The Link Between ADHD & Body Dysmorphic Disorder


by Carolyn Moriarty, LCPC



If you are familiar with ADHD (Attention Deficit Hyperactivity Disorder) and Body dysmorphic disorder (BDD), you may think they have nothing in common. After all, one is related to attention and hyperactivity, while the other revolves around body image and self-perception.

Surprisingly, research has found significant correlations between the two disorders in regard to how they impact a person’s thought processes and mental health.


Understanding ADHD


ADHD is a neurodevelopmental disorder that affects both children and adults. Individuals with ADHD often struggle with impulsivity, hyperactivity, and difficulty maintaining attention. They may have trouble focusing on tasks, organizing their thoughts, and regulating their emotions. Traditionally, ADHD has been associated with academic underachievement, relationship problems, and low self-esteem.


Understanding Body Dysmorphic Disorder


BDD is a mental health condition characterized by obsessive thoughts and extreme distress about perceived flaws in one’s appearance. People with BDD often spend excessive amounts of time worrying about their appearance, engaging in repetitive behaviors such as mirror-checking or seeking reassurance from others. They may avoid social situations or even undergo unnecessary plastic surgeries to fix their perceived flaws.



The Surprising Link


Some studies have indicated that there is a higher occurrence of BDD among individuals diagnosed with ADHD than in the general population, though the relationship between the two disorders is still being researched.

Here is a general explanation behind this premise:

  • Individuals with ADHD can experience intrusive thoughts, similar to the obsessive thoughts and compulsive behaviors characteristic of BDD.
  • In addition, individuals with ADHD often reach a stage of “hyperfocus”. When they are experiencing obsessive thoughts related to appearance, they can easily become even more hyper-fixated on them.
  • People with ADHD also crave instant gratification and results. If they are experiencing obsessive, persistent thoughts about body image, they may feel a greater compulsion to make changes to their weight and appearance.


Common intrusive thoughts related to BDD include:

  • spending several hours a day thinking about the area/areas of concern
  • thoughts of being ugly, deformed
  • worrying that other people take special notice of the perceived defect (e.g., laugh or stare at it)


Common compulsive behaviors related to BDD include:

  • seeking out cosmetic surgery/dental procedures

  • checking appearance in mirrors
  • seeking reassurance about appearance
  • overexercising, often in a way that targets the area of concern
  • body checking with fingers
  • picking at skin
  • checking body weight on scale
  • comparing one’s appearance/features with other people
  • avoidance of people, places, or things due to the unbearable anxiety the flaw causes (including mirrors or reflective surfaces)



Individuals with ADHD might struggle with body image due to other reasons, such as:

  • impulsive behavior, common in ADHD, can sometimes lead to poor choices in eating habits or self-care routines, affecting one’s body image.
  • difficulties with executive functions (like planning, organizing, and prioritizing) in ADHD can extend to managing exercise routines or healthy eating plans, impacting body image.
  • ADHD often coexists with other conditions like anxiety or depression, which can exacerbate negative body image perceptions.
  • research has shown that there is a potential overlap in genetic or environmental factors contributing to both ADHD and BDD.




While there is a potential relationship between ADHD and BDD, it is important to note that they are separate conditions with distinct diagnostic criteria. Treatment approaches for each condition may differ, and it is important for individuals to consult with a mental health professional for thorough evaluation and personalized treatment plan.

The mental health professional can help individuals:

  • identify the underlying reasons for fixation on appearance
  • increase awareness of negative thought patterns and emotions that perpetuate behaviors
  • practice self-acceptance and self-compassion
  • identify triggers and techniques to navigate them in a more effective manner

Talk-therapy treatment options include:


Cognitive-Behavioral Therapy (CBT)

CBT is an evidence-based treatment strategy, is also integral in treating those with symptoms related to BDD. This strategy works to identify commonly used thinking errors that serve to reinforce cycles of obsessions and compulsions.

Exposure and Response Prevention (ERP), otherwise known as exposure therapy, is an evidence-based method of treatment within CBT. ERP exposes a person to a stimulus (i.e. person, place or thing) that produces anxiety or discomfort. Throughout the exposure process, the individual is encouraged to actively resist engaging in their typical response to that trigger. This allows people to learn that their feelings of discomfort and doubts naturally subside on their own without them doing anything about it.


Acceptance and Commitment Therapy (ACT)

ACT is an additional treatment modality that can be incorporated into treatment. The intolerance of uncertainty is very common for people struggling with BDD, and acceptance can be an integral part of treatment by learning how to tolerate feelings and thoughts that may have once seemed unmanageable. Instead of trying to fight off thoughts with compulsions, ACT helps guide the person towards acceptance of thoughts and feelings as part of the experience of life. ACT works to help teach the individual that these compulsions can come and go rather than being stuck.



Seeking Mental Health Support


If you feel that you or a loved one may be experiencing some of the signs and symptoms associated with BDD, it may be time to speak with a professional. Scheduling an appointment with Chicago Counseling Center may be the first step among many for the battle against BDD. Meet our team to learn more!


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