Body Dysmorphia vs Eating Disorder: Understanding the Difference for Healing

4 Nov

Whether you constantly worry about your body or appearance, or feel trapped in a cycle of food, weight, shape and control, you might wonder: Is this a body image issue? A food/weight issue? Something else?
The lines between Body Dysmorphic Disorder (BDD) and Eating Disorder (ED) are often blurred. But distinguishing them matters, because the path to recovery changes when you know what you’re really working with.

In this blog, we’ll explore:

What BDD is, and how it differs from EDs
Where overlap happens, and why co-occurrence is common
How a trauma-informed approach can support deeper healing
How to find the right support (and what to look for)

What is Body Dysmorphic Disorder?

Body Dysmorphia is a mental health condition where someone becomes excessively preoccupied with perceived defects or flaws in their physical appearance, flaws which are often unnoticeable to others. The preoccupation is distressing, takes up significant time, interferes with daily life, and often drives behaviours such as mirror-checking, camouflaging, comparison, avoidance of social situations, or even pursuing unnecessary cosmetic procedures.
While body dysmorphia is about appearance, it’s important to recognise the emotional undercurrent: shame, fear of being seen, and deep vulnerability.

What are Eating Disorders?

Eating disorders (which include conditions such as anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding or eating disorders) are characterised by persistent disturbances in eating behaviour, weight or shape concerns, and associated distress. But they are not just about food.
Often, eating disorders serve a function: emotion regulation, a way to feel safe, a strategy to manage trauma, or a means to regulate internal chaos. For example, rigid rules around food or movement may provide predictability when one’s emotional world feels unpredictable. From a trauma lens, someone with an eating disorder might have a nervous system still tuned to threat, and controlling food/shape becomes one of the few ways they feel some agency.

Where the Overlap Lies, and Why It Gets Confusing

Body Dysmorphia and Eating Disorders share many features:

Distorted body image and dissatisfaction
Perfectionism, shame and self-criticism
Avoidance behaviours (of mirrors, social situations, food)
High comorbidity; it’s common for someone with an Eating disorder to also have Body dysmorphia-level body preoccupations, and vice versa
However, key differences exist:
Focus: In body dysmorphia, the central distress is about specific body parts/features (e.g., nose, skin, face, muscles). In Eating disorders, the distress more often revolves around food, weight, body size/shape as a whole.
Behavioural themes: Body dysmorphia may involve repetitive checking, camouflaging, avoidance and cosmetic procedures. Eating disorders often involve eating, restricting, bingeing, purging, over-exercise or other compensatory behaviours.
Function: While both can serve to regulate emotion or protect the self, the functional focus differs. In Eating disorders, behaviour is often about control of weight/shape. In Body dysmorphia, behaviour is about reducing anxiety about appearance or flaws.
Understanding this distinction helps ensure the right treatment focus; for instance, treatment for an Eating disorder might emphasise normalising eating patterns, while treatment for body dysmorphia emphasises reducing checking behaviours and building body-acceptance of perceived flaws even when they remain.

Why This Matters — For You and for Therapy

If you’re reading this and wondering, “Do I have Body dysmorphia, or an Eating Disorder, or both?”, the answer may be “yes to some of both.” What matters is recognising:

You’re not defined by the diagnosis; you’re a person with a survival strategy that once worked.
The emotional roots matter more than the behaviour alone. A trauma-informed approach helps unearth those roots, the early attachment wounds, hidden beliefs, internalised messages, and relational patterns.
Treatment must target both behaviour and meaning: yes, we learn healthier eating or reduce checking/avoidance, AND we work through underlying emotional truths like “I am safe even if I don’t meet the ideal,” or “My body signals matter more than my appearance.”

What Trauma-Informed Treatment Looks Like

Here are some hallmarks of a neuroaffirming, and trauma-informed treatment path:

Mapping early patterns: Learning how your early relational experiences (e.g., critical caregivers, feeling unseen, bullying) shape your internal world and behaviours now.
Recognising your survival stance: Whether it’s strict eating rules, avoidance of your appearance, or over-checking mirrors, these behaviours once helped you feel safe or manageable, and now they might be trapping you.
Developing emotional literacy: Building the ability to identify feelings (anger, shame, loneliness) instead of just acting them out (via food, weight, body checking).
Building new relational experiences: In therapy and beyond, you practice being seen, imperfect, vulnerable.
You learn to tolerate the perceived imperfection, navigate triggers, and build a sense of self that isn’t defined by body or food behaviours.
Collaboration and choice: As a neuroaffirming clinician, we value that you as the client are the expert in your life. You co-design goals (e.g., reducing liver checking, normalising eating, reducing mirror avoidance) and respect individual pace.
Flexibility & pace: Recovery is not linear, so rigid timelines harm. The focus is on process, not just outcome.

How to Find the Right Support

If you’re looking for help:

Look for clinicians credentialled via ANZAED. The directory on their site helps you find psychologists, dietitians, GPs who specialise in eating/body image issues. anzaed.org.au+1
Use the Butterfly Foundation’s helpline (1800 33 4673) for body image or eating-disorder concerns — free, national, 7 days/week. https://butterfly.org.au/get-support/helpline/
Inquire about what treatment model the service uses: trauma-informed strategies. This indicates depth beyond symptom management.
Ask if the clinician or service understands the overlap between body image and eating behaviour, and whether they are comfortable working with neurodiversity (if relevant to you).
Check for multidisciplinary care if needed: a multidisciplinary team (psychologist, dietitian, medical) is ideal in treating all parts holistically.

Final Reflection

Both Body dysmorphia and eating disorders are complex, layered, and deeply human responses to feeling unsafe, unseen, or unworthy. They are not your fault; they are adaptive strategies shaped by experience. The healing path is not just about changing behaviours; it is about understanding the story behind the behaviours, rebuilding trust in your body and self, and learning to live a fuller life that isn’t dominated by fear of appearance or food.
With compassionate, evidence-based therapy, especially when trauma wounds are addressed, recovery is possible. You don’t have to stay stuck in shame, checking, rules or avoidance. You are invited to step into connection, ease, and authenticity.
If your reflection, your food or your body has felt like a battleground, you might just be ready to find a different way, one where you are at home in your body, your mind and your life. And you don’t have to do it alone.

Note: The information provided in this blog is for educational purposes only and is NOT intended as medical /psychological advice. Please consult a healthcare professional for personalised guidance