Sexual attraction and the link between self-objectification and body dysmorphic disorder: A community-based adolescent study

Body dysmorphic disorder (BDD) is characterised by a preoccupation with perceived appearance flaws accompanied by repetitive behaviours or mental acts. The onset of body dysmorphic disorder (BDD) typically occurs in adolescence and is associated with high levels of distress and poor quality of life. Sexual minority groups have been identified as at particular risk of developing BDD, though community-based adolescent research remains limited. This study aimed to examine probable BDD (PBDD) prevalence across sexual attraction groups and explore its impact on distress and quality of life. The study also aimed to explore the relationship between self-objectification and PBDD, highlighting any differences across sexual attraction groups. Adolescents from the EveryBODY study (N = 5062; aged 11-19 years) completed measures capturing demographics, distress, quality of life, self-objectification, and BDD symptoms. The overall PBDD prevalence was 13.0% when including adolescents with comorbid weight/shape concerns. PBDD prevalence was significantly higher amongst adolescents attracted to boys, and PBDD was associated with higher distress and lower physical and psychosocial quality of life. Higher levels of self-objectification were associated with greater odds of meeting criteria for PBDD. The relationship was stronger among boys attracted to boys but weaker among girls attracted to boys; however, the effect sizes were small. These findings build upon previous adult-focused studies, indicating that adolescents affected by the male gaze (i.e., those attracted to boys) are at particular risk of developing BDD. The study also highlights the importance of early BDD screening and prevention programs targeting self-objectification.