Differences Between Men And Women With Body Dysmorphic Disorder

Medically reviewed by Andrea Brant, LMHC
Updated October 9, 2024by BetterHelp Editorial Team

Body dysmorphic disorder, also known as BDD, can be defined as a mental health condition that can affect anyone, regardless of gender. It can cause people to be overly worried with perceived flaws in their physical appearance. There may be slight differences in how body dysmorphic disorder presents between men and women. 

Over time, the constant worry about body image associated with BDD may lead to intense emotional stress and make it difficult to carry out daily activities like work, school, or spending time with friends. One way for people with BDD to seek professional help with body dysmorphic disorder may be to connect with a licensed therapist through an online therapy platform.

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What are the differences between men and women with body dysmorphic disorder?

BDD can affect both men and women, although there are usually some differences between the two groups of people. 

In the United States, BDD typically affects women and people assigned female at birth at a similar rate as men and people assigned male at birth. Worldwide, it usually affects between 1.7% and 2.9% of people. While women may develop BDD from societal and cultural pressures related to appearance, men's risk factors may involve the pressure to conform to an idealized masculine body type. 

According to Katharine Phillips, a leading BDD expert with Weill Cornell Medical College, “Body dysmorphic disorder (BDD) consists of distressing or impairing preoccupation with perceived defects in physical appearance that are actually nonexistent or only slight. This common and often-severe disorder, which affects more women than men, frequently goes unrecognized.”

Men with body dysmorphic disorder

BDD can show up in several ways among men and boys. One common sign of BDD in men can be muscle dysmorphia, also known as bigorexia. Men with this disorder may obsess over not being muscular enough, which might make them work out too much or even use steroids to reach their ideal body shape.

Another concern for men with BDD can be hair, particularly thinning or balding hair. Anxiety over their hair may lead them to try various treatments or even consider cosmetic surgery with hair transplantation. In addition, men with BDD may worry about skin concerns like acne, wrinkles, or scarring. They may constantly search for skin treatments but find these treatments don't give them the results they want.

Men with BDD may also feel unhappy about their height, possibly believing they're too short. This perception can affect their self-confidence and even influence their choice of clothing and shoes. They may specifically choose styles to make themselves appear taller.

Body fat may be another concern for men with BDD. Even with a low body fat percentage, they may feel anxious about their body fat distribution and constantly strive for a leaner appearance. As a result, they might develop disordered eating patterns or exercise excessively in an attempt to lose weight.

Finally, men with BDD can also feel anxious and unhappy with their genitals' size or shape. This anxiety can lead them to avoid social and sexual interactions, which can harm their relationships and overall well-being.

Women with body dysmorphic disorder

BDD often affects women and girls in a variety of ways. Women with BDD may obsess over their skin, focusing on wrinkles, acne, scars, or uneven skin tone. This obsession can lead to behaviors like spending too much time on skincare routines or feeling unable to go out in public without wearing makeup.

Hair can also be a cause for concern in women with BDD. They might feel stressed about their hair's texture or color, thinking it's too thin, too frizzy, or not the optimal shade. This preoccupation can lead them to spend a lot of time styling their hair, changing its color, or even removing it to try to achieve what they think is the "perfect" look.

Weight and body size may also be common areas of concern. Women with BDD might constantly diet, exercise excessively, or engage in other unhealthy behaviors to try to control their weight or achieve a specific body shape. This obsession can sometimes lead to eating disorders, which can cause severe physical and mental health concerns. Eating disorders can be life-threatening and often require medical health care for a full recovery. 

Breast size and shape may also cause distress for women with BDD. They might think their breasts are too small, too large, or uneven, which can make them self-conscious and even lead them to consider plastic surgery.

Facial features may be another area of focus. Women with BDD may fixate on parts of their face like their nose, lips, or eyes, thinking they're too big, too small, or not symmetrical. They might consider cosmetic treatment or overuse makeup to try to change the way they look. 

While plastic surgery may not be inherently wrong, it can be associated with various health risks, including the following:

  • Blood clots

  • Scarring

  • Nerve damage

  • Infections

  • Fluid build-up

  • Botched surgeries

  • Death

  • Other complications (like reactions to anesthesia)

Body shape, particularly the hips, thighs, or buttocks, can be another area of concern for women with BDD. Similar to worries about weight, this focus can lead to dieting and over-exercising in an effort to achieve a specific body shape or size.

