There's a difference between feeling a little self-conscious about a body area and full-blown obsessing over it.

Julia Naftulin
October 10, 2017

Kim Kardashian is all about a perfectly posed selfie and expertly contoured face. But even she experiences a self-esteem plunge when she hears negative comments about her body. On the most recent episode of Keeping Up with the Kardashians, Kim opened up about the toll being in the public eye has had on her body image.

In the episode, unretouched bikini photos of Kardashian went viral online. While dealing with the fallout, she admitted that her body insecurity has increased over the years. “You take pictures and people just body shame you," Kardashian said. "It’s like literally giving me body dysmorphia," she also commented.

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The term "body dysmorphia" has a buzz to it these days, and it's often thrown around by people who feel a little self-conscious about their appearance. But it's actually a true mental health condition—and nothing to take lightly. Body dysmorphia is "the preoccupation of imagined defects in one's appearance," says Tom Hildebrandt, PsyD, chief of the Division of Eating and Weight Disorders at Mount Sinai Health System in New York City. 

A person with body dysmorphia typically sees a specific body part or a group of body parts and thinks, my calves look weak or my face is so ugly and out of proportion. They become obsessed with these thoughts and let them take over their lives. "Obsessed" is not an exaggeration. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), body dysmorphic disorder, or BDD, is a type of obsessive compulsive disorder. The International OCD Foundation says BDD affects 1 in 50 people, or between 5 and 7.5 million people in the United States alone.

Based on one episode of her show, it's hard to know if Kardashian has BDD or just doesn't always like the way she looks. What signs can tell you that your body obsession truly is BDD? It's more than being critical of your appearance from time to time. Says Hildebrandt: "For someone with BDD, their entire life's balance hangs on whether they look okay or whether they've camouflaged their perceived flaw appropriately."

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When a person believes she has body issues and is hyper-aware of them, she may avoid social situations to not draw attention to her so-called flaws. She might also go to extremes to hide the perceived flaw, say by walking around with her hair covering her face or going under the knife. "People with the resources may get plastic surgery and go back repeatedly for more, because it only provides a temporary release from the anxiety about their appearance," explains Hildebrandt.

In KUWTK, Kim says that her body dysmorphia comes from all the body-shaming comments she receives from haters, trolls, and others in the general public. While negative remarks can make BDD worse, they aren't typically the cause of the disorder, says Hildebrandt. 

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The actual cause of BDD isn't known, but it may be similar to what triggers OCD. Hildebrandt says people with certain temperaments and ways of thinking are predisposed to BDD and may show OCD tendencies in other areas of their life. For example, a person who obsesses over her legs may also be obsessed with keeping a spotless home. "[It's] a cognitive style that causes you to prioritize things that are out of place rather than the big picture," says Hildebrandt.

Worried about a friend who displays BDD behavior? Take note of how often she tries to conceal parts of her face or body, or if she constantly seeks reassurance about a specific body region. If you or a loved one think you're suffering from it, talking to a therapist or counselor is a smart option. Treatment includes antidepressants and cognitive behavioral therapy.

BDD shouldn't be used carelessly as a slang term for someone who isn't 100% pleased with her body. We all have moments when we wished we were slimmer, had more muscle tone, or were taller or shorter. But when a person's entire life is dedicated to hiding and obsessing over perceived flaws, it's a serious mental health issue that needs to be addressed.