
• Repetitive Behaviors: During the course of the disorder, the person performs repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking, or seeking reassurance) or mental actions such as comparing their appearance with others.
• Clinical Significance: The preoccupation with appearance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Other Conditions: Clinicians rule out eating disorders by confirming that concerns about appearance are not primarily focused on body fat or weight.

While not definitive, research has shown interesting connections between body dysmorphic disorder and obsessive-compulsive disorder (OCD). Both share neurobiological features, such as intrusive thoughts and repetitive behaviors, and both respond to similar treatments ^[5]. However, body dysmorphic disorder includes distinct characteristics, such as its focus on appearance-related concerns, that set it apart from other mental health conditions. 

Cognitive Behavioral Therapy

Psychotherapy is the primary treatment approach for body dysmorphic disorder, with cognitive behavioral therapy (CBT) proving especially effective in helping people manage their symptoms ^[2]. 

During CBT sessions, therapists help people identify and challenge distorted thoughts about their appearance while developing healthier ways to respond to appearance-related concerns. The therapy process often includes exposure and response prevention techniques, where people gradually face situations they typically avoid and learn to resist compulsive behaviors such as mirror checking or excessive grooming. 

Therapy for body image concerns also helps people develop practical coping strategies and self-acceptance. Through therapeutic interventions, people learn to recognize triggers that intensify their symptoms and develop alternative responses ^[6]. Additionally, the treatment process may address underlying issues such as perfectionism, low self-esteem, or past experiences that contribute to appearance-related distress. 

Motivational Interviewing

Due to the nature of body dysmorphic disorder, many people have limited insight into their condition and may not recognize that their appearance concerns are excessive or unrealistic. This lack of awareness often creates barriers to seeking appropriate care. Many people with body dysmorphic disorder never seek mental health treatment, instead pursuing surgical, dermatological, or dental procedures to fix perceived flaws ^[7]. 

Motivational interviewing, a therapeutic technique designed to enhance internal motivation for change, can help address challenges stemming from limited awareness of the condition. Through this approach, mental health professionals work collaboratively with people to explore their concerns and ambivalence about treatment.

The process involves helping people recognize how their appearance preoccupation affects their quality of life while supporting their journey toward developing a positive self-image. Rather than directly confronting beliefs about appearance flaws, motivational interviewing creates a supportive environment where people can safely explore their experiences and gradually build readiness for change. This gentle, collaborative approach helps overcome resistance to treatment and increases the likelihood that people will engage in evidence-based care.

Medication for Body Dysmorphic Disorder 

Along with therapy, medication often plays an important role in treating body dysmorphic disorder, particularly when symptoms significantly impact daily functioning. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-reuptake inhibitors (SRIs) are typically the first-line medication treatment, as research has shown they can effectively reduce symptoms ^[8]. 

Common medications prescribed for the condition include fluoxetine (Prozac), escitalopram (Lexapro), and citalopram (Celexa). They work by increasing serotonin levels in the brain, which can help reduce obsessive thoughts about appearance and decrease related compulsive behaviors ^[4]. 

While medications can significantly relieve symptoms, they typically work best when combined with psychotherapy ^[8]. This combination approach helps address both the biological and psychological aspects of the condition, offering the best chance for long-term symptom management. 

Solutions for Body Dysmorphic Disorder

While professional treatment forms the foundation of care, several lifestyle modifications and self-help strategies can support recovery. These approaches work best when implemented alongside therapeutic interventions and medication management.

Recommended lifestyle changes include ^[6]: 

• Stress Management: Practice relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation to reduce anxiety about appearance concerns.
• Regular Exercise: Engage in physical activity that focuses on health and strength rather than appearance, helping to reduce stress and improve mood.
• Sleep Hygiene: Maintain consistent sleep patterns and create a relaxing bedtime routine to support overall mental health.
• Healthy Routines: Set time limits for grooming and mirror-checking activities to prevent these behaviors from controlling daily life.

The following support options can also enhance treatment outcomes ^[6]:

• Support Groups: Connect with others who understand body dysmorphic disorder through in-person or online support groups.
• Family Education: Involve family members in learning about the condition to create a more supportive home environment.
• Recovery Apps: Use mental health apps designed for tracking symptoms and practicing coping skills.
• Educational Resources: Access reputable information about the disorder through mental health organizations and treatment centers.
• Crisis Support: Keep contact information readily available for crisis hotlines and mental health emergency services.

As with most mental health conditions, the path to recovery often requires a combination of professional help and personal commitment to change. By incorporating these solutions into daily life while maintaining consistent treatment, people can develop stronger coping skills and work toward lasting improvement.

Prognosis for Body Dysmorphic Disorder

Individuals with body dysmorphic disorder often see significant improvement with proper treatment and support. In fact, research shows that most people who engage in comprehensive treatment plans see a reduction in symptom severity and an enhanced quality of life ^[2]. 

While the recovery journey varies for each person, many experience substantial improvement within several months of starting appropriate treatment. In terms of effectiveness, some people achieve complete symptom remission while others may experience mild symptoms that become more manageable with ongoing care ^[2]. Granted, relapses can occur, particularly during times of stress or significant life changes, but established coping strategies and professional support make these periods easier to navigate. 

Although improvement is possible at any stage of the condition, early intervention typically leads to better outcomes. Regular attendance at therapy sessions, consistent medication use when prescribed, and active participation in treatment also significantly increase the chances of positive long-term results. 

The Path to Recovery

Living with body dysmorphic disorder presents significant challenges, but effective treatments provide paths to recovery and healing. Through a combination of professional care, including CBT, motivational interviewing, and medication when needed, people can learn to manage symptoms and rediscover joy in their daily lives.

Recovery becomes possible when people take the first step toward seeking help. While the journey may include both progress and setbacks, modern treatment approaches offer hope and practical solutions for managing symptoms. With proper support and an ongoing commitment, many people move beyond appearance preoccupation to build meaningful connections and pursue their life goals with renewed confidence.