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DrSugar on Body Dysmorphic Disorder

DrSugar knows that a healthy body image is an important part of healthy living and felt it important to discuss a growing phenomenon that affects the way women see themselves.

Reality show star Heidi Montag recently made headlines sharing with the world her recent plastic surgeries, which included breast augmentation to a DDD cup, brow lift, nose job revision, liposuction, and buttock augmentation among other things. Heidi’s story brought to mind a condition I studied in medical school, body dysmorphic disorder (BDD). Her story also begs the question, "Why would an already beautiful young woman undergo multiple cosmetic surgeries at such a young age?" Since BDD is fairly common disorder, I felt compelled share more information about it with you all.

Learn the details of this disorder, when you read more.

The Mayo Clinic defines body dysmorphic disorder as a serious condition involving a preoccupation with a perceived flaw in appearance, be it minor or imagined. But to an individual with BDD, this flaw makes them experience excessive shame, anxiety, and often depression, leading them to seek cosmetic surgical procedures. Much of their self-worth is related to how they feel about their appearance.


BDD sufferers commonly complain of imagined or minor flaws of the head and face, but any body part can be the focus of concern. Frequently, individuals with BDD are concerned with more than one body part and are often concerned about acne, wrinkles, paleness, scars, thinning hair, or the shape or size of body parts such as the nose, lips, or face.

The Los Angeles Body Dysmorphic Disorder and Body Image clinic website explains that BDD sufferers frequently perform certain behaviors, with more than 90 percent performing repetitive behaviors to check, hide, or attempt to improve what they perceive as a physical defect, including checking the supposed flaw in mirrors or other reflective surfaces. Many BDD sufferers tend to seek reassurance related to the imagined defect and usually compare their appearance with that of others. These repetitive behaviors may take many hours per day and usually only provide very temporary relief from obsessions about their appearance. Avoidance of social situations is also very common.

Research estimates show that seven to 15 percent of cosmetic surgery patients suffer from BDD. Preliminary estimates suggest that Body Dysmorphic Disorder may be very common, with a rate of one to two percent in the general population. Embarrassment and shame often prevents sufferers from revealing their true degree of distress, not only to their spouses, friends, and family, but to healthcare professionals as well, making BDD extremely difficult to diagnose. The condition frequently begins in adolescence and tends to be chronic, affecting men and women in equal numbers.

Contributing factors to the development of BDD vary from individual to individual, but family environment during early development and peer relationships may be important in shaping body image. Cultural factors may also be important in mediating the distress experienced by BDD sufferers, although BDD appears to exist in many different cultures and in different parts of the world.

I do not know whether or not Heidi Montag suffers from body dysmorphic disorder, given I am not her physician and have never treated her. However, her story provides an important starting point for discussion about this common disorder that both men and women all over the world suffer from. If you have any signs or symptoms of body dysmorphic disorder, see your physician, mental health provider, or other health professional. Body dysmorphic disorder usually doesn’t get better on its own, and if left untreated, may get worse over time.

Have a question for DrSugar? Send it by private messaging me here, and I will forward it to the good doctor.

DrSugar's posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. Click here for more details.

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