Body dysmorphic disorder (BDD) is a mental condition characterized by a preoccupation or obsession with perceived flaws in one’s appearance. BDD is commonly associated with girls and women, but recent studies have found that nearly as many men as women are dissatisfied with their physical appearance.

Body dysmorphic disorder is a legitimate mental health condition that can significantly disrupt an individual’s work, education and social life. Psychological counseling or therapeutic interventions have been shown to successfully help people overcome BDD. However, many people with body dysmorphic disorder do not receive counseling and instead undergo procedures to alter their appearance. One study found that more than 75% of people with BDD seek surgical or dermatological treatment, and more than 65% of those people receive the treatment they initially sought.

Understanding Male Body Dysmorphic Disorder

While body dysmorphic disorder and its effects (e.g. anorexia) are widely acknowledged in women, BDD in men has long been under-studied. Men who suffer from BDD often become fixated with one physical feature, such as skin, hair, genitals or body size/stature. A man may be suffering from body dysmorphic disorder if he obsesses with monitoring his appearance or goes to great lengths to avoid seeing himself (e.g. avoiding mirrors or scales).

Muscle Dysmorphia (“Bigorexia”)

Muscle dysmorphia, also called “reverse anorexia” or “bigorexia,” describes men who have a misperception that they are not sufficiently lean or muscular. In many cases, men who have muscle dysphoria are more muscular than average and spend a great deal of time bodybuilding. Nonetheless, they still maintain a distorted perception of their physique.

  • Signs & symptoms that can help identify muscle dysmorphia, include:

    • Compulsive weight-lifting to increase muscle mass
    • Overtraining, even when injured
    • Special diets and use of protein supplements
    • Use of steroids
    • Attempts to hide physique
    • Constantly checking physique and comparing to others
    • Mood swings and depression
    • Prioritizing workouts or diet over relationships and responsibilities

Male Pattern Baldness

Male hair loss and baldness are incredibly common, as more than 60% of men will experience at least some hair loss by the age of 35. In fact, 85% of men aged 50 or older will have significantly thinning hair. Despite its prevalence, many men are embarrassed or ashamed by baldness. Products and drugs designed to achieve hair growth may further isolate men with thinning hair or baldness. Though baldness may contribute to body dysmorphic disorder, it is rarely the sole source of this disorder in men.

Men struggling with hair-loss-related BDD will often spend a great deal of time looking at their hair in a mirror or, conversely, will go to great lengths to avoid mirrors. They may also spend substantial sums of money on home or clinical remedies for hair loss.

Height

The vast majority of height dysphoria cases occur when men believe they are too short. So-called “stature lengthening” surgeries have become alarmingly common in the U.S. In these procedures, men pay hundreds of thousands of dollars to have the bones in their legs broken and, over the course of nearly a year, slowly pulled apart. The excruciating procedures average a mere height increase of 7.2 centimeters (2.8 inches).

Most studies have shown that dermatological, surgical and other non-psychiatric treatments for physical symptoms of body dysmorphic disorder are largely ineffective. However, some men who have recovered from stature lengthening surgeries report improved self-confidence and social lives. This observation underscores how powerful the perception of appearance can be in social settings.

Male Body Dysmorphia Statistics

Reliable statistics for male body dysmorphic disorder are difficult to derive. In part, this is because few men seek treatment for BDD itself, preferring surgical interventions or other forms of therapy. However, epidemiological studies have indicated that up to 2.4% of the adult population suffers from BDD.

Several studies have consistently found that men with body dysmorphic disorder are most commonly dissatisfied with skin, hair, facial appearance (with the nose being the most common area of concern), body build and genitals. One study found that 36% of people with BDD were unable to work for at least one week out of the previous month due to unmanaged psychiatric symptoms associated with BDD. Furthermore, 11% failed to complete their education because of concerns about physical appearance.

It is likely that men under-report dissatisfaction with their physical appearance. Data suggest that only around 6% of psychiatric patients discuss concerns about their appearance with their mental health care providers. Quality of life and overall mental health have been shown to be lower amongst men who have been diagnosed with body dysmorphic disorder than men without it. Additionally, suicidal thoughts and suicide attempts are significantly higher among men with BDD than men without. However, evidence shows that psychiatric treatments are effective in helping men manage and overcome body dysmorphic disorder.

Impact of Male Body Dysmorphic Disorder on Overall Health & Wellness

The risk of suicidal thoughts or behaviors is alarmingly high among people with body dysmorphic disorder. One study found that nearly 80% of men with BDD had contemplated suicide, and nearly 25% had attempted suicide.

Men with body dysmorphic disorder often go to great lengths to change or hide their area of concern. Some men spend thousands of dollars on clothing or dermatological procedures; others spend hundreds of thousands of dollars on surgical procedures. In some cases, men retreat from society altogether, choosing to avoid social interaction entirely.

Treating Body Dysmorphic Disorder in Males

A number of studies have recently been conducted to determine the most effective treatment strategies for men and women with body dysmorphic disorder. Although research specific to men is currently in its preliminary stages, ongoing research continues to provide new insights into gender differences in BDD.

There are currently two first-line treatments for body dysmorphic disorder: pharmacotherapy and behavioral therapies.

  • Pharmacotherapy:

    Antidepressant medications have been successful in helping people manage body dysmorphic disorder, but they are associated with unwanted side effects like sleep disturbances, sexual dysfunction and weight gain, which are counterproductive and reduce adherence to treatment. There is an ongoing effort being made to identify the most effective medication types and doses for BDD, but a great deal remains left to be clarified in the effectiveness of pharmacotherapy for BDD treatment.

  • Behavioral therapies:

     There are several types of behavioral therapies, but cognitive behavioral therapy (CBT) has proven to be particularly useful for people with body dysmorphic disorder. CBT aims to identify negative thoughts and behavior patterns and develop coping strategies and positive behavioral responses. Over time, these strategies replace negative perceptions with positive ones. One study found that people who completed a CBT treatment regimen reported an average 68% reduction in symptoms.

Body dysmorphic disorder can be an incredibly debilitating psychiatric illness, and many people who struggle with BDD develop comorbid substance use disorders to mask mental and emotional dissatisfaction. The Recovery Village provides comprehensive programs to treat the physical and psychological components of addiction and co-occurring disorders.