Loving Through the Mirror: Supporting a Partner with Body Dysmorphia

By Noelle Rizzio, LCPC, PEL

Body image struggles are often seen as a “women’s issue,” but research tells a different story. Men, too, experience deep and distressing dissatisfaction with their appearance, sometimes to the point of obsession. For many, this takes the form of Body Dysmorphic Disorder (BDD), a serious mental health condition that can silently erode confidence, relationships, and self-worth.

For partners of men with body dysmorphia, the experience can be confusing and painful. They may find themselves constantly reassuring, worrying, or walking on eggshells - unsure how to help without making things worse. Understanding what BDD is, how it manifests in men, and what support truly looks like can bring compassion and clarity to both partners and clinicians working alongside them.

Understanding Body Dysmorphia in Men

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), Body Dysmorphic Disorder is characterized by a preoccupation with one or more perceived flaws in physical appearance that are either unnoticeable or appear minor to others. These intrusive thoughts lead to repetitive behaviors such as mirror checking, excessive grooming, or seeking constant reassurance (American Psychiatric Association, 2022).

While BDD affects both genders, men are more likely to fixate on specific concerns related to muscularity, hair loss, skin, height, or genital size (Phillips & Menard, 2006). One subtype — muscle dysmorphia — leads some men to believe they are small or weak even when they are objectively muscular. This variant is strongly linked with compulsive exercise, disordered eating, and performance-enhancing substance use (Pope et al., 2017).

Because male body image concerns are often masked by social norms around “fitness” or “self-improvement,” BDD in men frequently goes unrecognized. Shame, stigma, and traditional masculinity beliefs can make it even harder for men to admit their distress or seek help (Griffiths et al., 2016).

The Partner’s Experience

Loving someone with body dysmorphia can bring a unique set of emotional challenges. Partners often feel frustrated or helpless when reassurance — “You look great!” — doesn’t seem to help, or when discussions about appearance spiral into conflict or withdrawal.

Over time, partners may become caught in a painful cycle: the person with BDD seeks comfort and validation, while their partner feels pressured to provide endless reassurance that never quite satisfies. This can lead to emotional exhaustion, resentment, or feelings of inadequacy in the relationship (Veale et al., 2016).

It’s also common for partners to blame themselves, wondering if they’re saying the wrong thing, or if they could somehow “fix” their loved one’s distorted self-image. Recognizing that BDD is not a vanity issue but a mental health disorder is crucial. Compassion begins with understanding that these thought patterns are intrusive, unwanted, and often deeply rooted in anxiety and perfectionism.

What Helps — and What Doesn’t

The instinct to comfort a partner is natural, but when it comes to BDD, some well-intentioned responses can unintentionally reinforce obsessive thinking. Here are some approaches supported by research and clinical practice:

1. Focus on Feelings, Not Appearance

Instead of reassuring (“You don’t look fat” or “Your hair is fine”), try acknowledging emotions:

“I can tell you’re really uncomfortable with how you’re feeling about your body today. That must be really hard.”

Empathy validates emotional pain without feeding into appearance-based obsessions (Veale & Neziroglu, 2010).

2. Encourage Professional Support

Cognitive Behavioral Therapy (CBT) — specifically Exposure and Response Prevention (ERP) — is the gold standard treatment for BDD. SSRIs (selective serotonin reuptake inhibitors) are also shown to be effective for some individuals (Phillips, 2017). Encouraging a partner to seek therapy should be framed gently, emphasizing that BDD is treatable and not a personal failing.

3. Set Compassionate Boundaries

It’s okay to set limits on reassurance-seeking. For example, “I love you and I know you’re struggling, but I can’t keep answering questions about your appearance. Let’s focus on what might help you feel calmer instead.” Boundaries protect both partners and model a healthier dynamic.

4. Build an Emotionally Safe Environment

BDD can thrive on shame and secrecy. Partners can help by normalizing mental health conversations and affirming that vulnerability is not weakness. Creating moments of connection unrelated to body image — shared hobbies, humor, quality time — helps re-anchor the relationship in genuine intimacy.

5. Take Care of Yourself

Supporting someone with a chronic mental health condition can be draining. Partners benefit from their own sources of emotional support - therapy, trusted friends, or online communities. Self-care is not selfish; it’s necessary to remain grounded and compassionate.

The Role of Clinicians

Clinicians working with couples or families affected by BDD can play a key role in fostering understanding and resilience. Psychoeducation helps partners recognize symptoms and avoid inadvertently reinforcing compulsions. Couples therapy can also address communication breakdowns and emotional distancing that often accompany BDD.

For therapists treating men with BDD, addressing underlying themes of masculinity, control, and self-worth can be essential. Helping clients differentiate between healthy fitness goals and compulsive, self-punishing behaviors is particularly important in male presentations (Olivardia, 2021).

Integrating mindfulness, self-compassion, and body neutrality practices may also support long-term recovery and relational healing.

Takeaway for Clinicians

Partners often carry a quiet burden in the background of BDD — trying to soothe, support, and stay connected to someone who struggles to see themselves clearly. Clinicians should remember that partners need psychoeducation and emotional space of their own. Incorporating them into treatment (when appropriate) can enhance understanding, reduce relational tension, and improve outcomes for both individuals.

The ultimate goal is to help both partners move from a place of shame and fear toward empathy, patience, and hope.

Resources for Partners and Professionals

• Body Dysmorphic Disorder Foundation (BDDF) – www.bddfoundation.org

• Anxiety and Depression Association of America (ADAA) – www.adaa.org

• National Alliance on Mental Illness (NAMI) – www.nami.org

• International OCD Foundation: BDD Resource Center – https://iocdf.org/bdd

• Phillips, K. A. (2017). The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. Oxford University Press.

• Veale, D., & Neziroglu, F. (2010). Body Dysmorphic Disorder: A Treatment Manual. Wiley-Blackwell.

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).

Griffiths, S., Murray, S. B., Krug, I., & McLean, S. A. (2016). The contribution of social media to body image concerns among men and women: A systematic review. Body Image, 17, 175–187.

Olivardia, R. (2021). Men, muscles, and dysmorphia: Understanding male body image. Psychology Today.

Phillips, K. A., & Menard, W. (2006). Gender similarities and differences in 200 individuals with body dysmorphic disorder. Comprehensive Psychiatry, 47(2), 77–87.

Pope, H. G., Phillips, K. A., & Olivardia, R. (2017). The Adonis Complex: The Secret Crisis of Male Body Obsession. Touchstone.

Veale, D., Gledhill, L. J., Christodoulou, P., & Hodsoll, J. (2016). Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image, 18, 168–186.

In loving through the mirror, partners don’t need to fix what’s “wrong” — they need to help their loved one see what’s real, possible, and worth healing.