BDD is often wrongly thought of as a 'vanity' obsession, but it is actually the opposite, because people with BDD believe they are very ugly, even though people without BDD do not think they are. There is not usually actually anything wrong with the way the person with BDD looks, but to that person, there is. A person with BDD can spend hours looking in the mirror, but they are not being vain, as they do not think they are attractive. People with BDD usually realize that worrying about their looks so much is bad, but they can not help it.