If you have ever struggled with your body image and if these thoughts have seemed to consume your thoughts and behaviors, you may wonder: Do I have body OCD? Is body OCD an “actual” thing? This is a valid question that comes up often.

OCD or Obsessive Compulsive Disorder is a disorder in which you have recurring, unwanted thoughts, ideas or sensations (obsessions). To get rid of the thoughts, you may feel driven to do something repetitively (compulsions). Body Dysmorphic Disorder (BDD) is another disorder that is sometimes confused with or casually referred to as “body OCD”. There are many similarities between OCD and BDD, which can, at times, contribute to BDD being misdiagnosed as OCD. While there is overlap between the presentation of these two disorders, they are actually two distinct disorders with notable differences.

Understanding Body Dysmorphic Disorder (BDD)

Body dysmorphic disorder is a mental health condition in which you can’t stop thinking about one or more perceived defects or flaws in your appearance — a flaw that is minor or invisible to others. While these flaws are typically minor or nonexistent, the preoccupation with these perceived flaws can be distressing and, for some, all-consuming.

If you struggle with BDD, you know it can interrupt your ability to function at work, school, and in social settings. If you have BDD, you may engage in repetitive behaviors or mental acts in response to perceived flaws, such as repeatedly checking your appearance in mirrors or seeking reassurance – consciously or subconsciously – from others about your appearance. In response to your flaw(s), you may also engage in avoidance behaviors, such as avoiding social situations or wearing excessive makeup or certain clothes to conceal perceived flaws. These and some of the other BDD symptoms can be characteristic of other disorders, too, which can make it hard to distinguish it from OCD or some eating disorders.

There is still a lot to learn about BDD, as the research for it is about a decade or more behind OCD research. From what we know, BDD affects both men and women and can occur at any age, though it often begins in adolescence or early adulthood. The exact cause of BDD is not yet fully understood, but genetic predisposition, neurobiological factors, and environmental influences and experiences may contribute to its development.

Is it BDD or OCD?

While BDD and OCD are distinct disorders, there is significant overlap between them. Neuropsychiatric Disease and Treatment journal published new research that included the 53 most recent studies on the relationship between OCD and BDD. The study showed that the rate of OCD and BDD occurring together (comorbidity) was up to 43%. While this is helpful to know, the co-occurrence of BDD and OCD can complicate diagnosis and treatment. Some may experience symptoms that are characteristic of both disorders, making it challenging to determine which condition is primary. Additionally, if you have both BDD and OCD, you may have more severe symptoms and experience greater impairment in functioning compared to those with either disorder alone.

One of the biggest differences between OCD and BDD are the focuses of the obsessions: the focuses and obsessions associated with OCD can vary significantly, whereas those of BDD are solely on your appearance or body. People with OCD typically use compulsions to alleviate uncertainty, whereas those with BDD may use the compulsions to alleviate negative emotions.

Treatment Differences

The treatments that are effective for BDD and those that are effective for OCD are one of the biggest distinctions between the two disorders. Dr. Colleen Reichmann explains that exposure response prevention is one of the treatments often used to help treat OCD. This treatment strategy encourages you to face your fears and let obsessive thoughts occur without ‘neutralizing’ them with compulsions. This treatment, however, has actually shown to be harmful for those with BDD. BDD is more commonly and successfully treated with cognitive behavioral therapy, interpersonal, process-based therapy, focusing on early childhood experiences and traumas that could have contributed to the presentation of BDD. 

Because of the stark difference in treatment approaches, it’s important that, if you feel you may be struggling with “body OCD,” you see a clinician who understands the difference between BDD and OCD and approaches treatment accordingly.

So, Is “Body OCD” a Thing?

Given the overlap between BDD and OCD, some researchers and clinicians have proposed the concept of “body OCD” to describe cases where obsessive-compulsive symptoms primarily focus on concerns about physical appearance. However, this term is not officially recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Instead, those who experience obsessive-compulsive symptoms related to their physical appearance will likely be diagnosed with either BDD or OCD, depending on the specific nature and origin of their symptoms.

OCD, ‘Body OCD,’ & BDD: Takeaways

Body dysmorphic disorder and obsessive-compulsive disorder are distinct but related mental health conditions that can significantly impact an individual’s well-being. While there is overlap between BDD and OCD, mental health professionals do not officially recognize the term “body OCD.” If you experience obsessive-compulsive symptoms related to your physical appearance, a clinician may diagnose you with either BDD or OCD based on the specific nature of your symptoms. Seeking out a clinician who is professionally trained in addressing your struggles can assist you in receiving the attention and care you deserve for the challenges you face. Additionally, advocating for yourself is crucial. Arming yourself with knowledge about your struggles can help you determine if the clinician you are seeing is capable of providing you with the level of care you need and deserve.

By: Erika Muller, Assistant for Wildflower Therapy LLC

All images via Unsplash

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