top of page

Body image issues and body dysmorphia


Many of us struggle with Body Image Concerns at one level or another, though this can become more serious, impacting our lives significantly, and body dysmorphic disorder (BDD) can become debilitating. Our culture's focus on appearance and idealized body types can create immense pressure, leading to harmful self-criticism and mental health struggles. However, there are a number of psychological approaches designed to help you foster a healthier relationship with your body.

Understanding Body Image

Body image encompasses how we think, feel, and perceive our physical selves. A positive body image is about accepting and appreciating our bodies, while negative body image involves persistent dissatisfaction and shame. Poor body image can manifest in unhealthy dieting, excessive exercise, and a preoccupation with perceived flaws.

Body Dysmorphic Disorder (BDD)

BDD is a more severe mental health condition marked by an intense fixation on slight or imagined physical imperfections. People with BDD may spend hours obsessing over a specific body part, engaging in repetitive behaviours like mirror checking, skin picking, or seeking cosmetic procedures. This preoccupation can be deeply distressing, causing social isolation and hindering daily functioning.

Psychological Pathways to Healing

Seeking help is crucial if you're facing significant body image concerns or BDD. Among the most effective psychological approaches are:


  • Cognitive Behavioural Therapy (CBT): CBT addresses the root of negative body image and BDD by identifying and replacing harmful thought patterns. A therapist will guide you in challenging unrealistic body standards, reframing self-criticism, and building a more compassionate inner voice.

  • Exposure and Response Prevention (ERP): A specialized form of CBT, ERP is often used for BDD. It involves gradual exposure to triggering situations (e.g., looking in mirrors) while developing healthier ways of coping instead of engaging in rituals like reassurance-seeking or checking.

  • Mindfulness and Acceptance-Based Therapies: These approaches focus on accepting difficult thoughts and emotions surrounding your body without judgment. Mindfulness meditation encourages present-moment awareness and cultivating self-compassion, a crucial tool in healing body image issues.

  • Acceptance and Commitment Therapy: ACT helps us to understand that thoughts and feelings about our bodies are just that – thoughts, as opposed to facts. ACT shows us how ‘Cognitive fusion’ causes us to accept these self-critical thoughts as statements of reality, rather than simply being distorted thinking patterns. ‘Experiential avoidance’ means we may not have considered other explanations for our feelings. ACT also emphasizes reconnecting with valued living more broadly, which we may have lost sight of during these difficulties, and might also help us to drop unhelpful behaviours.

  • Psychodynamic Therapy: Perhaps the origin of anxiety about our body image lies in our early relationships. Perhaps we were criticised for our weight or how we looked, or just felt bad about ourselves and this then took a particular form. This can set up negative thinking processes where our relationship to our body expresses something of our broader difficulties. Understanding the context of these difficulties can then enable us to start to see our body image issues in a more realistic, contextualised way.  

Additional Resources and Support

In addition to therapy, here are some valuable paths to explore:


  • Media Literacy: Become aware of the unrealistic and filtered images prevalent in social media and advertising. Consider limiting your exposure to content that triggers body dissatisfaction.

  • Body Positive Communities: Seek online resources or support groups promoting body acceptance and diversity. Surrounding yourself with positive messages can be immensely helpful.

  • Self-Care: Focus on nourishing activities that boost your well-being, regardless of appearance. Engage in hobbies, connect with supportive loved ones, and prioritize healthy sleep and stress management.

The Importance of Seeking Help

If negative body image or BDD is interfering with your life, don't hesitate to seek professional guidance. Organizations like the BDD Foundation ( provide specialized support in the UK. With the right help, you can overcome these challenges, develop self-acceptance, and find peace with the body you're in. Therapists at Holborn Psychotherapy Practice can all help with this and offer a variety of treatment approaches. However, if your difficulties have become more entrenched it might be worth speaking to a Clinical Psychologist or a therapist specialising in body dysmorphia. This can be discussed with any of the therapists you might approach who will refer you on if this is indicated.

Choice of approaches

Acceptance and Commitment Therapy

Cognitive Behavioural Therapy

Existential Therapy

Eye Movement Desensitization  and Reprocessing

Integrative Psychotherapy

Psychodynamic Therapy

How we can help

bottom of page