Thinking about our appearance and different aspects of our bodies allows us to develop an awareness of our health. This awareness can then help a person better care for themselves and live a happier and healthier life. However, like anything, too much of a good thing can become destructive and unhealthy.

Body dysmorphic disorder (BDD) is a condition where someone is so preoccupied with a perceived physical flaw that the act of overthinking causes them harm. They may ruminate so often on the perceived flaw that they neglect themselves in other ways.

Since BDD can cause great distress, sufferers seek out methods to treat their condition. Some turn to substances, like marijuana, for relief. Marijuana use may seem desirable for people with BDD because it can temporarily suppress anxious thoughts. However, we do not know much about how effective marijuana is for treating BDD long-term and its use may cause more harm than good.

What is Body Dysmorphic Disorder (BDD)?

For someone to be medically diagnosed with BDD, they must meet criteria established by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V).

  • Criteria for diagnosing BDD:

    According to the DSM-V, a person has BDD if they meet the following four criteria:

    • They are preoccupied with one or more perceived defects or flaws in physical appearance. Other people either do not see the flaw or consider it minor.
    • Because of their concerns, they perform repetitive actions like mirror checking, excessive grooming, skin picking or comparing themselves to others. They perform these tasks to help alleviate the anxiety caused by their obsession.
    • Their obsession causes them significant impairment or problems in social or job-related functions
    • These symptoms are not better explained by the presence of an eating disorder

BDD may seem like an eating disorder, but it is not. BDD is a disorder of thinking and is similar to obsessive-compulsive disorder (OCD) because a person has obsessive thoughts that cause them to try to stop those thoughts with compulsive behavior, such as mirror checking.

  • Someone with BDD may focus on:

    • The appearance of the skin or visible veins
    • Breast size
    • Genitalia
    • Muscle size and tone
    • Parts of the face like skin complexion, presences of wrinkles or acne and nose shape
    • Thinning hair

BDD & Marijuana Use Statistics

In one study, about half (48.9%) of people with BDD reported that they had a substance use disorder (SUD) some time in their life. SUD develops when someone uses a substance to the extent that it interferes with their normal functioning. Common examples are alcohol and marijuana, but other substances like prescription medication, cocaine and heroin can also be considered as drugs of choice, to name a few.

In this study, people abused alcohol and cannabis the most. The authors of the study speculate that people with BDD abuse these drugs to help alleviate social anxiety. This explanation makes sense, as we would expect high levels of anxiety in people with BDD.

The Effects of Marijuana on BDD

Not only can marijuana intoxication worsen symptoms of BDD, but withdrawal symptoms have the potential to as well. Withdrawal symptoms are uncomfortable effects that happen when the body is dependent on a drug. Marijuana does not always cause physical withdrawal symptoms, and it may cause psychological ones as well.

  • Common marijuana withdrawal symptoms:

    • Decreased appetite
    • Depressed mood
    • Headaches
    • Increased aggression
    • Irritability
    • Nausea
    • Nervousness and anxiety
    • Trouble sleeping

Does Marijuana Use Cause BDD?

Marijuana use does not cause BDD, but it may make some symptoms worse. Research shows that many people with BDD also have overlapping substance use disorder, as these drugs may initially help alleviate some of the rumination and anxiety that characterizes BDD.

Will Marijuana Use Increase the Symptoms of BDD?

Yes, marijuana has the potential to increase body dysmorphic disorder symptoms. Reduced anxiety may come with a price, and higher doses of marijuana may have the following effects:

  • Altered sense of time, (i.e., time feels faster or slower than normal)
  • Altered senses, like seeing brighter colors or hearing more vivid music
  • Changes in mood
  • Delusions or false beliefs
  • Difficult or slowed thinking
  • Hallucinations, or seeing and hearing things that are not there
  • Trouble remembering things

Some of those symptoms have the potential to worsen BDD. For example, marijuana may increase delusions of ugliness or cause uncomfortable hallucinations.

If someone is genetically predisposed to develop BDD, marijuana use may trigger thoughts and behaviors that make the disorder more likely to manifest.

How Does Marijuana Hinder Treatment of BDD?

The symptoms of marijuana intoxication and withdrawal can both hamper the treatment of BDD.

The cornerstone of body dysmorphic disorder treatment is called cognitive-behavioral therapy (CBT). CBT is a type of talk therapy that encourages a person to realistically evaluate their behaviors and their reactions to things that happen to them. CBT encourages helpful changes that allow a person to develop healthy and realistic coping strategies.

For example, during CBT, a person with BDD will be encouraged to examine their beliefs around their body. They may be asked to explore how their thoughts around body shape do more harm than good. A therapist may ask them to question whether “mirror checking” does anything to change their appearance or thoughts around their appearance. Once the patient concludes their behavior is harmful, the therapist will then encourage new coping skills to take its place.

Marijuana can hamper treatment by introducing symptoms like mood swings that distract from and interfere with therapy.

Someone who has a mental health condition like BDD with an SUD has what’s called a co-occurring disorder that requires dual diagnosis treatment. This type of treatment addresses both disorders simultaneously.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.