# Prevalence of body dysmorphic disorder, gender differences and association with body mass index among medical students in Pakistan

## TL;DR

This study found that about 5% of medical students in Pakistan have body dysmorphic disorder, with no link to body mass index and equal rates in both genders.

## Contribution

The study reports the prevalence of BDD among Pakistani medical students using DSM-5 criteria and reveals no association with BMI.

## Key findings

- BDD prevalence was 4.65% among medical students, equally affecting males and females.
- No significant association was found between BDD and BMI.
- Females reported significantly higher skin-related concerns compared to males.

## Abstract

Body dysmorphic disorder (BDD) is a mental disorder characterised by a preoccupation with some perceived defects or flaws in an individual’s physical appearance which often go unnoticed by others. The preoccupation causes marked stress and impairment of a person’s normal functioning. Limited studies have examined the prevalence based on the newer DSM-5 criteria for BDD, with very few done in Pakistan thus far. Studies on the association of BDD with BMI are limited and have yielded conflicting results.

This study aimed to assess the point prevalence of BDD and gender differences, along with its association with BMI in medical students.

This cross-sectional study recruited medical students in a medical university in Lahore. Systematic random sampling was employed, the participants’ BMI was measured and a standard self-report questionnaire was filled by participants. Pearson’s Chi-Square test was used for group comparisons and associations between categorical variables, while Spearman’s Rank Correlation was applied for continuous variables.

Of the 215 students included (109 males, 106 females), the prevalence of BDD was 4.65% (n = 10; 5 males and 5 females). The mean BMI was 23.07 ± 3.88 kg/m2, with 60.5% classified as normal weight. No significant association was found between BDD and BMI. Overall, 62.3% of students reported body dissatisfaction; males most often cited hair and fat, whereas females reported skin concerns, with significantly higher skin-related concerns among females (p = 0.010).

BDD is notably prevalent among medical students, involving both genders equally, and is unaffected by BMI. The findings underscore the importance of addressing concerns related to outward appearance, suggesting a need for mental health support and early intervention in medical educational settings.

The online version contains supplementary material available at 10.1007/s44192-025-00343-x.