Understanding Body Image and Body Dysmorphic Disorder
By Anya Ahuja
As human beings in 2025, our technology is fast, the stimuli are great, and our lives are full and complicated. However, regardless of who we are, where we live, or what we do (the often-defining question for New Yorkers) there are two things we must do every single day we roam this earth: we have to interact with our bodies, and we have to eat food. Interacting with our bodies is inherently necessary to existence. Each person’s relationship with their bodies differs from the next. How we see, feel, think about, and treat our bodies come together to comprise what is called our body image. I am confident that we all have heard the phrase “body image” before – but what exactly is body image? Let us explore the concept of body image, as well as differentiate from the clinical disorder known as body dysmorphic disorder.
What Is Body Image?
Body image is comprised of four aspects:
Perceptual body image: the way we see our bodies. Important note: this does not mean how we look. How we see our bodies is not necessarily correct or objective.
Affective body image: the way we feel about our bodies.
Cognitive body image: the way we think about our bodies.
Behavioral body image: the way we treat our bodies and what behaviors we engage in because of overall body image.
These four components converge to shape how we experience body image. Each of these aspects is influenced by internal factors (such as self-esteem, mental health, and personality traits) as well as external factors (such as family and peer, cultural and media messaging, and medical history and experiences) (Cash & Smolak, 2011).
What Influences Body Image?
Family and Peers
Our body image begins forming early through the words, behaviors, and attitudes modeled by our family and/or peers. How our family, siblings, or peers think about weight, shape, and attractive deeply impact our body image. Whether comments about themselves, others, or our body, our loved ones and those around us influence our individual body image.
Social Media
Social media is an unavoidable and crucial part of our daily existence now. The way we engage with social media – what applications and websites we use, who we follow, how we filter, and how we interpret content – shapes the relationship we build with our bodies.
Cultural Standards and Systems
Our body image is constructed within a broader context of cultural values and societal systems. These standards and systems inform what we consider attractive, healthy, or acceptable. Each of these definitions varies across time, place, and community. Systems such as advertising, fashion, and healthcare reinforce certain ideals through repetition and visibility, socially affirming some bodies more than others. These shifting cultural norms serve as the backdrop against which we evaluate ourselves.
Life Stages and Development:
Throughout our life, our bodies go through phases of growth, change and adaptation. Each stage can reshape how we feel in and about our bodies. Experiences such as puberty, aging, pregnancy, illness, and changes in physical activity can bring shifts in how we relate to our bodies.
Mental Health
Mental health and body image are deeply intertwined. Individuals who experience depression, anxiety, or trauma report heightened body dissatisfaction (Alleva, & Tylka, 2021). Mental health and body image often influence the other in a reciprocal and complex manner. Emerging research highlights that poor mental health can exacerbate negative body image, while persistent body dissatisfaction can, in turn, increase vulnerability to emotional distress and psychopathology (Alleva & Tylka, 2021).
How Do I Know What My Body Image Is?
The answer to this question is not necessarily obvious. A solid starting point to tune into your body image is to start noticing your thoughts, emotions, and behaviors related to appearance. Do you avoid mirrors, often compare to others on Instagram, or criticize any specific body parts? Do you think of your physical and external body when deciding whether to eat or not eat something? How do you usually respond to a negative feeling about your appearance? Does how you feel about your body stop you from participating in any activities? What do you appreciate about your body that isn’t related to appearance? Try to explore how you talk to yourself and how your beliefs about your body impact your daily life.
Positive body image does not necessarily mean embracing every single feature of your physical self; but positive body image implies fundamental respect and the ability to live without debilitating preoccupation with appearance. Conversely, negative body image may involve persistent dissatisfaction, anxiety, or shame that can interfere with daily functioning and overall emotional well-being.
Body image exists on a continuum that can shift across time, experiences, and emotional states. Many people experience fluctuations in how they relate to their bodies, and supporting clients in developing body image flexibility, or the capacity to respond to body-related thoughts and feelings with openness rather than avoidance, is an emerging focus in mental health counseling work (Sandoz et al., 2023). Another important and increasingly relevant concept in this space is body neutrality, which encourages individuals to shift focus away from appearance altogether and acknowledging the body for what it allows an individual to do, accomplish, or enjoy. Body neutrality can be a more approachable perspective, particularly for clients who feel that body positivity feels unimaginable (Cohen et al., 2022). Body neutrality allows space for a more functional, compassionate, and sustainable relationship with one’s physical self.
What Is Body Dysmorphic Disorder (BDD)?
Body Dysmorphic Disorder (BDD) is a mental health condition characterized by an intense preoccupation with perceived flaws in one’s physical appearance – flaws that are often minor or unnoticeable to others. Individuals with BDD may spend hours each day obsessing over a specific body part. This preoccupation leads to significant emotional distress and can interfere with work, relationships, and daily functioning. Common behaviors include mirror checking, camouflaging with makeup or clothing, seeking reassurance, or avoiding social situations altogether (Phillips & Stein, 2022).
How Common is it and Who Does it Affect?
BDD is more prevalent than often realized – the disorder affects approximately 2% of the general population, though some studies suggest even higher rates among adolescents and certain subgroups, such as cosmetic surgery patients and individuals with eating disorders (Veale & Matsunaga, 2023). The disorder typically begins in adolescence and affects people of all genders, races, and socioeconomic statuses, though the areas of concern may differ. BDD is not a form of vanity – the disorder is a serious and often misunderstood psychiatric condition with elevated risks of depression, substance use, and suicidality (Schneider et al., 2022). Studies show that over 75% of people with BDD experience suicidal ideation, and more than 25% have attempted suicide at least once in their lifetime (Phillips & Stein, 2022). Early recognition and intervention can make a significant difference. Cognitive Behavioral Therapy (CBT) tailored for BDD and selective serotonin reuptake inhibitors (SSRIs) have both been shown to significantly reduce symptoms and improve quality of life (Veale & Neziroglu, 2022). As mental health providers, understanding the signs and seriousness of BDD is critical in helping those who struggle.
Though navigating body image struggles and body dysmorphic disorder can be isolating, support from a therapist can make a meaningful difference. With support, individuals will begin to challenge unhelpful thoughts, reduce compulsive behaviors, and build a more balanced relationship with their appearance.
If you are interested in learning more about your relationship with body image, you can work with Anya or any of our therapists by contacting us here and listing your preferred therapist, or using the button below to make an appointment.
References
Alleva, J. M., & Tylka, T. L. (2021). Body image research: A review of recent methodological
advances and future directions. Body Image, 39, 216–226. https://doi.org/10.1016/j.bodyim.2021.07.013
Cash, T. F., & Smolak, L. (Eds.). (2011). Body image: A handbook of science, practice, and
prevention (2nd ed.). The Guilford Press.
Grogan, S. (2016). Body image: Understanding body dissatisfaction in men, women, and children
(3rd ed.). Routledge.
Schneider, S. C., Turner, C. M., Storch, E. A., & Wilhelm, S. (2022). Suicide risk in body
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Phillips, K. A., & Stein, D. J. (2022). Body dysmorphic disorder. BMJ, 377, e069387.
https://doi.org/10.1136/bmj-2021-069387
Veale, D., & Neziroglu, F. (2022). Body dysmorphic disorder: A treatment manual. Wiley-Blackwell.
Veale, D., & Matsunaga, H. (2023). Body dysmorphic disorder: Advances in research and clinical
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