Body dysmorphic disorder (BDD) involves an extreme and distressing obsession with one’s appearance, perceived flaws or imperfections. Alcohol use is common among people with BDD, with estimates that nearly a third of people with BDD misuse alcohol.

Although the mood-altering effects of alcohol can provide temporary relief from obsessions and intrusive thoughts caused by BDD, it can prevent someone from seeking professional help for their condition. The co-occurrence of alcohol use and BDD is common and should be considered when diagnosing and treating BDD.

Can Alcohol Use Cause Body Dysmorphic Disorder?

BDD and alcohol use can be related, but alcohol is unlikely to be the sole cause of BDD.

BDD can often begin early in life, during childhood or teenage years. In most cases, young people don’t have access or exposure to alcohol at this age. However, early-onset BDD can be a risk factor for later alcohol abuse. If the condition persists or begins in late adolescence or early adulthood, someone with BDD may begin misusing alcohol.

Developing BDD is a result of complex factors involving personality, family history, and other mental health conditions. Although BDD and the consumption of alcohol tend to begin around the same age, it’s not likely that a single factor — such as alcohol — would cause BDD. The relationship between BDD and alcohol depends on personality, the age the disorder began and other aspects of mental health. Alcohol might be used as a coping strategy for BDD, but it’s not likely to cause BDD.

Does Alcohol Affect Body Dysmorphic Disorder Symptoms?

Although it might provide temporary relief, alcohol can worsen or prolong BDD symptoms by preventing someone from seeking professional help.

Some of the feelings and beliefs associated with BDD are shame, embarrassment, and hyper-awareness of appearance or flaws. These symptoms can make it difficult to function normally in day-to-day life and particularly in social situations. Alcohol can provide temporary relief from these symptoms, but people with BDD can become reliant on alcohol to function.

People with BDD report drinking because having BDD is upsetting, or to help them forget about their body or appearance. People with BDD can get caught in a cycle of needing alcohol for symptom relief or to function socially. Because of this cycle, they may continue to self-medicate rather than seek treatment for the underlying causes of BDD, which can prolong the illness or make it worse.

Can Body Dysmorphic Disorder Lead to an Unhealthy Relationship with Alcohol?

Relying on alcohol for temporary relief from feelings of distress and dissatisfaction can lead to an unhealthy reliance on alcohol. It’s been estimated that alcohol dependency in people with BDD might be as high as 29% and is more common in men than women.

People with BDD reported drinking alcohol to improve how they feel about themselves and allow them to socialize without constant anxiety about their appearance. Because alcohol alters thoughts and behaviors, it provides temporary relief from obsessions about appearance.

Alcohol might help someone with BDD feel better temporarily, but it doesn’t address underlying problems related to the disorder. Relying on alcohol for symptom relief can prevent someone from seeking professional treatment and developing healthy coping strategies.

Treatment Options for Body Dysmorphic Disorder and Co-Occurring Alcohol Addiction

The obsessions, intrusive thoughts and ruminations about appearance in BDD can be very distressing and can keep people from living their lives. Many people seek treatment for BDD through cosmetic or surgical procedures to change their appearance. However, this option is likely only to provide temporary relief and does not address the underlying problems.

Body dysmorphic disorder treatment seeks to address underlying beliefs about appearance and build coping skills to manage intrusive thoughts and beliefs. If there is co-occurring alcohol addiction, treatment must also address the reasons for drinking and provide new skills and strategies to cope with BDD that do not involve alcohol.

There is a range of treatment options for BDD that can also address a co-occurring alcohol use disorder. These include:

  • Medication/anti-depressants, which can help reduce intrusive thoughts
  • Cognitive-behavioral therapy, which focuses on challenging thoughts and beliefs about appearance as well as adjusting problematic behaviors
  • Interpersonal therapy, which helps to improve a person’s social functioning and relationships, particularly without the use of alcohol

These treatments might be used on their own, or in combination. Professional treatment for BDD can help reduce levels of appearance-related distress and reduce reliance on alcohol for symptom relief.

Key Points: Alcohol and Body Dysmorphic Disorder

Alcohol abuse and body dysmorphic disorder commonly co-occur. There are several key points to consider in diagnosing and treating BDD with alcohol abuse.

  • Obsessing about appearance and perceived flaws in BDD can be extremely distressing. Affected individuals may turn to alcohol for temporary relief from symptoms, or to help them cope with feelings of distress.
  • BDD and alcohol use is an unhealthy cycle that can make symptoms of BDD worse and increase health risks related to alcohol abuse.
  • Alcohol is unlikely to cause BDD but can contribute to BDD making symptoms worse.
  • Using alcohol in BDD is a temporary coping strategy that prevents a person from addressing the serious underlying issues.

If you or a loved one live with BDD and a substance use disorder, contact The Recovery Village to discuss treatment options.