“Someone with BDD constantly obsesses about their appearance, spends hours in front of the mirror, throws fits because they don’t look how they want, [seeks] constant validation about their looks, turns to surgery as a way to change their bodies, focus on one or two specific imaginary defects on their bodies, and are never satisfied – no matter what – with just being themselves,” Hylen added.
Natascha Santos, a certified bilingual school psychologist and behavior therapist who specializes in obsessive compulsive disorder and body dysmorphic disorder, said in an email that people with BDD often have depression, which is associated with low self-esteem. Many BDD sufferers also have suicidal thoughts.
“With low self-esteem and overvalued ideation on this perceived/imagined body defect, they really believe that there is something wrong with the body part of concern,” Santos said.
Laura Cipullo, a registered dietician, certified diabetes educator and nutritionist, said in an email that some people recovering from eating disorders suffer from BDD, and even more suffer from low self-esteem.
“While there is no clinical definition of low self-esteem, it is generally defined as an absence of a sense of contentment and self-acceptance that stems from a person's appraisal of their own worth, significance, attractiveness, competence and ability to satisfy their aspirations,” Cipullo said.
“Those struggling with low self-esteem often take things very personally, have difficulty in social interactions, are unable to accept compliments, and have pessimistic tendencies. Low self-esteem puts one at greater risk for an eating disorder.”
She agreed that BDD and low self-esteem almost always are present together.
“Several studies have been conducted finding those suffering from BDD also experience lower self-esteem compared to those not suffering from the disorder,” Cipullo said.
“It is unclear at this time whether poor self-esteem predisposes one to BDD and/or is a consequence of the disorder, but a correlation definitely seems present.”