Lastly, the natural aging process may be a source of anxiety for women with BDD. They may become overly focused on signs of aging, like wrinkles or sagging skin, which can lead them to overuse anti-aging products or consider cosmetic procedures to maintain a youthful appearance.

Getty/AnnaStills

Coping strategies and prevention for men and women with body dysmorphic disorder

BDD can be difficult for both men and women. There may be ways to manage its impact and prevent it from worsening. These strategies might focus on critical problems that come with BDD, like constantly comparing yourself to others, feeling bad about yourself, and having negative thoughts. Here are some potential coping strategies:

Avoid comparing yourself to others

If you find yourself constantly comparing your appearance to other people's, it can exacerbate your BDD symptoms. Try to recognize when you're doing this and shift your attention to your own unique qualities.

Cultivate a daily mindfulness practice

Mindfulness techniques may help you become more aware of your negative thoughts and learn how to manage them. Techniques like meditation and deep breathing may help you relax and reduce stress.

Build self-esteem

Boosting your self-image may help you overcome BDD. Doing things you enjoy, such as hobbies and spending time with friends and family who support you, may help you feel better about yourself and who you are.

Educate yourself

Another potential way to prevent BDD may be to promote mental health education and awareness. Individuals may be more likely to seek help before symptoms worsen if they understand the root causes and early warning signs of BDD.

Seek treatment for co-occurring conditions like obsessive-compulsive disorder

Individuals with body dysmorphic disorder (BDD) and co-occurring mental disorders like obsessive-compulsive disorder (OCD) often experience overlapping symptoms and challenges. For example, they might exhibit increased repetitive behaviors and severe distress in their daily lives due to perceived defects.

Seeking treatment for OCD and other co-occurring conditions like obsessive-compulsive disorder may improve BDD symptoms, providing individuals with comprehensive support and strategies to manage their symptoms effectively.

This might include a combination of mental health care treatments such as therapy and medications like selective serotonin reuptake inhibitors (SSRIs) following a complete diagnosis. When BDD and co-occurring conditions are treated, triggering body dysmorphic disorder symptoms and compulsions may be easier for an individual. 

Knowing when and how to seek help for body dysmorphic disorder

Recognizing the signs of BDD may be the first step to seeking help. BDD can be triggered by various factors, such as social pressure, past experiences, family history, or other mental health conditions, like severe depression. If you or someone you know is struggling with BDD, it can be best to seek professional help as early as possible. Getting help early on may make a difference in the efficacy of treatment, and it can improve overall mental health. 

Some signs that you or someone else might need help include having a hard time with daily activities, relationships, or work because of worries about appearance, feeling anxious or distressed about how you look all the time, doing things over and over, like checking yourself in the mirror or picking at your skin, and avoiding social situations because you're worried about how you look. 

When looking for help, you may want to talk to a mental health professional, like a psychologist, psychiatrist, or counselor, who knows how to treat BDD. These professionals can accurately diagnose the problem and develop a treatment plan that fits your needs.

A mental health professional may provide resources to help with certain factors unique to the individual patient. When BDD is treated by a professional, they may be able to prevent it from getting worse as they work through underlying causes. 

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Benefits of online therapy

Online therapy may offer several advantages to people seeking treatment for BDD, such as convenience and increased availability. Those who don’t always feel comfortable going out in public due to BDD symptoms may find it easier to connect with a therapist from the comfort and safety of their homes. In addition, they can choose between videoconference, phone call, and online chat, depending on their comfort levels.

Effectiveness of online therapy

Research has shown that cognitive behavioral therapy (CBT) administered over the internet may effectively treat symptoms of BDD with improvements lasting even after treatment ends. The referenced study generally found that online therapy could be a realistic option for managing BDD symptoms.

Takeaway

In general, body dysmorphic disorder is a mental health condition that does not discriminate based on gender and usually leads to distress and intense worry about perceived physical imperfections. While it can affect both men and women, there can be subtle differences in the focus areas. For instance, men might find themselves more concerned about body build, hair loss, or genitalia size, while women may express worry regarding weight, body shape, or breast size. Despite these potential differences in perceived flaws, what can unite individuals affected by this condition may be its impact on daily life. The persistent self-scrutiny and fear of judgment may lead to feelings of shame and debilitating anxiety. Still, treatment options for BDD are available, and online therapy can be a convenient place to start.
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