Is Body Dysmorphia an Eating Disorder?

Do worries about your appearance keep you from living your life? We all feel self-conscious about our bodies at some point in our lives. We might:

• Be teased for the color or texture of our hair
• Get critical remarks about how short or tall we are
• Receive messages about what our body shape or size “should” look like

Any of these experiences could contribute to us feeling worried or preoccupied with our appearance. Even if we don’t recall events like the ones just mentioned, we may still feel deeply that something about our bodies could be better. If you’re obsessing about your body shape, size or weight, you could be struggling with an eating disorder or body dysmorphic disorder (BDD). 

Body dysmorphia vs. eating disorders

People with both eating disorders and BDD might notice that they:

• Excessively look in the mirror
• Wear concealing clothing frequently
• Avoid going out with friends due to worries or concerns about their physical appearance and how others might perceive them

If this is you, you may get upset or scared when people share pictures of you on social media without your approval, are asked to wear something that can’t hide your perceived problem areas or are pushed toward other social situations that make it difficult to hide your perceived flaws. You might also feel the need to seek reassurance about your physical appearance from trusted friends and family to help you feel more comfortable.

Eating disorders and BDD can be similar in these ways.

• Do you regularly avoid friends or family because you are self-conscious about how you look?
• Do you spend most of your free time trying to change your body?
• Do you feel so distracted by your perceived flaws that it gets in the way of school or work?

If so, you may have wondered if life could ever feel less restrained, and if so, how. Trying to find healing often requires us to put a name to what we’re experiencing.

What's the difference between body dysmorphia and eating disorders?

Here are some key differences between an eating disorder and body dysmorphia:

• Most eating disorders tend to focus on your overall size, shape and weight.
• Body dysmorphia tends to focus on a specific part of your body like your nose, muscle mass, hairline, or stomach. 
• Most eating disorders cause you to feel so much distress about your body shape and weight that it negatively impacts your eating behaviors.
• Body dysmorphia always includes repetitive behaviors (like skin picking, excessive grooming, or repeatedly mentally comparing self to others),

What is body dysmorphia?

Body dysmorphia can impact people in a large variety of ways. This could range from feeling “unattractive” to feeling “like a monster.” One of the most common concerns among those with BDD is actually a preoccupation with one's skin or hair.

Imagine you have a friend who shares they are feeling self-conscious about their acne scars and overall skin texture. When your friend openly shares this with you, you’re surprised to hear about how heavily this is impacting your friend – you didn’t even notice the scars until your friend pointed them out. Your friend says that they feel “hideous” and are embarrassed to go out in public, leading them to isolate. They also shared that they’ve been spending a significant amount of time trying to find solutions for their skin, leaving them financially strained and feeling distracted at work. Your friend also shared that they feel obsessed with their skincare routine and have repetitive actions as part of this routine that they feel they have to keep up with despite the amount of time it takes every day (leading to lack of adequate sleep). Your friend might have BDD.

BDD is categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as an obsessive-compulsive related disorder. But BDD is not the same thing as obsessive compulsive disorder (OCD). However – like many other mental health conditions –individuals with BDD can also have other mental health disorders like OCD, depression, anxiety or eating disorders.

How to help someone with body dysmorphia

Imagine that your friend (the same one from before who has some BDD signs) also has some concerns about their body weight and shape. They shared that these concerns are causing a dip in their self-esteem, but that it is not impacting their daily life or leading to any repetitive and/or negative change in their relationship to food. People with BDD can have size, shape, and weight concerns — but, unless they have an eating disorder, too, this typically won't result in a significant impact to their eating behaviors.

If you or someone you love is struggling with negative body image, it is important to know the signs and symptoms of both BDD and eating disorders. These illnesses are complicated, terrifying, and real. Both BDD and eating disorders cause millions of people to lead lives filled with a great deal of pain and suffering. And, a thorough eating disorder assessment paired with a correct diagnosis can make all the difference by helping individuals find the most effective treatment options available to them.

A correct diagnosis ensures that someone suffering with BDD and no eating problems follows an appropriate (and possibly different) treatment path compared to a person with BDD and an eating disorder. Similarly, an individual with an eating disorder but no BDD might follow a different therapeutic journey altogether. It’s confusing – and that’s why seeking support from an appropriate source is so important.

If concerns about wight and shape are negatively impacting your eating behaviors or the eating behaviors of someone you love, it is important to get help as soon as possible.

Learn: What is an eating disorder assessment like?

How do I know if I have an eating disorder?

If you think you might have an eating disorder, make an appointment with a health care provider (like your doctor, or a therapist) to talk about your concerns. Help is available across the world both in-person or online through virtual eating disorder treatment. If someone you care about is struggling with issues related to body image or eating, please encourage them to get help. Eating disorders are overwhelming and cunning and can go unnoticed or minimized for far too long. 

Some common eating disorder signs and symptoms include:

• An intense fear of gaining weight or fear of being in a larger body
• A drive to change one’s weight, body size or shape, at any cost
• Feeling disgusted with oneself, depressed or guilty after eating
• Dramatic or rapid weight changes
• Preoccupation with food and calorie intake
• Eating until feeling uncomfortably full
• Compulsive or excessive exercise
• Obsession with food cleanliness or purity
• Refusing to try new foods or identifying as a “picky” eater
• Isolation and withdrawing from others
• Being less interested in daily activities

If you or a loved one might be struggling with an eating disorder, and are interested in eating disorder treatment options, call Eating Recovery Center for a free assessment. Life does not have to be ruled by food or body image concerns. Call 877-825-8584 for confidential conversation and support.

This page was updated following clinical review by Katie Bendel, LMSW, community outreach liaison for Eating Recovery Center and Pathlight Mood & Anxiety Center on June 22, 2023.

Read These Next:

• Body Dysmorphia and Eating Disorders in Gay Men
• Are Eating Disorders Mental Illnesses?
• The Anorexia Subtypes: Restricting Type & Binge/Purge Type

References:

Hartmann, A.S, Thomas, J.J., Greenberg, J.L., Matheny, M.L., Wilhelm, S. (2014). A comparison of self-esteem and perfectionism in anorexia nervosa and body dysmorphic disorder. The Journal of Nervous and Mental Disease, 202(12), 883-888.

Rabe-Jablonska Jolanta, J., & Sobow Tomasz, M. (2000). The links between body dysmorphic disorder and eating disorders. European Psychiatry, 15(5), 302-305

Ruffolo, J. S., Phillips, K. A., Menard, W., Fay, C., & Weisberg, R. B. (2006). Comorbidity of body dysmorphic disorder and eating disorders: Severity of psychopathology and body image disturbance. International Journal of Eating Disorders, 39(1), 11-19.