Body dysmorphia disorder is a mental disorder defined by an overwhelming preoccupation with a perceived flaw in one's physical appearance. Whether the physical issue is real or imagined, ruminations concerning this perceived defect become pervasive and intrusive, consuming substantial mental bandwidth for extended periods each day (Wikipedia).
To meet diagnostic criteria, patients must engage in repetitive behaviors, such as excessive mirror checking, camouflaging, skin picking, excessive grooming, excessive weight lifting, or pervasive mental acts such as comparing one’s appearance to others. These behaviors are time-consuming, difficult to control, and distressing to the individual (ncbi.nlm.nih.gov).
Some patients are excessively preoccupied with a single body area. In contrast, others develop preoccupations with multiple body areas, averaging between 5 to 7 different areas of concern.
This perceived flaw can be something others also can see, or it can be entirely delusional.
A person with body dysmorphia can...
→ avoid mirrors
→ groom excessively & constantly change outfits
→ experience delusions that others are covertly pointing out their flaws
→ socially isolate to hide their perceived flaw
→ spend a lot of time comparing their looks with other people's
→ spend hours trying to hide or fix their perceived flaw
→ get depressed and suicidal
Body dysmorphia can be caused by...
→ genetic factors - especially family members with the same diagnosis or with OCD
→ trauma, abuse, neglect - most commonly emotional neglect or sexual abuse
→ bullying
→ cultural aspects
A character with body dysmorphia...
→ can be very socially avoiding and isolated to avoid being seen by others and being commented on / made fun of
→ can have a history of being bullied for example at school
→ can be described being preoccupied with grooming excessively and silently comparing themselves with everyone around them
→ can take very badly any comments on their perceived flaw, even pushing them into suicidality
→ can dream of undergoing cosmetic surgery or even go through one to hide their perceived flaw
If there's a different diagnosis which explains the symptoms better (for example an eating disorder), the diagnosis of body dysmorphia is most commonly not given.
Body dysmorphia shares similarities with gender dysphoria. Both include a desire to change a feature of one's physical appearance, resulting in clinical distress and impairment in social or occupational functioning. The physical appearance in gender dysphoria is focused on primary or secondary sex characteristics, with additional psychological distress from incongruency of the individuals expressed experienced gender (ncbi.nlm.nih.gov).
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