Another pimple? Bad hair day? Sooner or later, almost everyone worries about some aspect of their appearance. But when that worry becomes an obsession, an all-consuming fixation that interferes with normal functioning, body dysmorphic disorder may be the cause. Body dysmorphic disorder (BDD) is characterized by an extreme preoccupation with what one believes to be flaws in one's appearance (Bjornsson, Didie, & Phillips, 2010). These imperfections are often minimal or even non-existent, but they are very real and painful for those with BDD. BDD affects approximately 0.07% to 2.4% of the general population and 2% to 13% of adult students. Actual rates can be very high given the nature of BDD as affected people often hide their symptoms and go undiagnosed. These numbers suggest that BDD is more common than the more studied and publicized disorders of schizophrenia or anorexia nervosa. BDD usually begins in childhood or adolescence. In a study of 428 adults with BDD, 66% of subjects had onset before age 18, with the most common age being 12 to 13 (Bjornsson, Didie, Grant, Menard, Stalker & Phillips, 2013). causes significant dysfunction, with sufferers spending hours each day thinking about and caring for perceived defects; engaging in time-consuming rituals of mirror checking, excessive grooming, and attempts to disguise the flaw. The result is significant professional, social and academic impairments. In a 2005 study of 200 subjects with BDD, Phillips, Menard, Fay, and Weisberg found that the subjects often did not go to work or school; 37.6 percent of the subjects were unemployed, a much higher rate than the general population. overall, and 11% of subjects dropped out of school because of BDD. BD... middle of the paper... cool mess. Research in Psychiatry: Neuroimaging, 172, 161–167. Phillips, K. A. (2001). Body dysmorphic disorder. Somatoform and factitious disorders. Washington: American Psychiatric Publishing.Phillips, K.A., Menard, W., Fay, C., Weisberg, R. (2005). Demographic characteristics, phenomenology, comorbidities, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics, 46(4).Phillips, K.A., Wilhelm, S., Koran, L.M., Didie, E.R., Fallon, B., Feusner, J.D., Stein, D.J. (2010). Body dysmorphic disorder: some key questions for the DSM-V. Depression and Anxiety, 27(6), 573-91.Rauch, S.L., Phillips, K.A., Segal, E., Makris, N., Shin, L.M., Whalen, P.J., . . . Kennedy, D. N. (2003). A preliminary morphometric MRI study of regional brain volumes in body dysmorphic disorder. Research in psychiatry: neuroimaging 122 (1), 13–19.