Individuals with BDD are preoccupied with one or more perceived flaws in their physical appearance that are not observable to others. In short, they do not see their appearance the way others do. These negative beliefs about appearance lead individuals with BDD to engage in a range of compulsive behaviors to try and improve or hide their appearance (i.e., excessive checking of appearance in the mirror, spending excessive amounts of time getting dressed, putting on make-up or styling hair, wearing certain types of clothes to cover up or disguise disliked parts of the body, seeking reassurance from others about physical appearance, skin picking to improve the appearance of skin). However, these efforts rarely succeed in eliminating appearance concerns.
Common concerns about appearance in BBD include worries about hair, different parts of the face (i.e., nose, placement of eyes), and skin, however, BDD can focus on any part of the body. Some men with BDD are concerned that their body build is too small and spend considerable time and energy trying to build larger muscles. The body image concerns that are present in BDD exceed the normal levels of concerns that many people experience about their physical appearance and can be quite impairing.