Comparing OCD and Body Dysmorphic Disorder Symptoms

Young woman looking in the mirror and pinching skin on her stomach
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Body dysmorphic disorder (BDD) is a form of mental illness in which the person is obsessed and/or preoccupied with an imagined defect or some tiny aspect that they see as a flaw in their appearance.

In order to be diagnosed with body dysmorphic disorder, preoccupation with the imagined defect in appearance must cause the person significant distress and/or impair their ability to get along with others or perform their duties at work.

For example, a person affected by body dysmorphic disorder might avoid leaving the house because she thinks her nose is too big or her ears are too small. Importantly, a diagnosis of body dysmorphic disorder must rule out anorexia and/or bulimia, which may also involve a preoccupation with appearance.

Body dysmorphic disorder is categorized by the most current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an obsessive-compulsive related disorder, which means that the symptoms are similar to, but not exactly the same as, symptoms found in obsessive-compulsive disorder (OCD).


The symptoms of both OCD and BDD have similarities; so much so, BDD is sometimes misdiagnosed as OCD.

  • Like OCD, body dysmorphic disorder involves persistent and recurrent obsession-like thoughts that are distressing and often uncontrollable.
  • People with body dysmorphic disorder engage in repetitive, compulsion-like behaviors such as looking in the mirror over and over again, repeatedly changing clothes, asking other people about the imagined defect and skin-picking.
  • As can be the case with OCD, body dysmorphic disorder often involves a preoccupation with symmetry and perfection.
  • Both OCD and body dysmorphic disorder usually start in adolescence, can cause substantial disability and respond to treatment with antidepressants including selective serotonin reuptake inhibitors (SSRIs) as well as cognitive-behavioral techniques.


Despite the apparent similarities between OCD and body dysmorphic disorder, several features distinguish these two illnesses.

  • While the focus of obsessions and compulsions in OCD can vary greatly (such as contamination, the death of a loved one, symmetry, guilt, violence, sexuality), the symptoms of body dysmorphic disorder are focused solely on one’s appearance or body.
  • People with body dysmorphic disorder often have poorer insight into the nature and irrationality of their symptoms compared to people with OCD. In fact, from a clinical perspective, some individuals with body dysmorphic disorder are considered to be delusional.
  • For people who have body dysmorphic disorder, concerns or obsessions about appearance are often less intrusive (although still distressing) than the obsessions experienced in OCD.

Can You Have OCD and BDD at the Same Time?

Yes. In fact, OCD and body dysmorphic disorder often occur together. Neuropsychiatric Disease and Treatment 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 anywhere from 3% to 43%.

If You Have Symptoms, Seek Help

If you feel that you are experiencing symptoms of either OCD or body dysmorphic disorder, it is important that you consult with your doctor or another qualified mental health professional.

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  • Frare, F., Perugi, G., Ruffolo, G., & Toni, C. “Obsessive-compulsive disorder and body dysmorphic disorder: a comparison of clinical features” European Psychiatry 2004 19: 292-298.