Body Dysmorphic Disorder was included in the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association (APA) in 1987, and is classified as a type of obsessive-compulsive disorder. In other words, unlike the controversial concept of “intensive phobia”, it is a genuine mental illness recognized by professionals. Let’s look at the causes. Many people may have been depressed and complained about their appearance, but most of them can still evaluate their looks objectively and can live, work, and socialize normally. Patients with true somatoform deformation disorder, on the other hand, magnify their appearance defects and fall into a quagmire of anxiety and compulsive behaviors. They often face maladaptive behaviors such as compulsive plastic surgery, compulsive third-view observation of their appearance and demeanor, and compulsive suspicion of others gazing at them. One might think that since imperfect appearance is the source of distress for people with somatoform disorder, wouldn’t everything be fine if they improved their appearance through cosmetic surgery and fitness? But this is not the case in reality. Even after cosmetic surgery, the majority of patients’ anxiety symptoms are still not relieved or even worsened. Doubt and devaluation of their appearance throw their lives into chaos, and these behaviors and thoughts are difficult to control. Rather than suffering from imperfections in appearance, patients with somatoform disorder really suffer from the obsessive criticism of their appearance that lingers in their brains. Currently, the scientific community lacks a complete and clear explanation for the causes of somatoform disorder. Some studies suggest that the disorder may be related to some physiological factors and that genetic factors play a role in its development. On the other hand, childhood experiences and cultural factors are also important causative factors.