8th October 2020

Body dysmorphic disorder in the workplace

16th August, 2019

Paul Carter

Whether you are giving a presentation, leading a team meeting or interviewing for a dream job, you are worrying what people see when they look at you. Every interaction confirms your fears. You believe there is something wrong with the way you look and people cannot stop staring at you.

‘Body dysmorphic disorder (BDD) is a disabling preoccupation with perceived defects or flaws in appearance that will persist despite reassurance.

It can affect both men and women, and makes sufferers excessively self-conscious,’ says the BDD Foundation which campaigns to raise awareness of the disorder and reduce the stigma, discrimination and isolation it causes.

A misunderstood and under-reported mental health disorder, it is often associated with fears of rejection or humiliation. Research indicates that 2-3%[i] of the general population struggle with it.

An estimated 42%[ii] of these sufferers are in full-time employment or education. This is an issue for employers as:

·     Existing employees are used to keeping BDD a secret and may not want to talk about it at work.

·     Young adults moving from education into employment have heard ‘it’s okay not to be okay’ and may expect a supportive employer.

·     Parents of BDD sufferers may feel distressed but don’t know how to discuss it with their employer.

Mental Health Awareness Week in May focused on how body image affects health and wellbeing. People may have shared their stories of living with BDD and how it has affected them in their careers.

The common theme in BDD stories is the difficulty that sufferers face in getting a diagnosis and accessing effective treatment, especially in the transition from children’s to adult mental health services. People don’t just grow out of it.

Therefore, a greater awareness of BDD in society and the workplace can make it easier for those directly or indirectly affected by the disorder to access support and treatment.

Why does it matter?

“BDD can have a significant and devastating impact on people’s careers and their experiences within the workplace,” says Nicole Schnackenberg, an educational psychologist and a trustee of the BDD Foundation with lived experience of BDD. “People with this diagnosis may struggle with full-time employment and may have long absences from work. Some become long-term unemployed, while others stay within the workforce but have a daily battle of facing the world.”

People with BDD may struggle to make eye contact and interact with colleagues because they are panicking about their appearance and what people think of their perceived defect.

They may constantly check their appearance in reflective surfaces and photographs, or never check their appearance because they can’t bear the way they look.

The exhaustion and anxiety of the disorder makes it hard to concentrate. Just imagine how they feel when it’s “team photo time”.

While most people can relate to the triggers and symptoms of depression, stress and anxiety, it can be more difficult to discuss and manage the symptoms of BDD.

This can range from comments like “I can’t stand the way I look”, to people seeking reassurance on their perceived defect and parents having to reduce their hours or resign because their children cannot leave the house.

To make it easier to discuss the reality of living and working with BDD, it needs to be out in the open.

How can employers help?

Employers need to understand that BDD is as debilitating as any other mental health disorder. Referencing it in mental health guidance, wellbeing events and occupational health support can help people say “I am acting like this because I have this condition”.

This starts the conversation on symptoms, support and how to engage with colleagues if the symptoms affect workplace relationships and performance. It has to be a two-way conversation based on the principles of reasonable adjustments to meet business and employee needs.

Younger employees with lived experience of BDD can collaborate with mental health champions and networks to highlight how body image affects mental health and ability to thrive.

This will be reassuring for people who choose not to be open because it is a personal matter or they are in recovery. As if they relapse or reach breaking point they know they can access support.

Parents of sufferers can feel the impact of BDD too. Talking to colleagues with BDD may help them to understand the disorder so they can discuss it with their children. Employers can signpost the BDD Foundation and the National and Specialist OCD, BDD and Related Disorder Service for Children and Young People to help parents find out more about diagnosis and treatment.

Final reflections

There is life after BDD. The MP Chris Evans and educational psychologist Nicole Schnackenberg have shared their stories to break the stigma and show sufferers they can have a future. For those who think it may never happen to them, muscle dysmorphia and body image in men seems to be a growing issue.

As BDD makes people fixate on their figures, the 24-28% suicide attempt rate and 78-81% suicidal ideation rate[iii] are measurements that cannot be ignored. It’s time to add body image issues to the mental health agenda in the workplace.

Find out more by attending the BDD Foundation Conference 2019 on 9th November at Regent’s University, London.

[i] Rief, W., Buhlmann, U., Wilhelm, S., Borkenhagen, A. D. A., & Brähler, E. (2006). The prevalence of body dysmorphic disorder: a population-based survey. Psychological medicine, 36(6), 877-885.

[ii] Phillips, K. A., Menard, W., Fay, C., & Weisberg, R. (2005). Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics, 46(4), 317-325.

[iii] Phillips, K. A., Coles, M. E., Menard, W., Yen, S., Fay, C., & Weisberg, R. B. (2005). Suicidal ideation and suicide attempts in body dysmorphic disorder. The Journal of clinical psychiatry, 66(6), 717-725.

Paul Carter

Paul Carter is a Senior HR Consultant at Civil Service Employee Policy in London. He has worked in HR for five years after spending 10 years in communications and committee management. He is CIPD qualified and writes HR blogs to encourage debate on how to make the world of work a better place. Writing and running help him manage his mental health and he is determined to raise awareness of what living with Pure OCD is like. He is always interested in meeting new people and exploring new opportunities.

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