Worried About Your Body Image?

Nov. 25, 2003 -- Imagine being so obsessed with a part of your body that you were literally frozen in front of the mirror scrutinizing it. Or feeling so afraid of what you might see if you did look, that you avoid mirrors altogether.

For approximately five million people in the United States with body dysmorphic disorder or BDD, this reaction to their bodies is a reality that can have significant impact on their lives.

"BDD is an extreme preoccupation with a part of one's appearance," says Roberto Olivardia, co-author of the Adonis Complex. "Often times that preoccupation is with an imagined defect where the person is seeing something that other people clearly cannot see."

Slight anomalies like scars or minor hair loss that produce exaggerated responses such as social avoidance and camouflaging can also earn a diagnosis of BDD.

"It's about looking at yourself in the mirror and not even being able to say that you look OK," Erika Pikor, a longtime sufferer, told ABCNEWS medical correspondent Dr. Tim Johnson.

Pikor was diagnosed with BDD after spending years obsessing about her appearance, sometimes spending as many as three hours checking herself in the mirror and withdrawing from social contact.

"I feel like I've lost a lot just because of this," Pikor says. "A lot of time that I've just lost, gone. It's very disappointing because it's time I could have been very productive in doing things that I enjoy. But I came to a point where I didn't enjoy anything anymore."

Undetected and Misdiagnosed

Although the disorder was first described over a century ago, BDD did not make a name for itself in the diagnostic literature until the late 1980s. And while strides have been made in increasing awareness about it, BDD remains widely unrecognized and misdiagnosed.

"I would say the majority of people that come to me have been people who have been struggling with BDD for years," says Olivardia who runs a group for people with BDD at McLean Hospital in Belmont, Mass. "A lot of people go through years of being misdiagnosed with depression."