Body dysmorphic disorder psychoeducation

Many clients share insecurities about their body image, but at what point does it become body dysmorphic disorder? 

This body dysmorphic disorder psychoeducation handout provides an overview of a healthy body image, factors influencing self-perception, body dysmorphic disorder, signs to look out for, and treatment options. 

We’ve included a free downloadable body dysmorphic disorder PDF to save to your electronic health record (EHR) and use in your practice.

What is a healthy body image?

Body image is a construct relating to how we see, think, and feel about our appearance, and how we behave as a result of our body image—concepts explored further in our body image info sheet. This perception, together with sociocultural influences, has the potential to either negatively or positively influence physical and mental well-being. 

For example, holding a negative perception of one's appearance is a risk factor for eating disorders and mental health concerns. However, looking at one's body through a positive lens, by appreciating and accepting the body as it is, is associated with well-being, higher self-esteem, and a healthy outlook.

Signs of a healthy body image in a client may include:

• Looking in the mirror and liking how they look

• Appreciating their unique qualities

• Being able to name a favorite body part

• Not speaking negatively about other people's bodies

• Recognizing that social media distorts body image

• Not comparing their appearance to other people

• Posting realistic pictures of themselves on social media instead of trying to appear "perfect"

• Not equating beauty with body size

When people become overly concerned with their appearance and it impacts their behaviors and quality of life, they may be experiencing body dysmorphic disorder.

What are the signs of body dysmorphic disorder?

Body dysmorphic disorder is a mental health condition characterized by a preoccupation with body image and perceived flaws, and behaviors or rituals to reduce body appearance-related anxiety.

While most people think of themselves as having flaws or are dissatisfied with areas of their body, BDD causes distress and significantly affects the person's day-to-day functioning, including an increased risk of suicide. However, according to researchers, the diagnosis is often missed.

The key signs of body dysmorphic disorder include:

• Preoccupation with a perceived defect or markedly excessive concern with a slight physical anomaly related to hair, skin, nails, body shape, and any other area of their body or appearance

• Ritualistic behaviors, like excessive mirror checking or avoiding mirrors

• Covering or camouflaging the area of concern with makeup, clothes, or hats

• Refusing to have their photograph taken

• Avoiding social events

• Expressing concerns about appearance, calling out features as too small, big, or crooked

• Not leaving the house

• Believing others may be as disgusted by their appearance as they are

• Seeking reassurance from others

• Excessive grooming

• Overexercising

• Comparing themselves to others

• Significant distress and/or functional impairment

• Visiting multiple healthcare providers about their appearance

• Seeking plastic surgery and other cosmetic procedures

• Feeling anxious or depressed

• Suicidal thoughts

Symptoms can cause significant distress or impair daily life, relationships, or overall functioning. While rituals and behaviors may temporarily relieve the appearance-related anxiety, concerns return shortly after. 

Recognizing these signs early is a core part of body dysmorphic disorder psychoeducation for both clients and the providers supporting them.

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Treatment options for body dysmorphic disorder

Effective treatment for body dysmorphic disorder includes: 

• Cognitive behavioral therapy (CBT): Studies show that CBT reduces the severity of BDD and related symptoms, including depression. CBT involves body dysmorphic disorder psychoeducation, identifying and challenging unhelpful thoughts about their appearance, and developing coping strategies to interrupt rituals and avoidance behaviors. 

• Medication: Selective serotonin reuptake inhibitors (SSRIs) are considered a first-line treatment for BDD. SSRIs are antidepressants, and they can treat the disorder and associated compulsive behaviors, as well as anxiety, depression, and other conditions. 

How to use the body dysmorphic disorder psychoeducation handout

You can download and use the body dysmorphic disorder psychoeducation handout in several ways:

• Use the worksheet to provide body dysmorphic disorder information to clients.

• Use the handout as a body image info sheet in group therapy sessions to encourage clients to share more about their body insecurities with other participants.

• Share the body image info sheet with coworkers.

• Review the “What is body image disorder?” handout with interns or supervisees.

Sources

• Association for Behavioral and Cognitive Therapies. (n.d.). Body dysmorphic disorder.

• Hartman, A., Greenberg, J., & Wilhelm, S. (2013). A therapist's guide for the treatment of body dysmorphic disorder. International OCD Foundation.

• Johns Hopkins Medicine. (n.d.). Body dysmorphic disorder.

• Merino, M., Tornero-Aguilera, J. F., Rubio-Zarapuz, A., Villanueva-Tobaldo, C. V., Martín-Rodríguez, A., et al. (2024). Body perceptions and psychological well-being: A review of the impact of social media and physical measurements on self-esteem and mental health with a focus on body image satisfaction and its relationship with cultural and gender factors. Healthcare (Basel, Switzerland).

• National Eating Disorders Association. (2005). Ten steps to positive body image.

• National Eating Disorders Collaboration. (n.d.). Body image. Eating Disorders Explained.

• Presutti, B. (n.d.). Body image workbook. K-State University CAPS.

• Rodgers, R. F., Laveway, K., Campos, P., & de Carvalho, P. H. B. (2023). Body image as a global mental health concern. Global Mental Health (Cambridge, England).

• Singh, A. R., & Veale, D. (2019). Understanding and treating body dysmorphic disorder. Indian Journal of Psychiatry.

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