(e.g., eyes, teeth, weight, stomach, breasts, le gs, face size or shape, lips, chin, eyebrows,
genitals). Some individuals are concerned abou t perceived asymmetry of body areas. The
preoccupations are intrusive,  unwanted, time-consuming (occurring, on average, 3–8
hours per day), and usually diff icult to resist or control. 
Excessive repetitive behaviors or mental ac ts (e.g., comparing) are performed in re-
sponse to the preoccupation (Criterion B). The individual feels driven to perform these be-
haviors, which are not pleasurable and may increase anxiety and dysphoria. They are
typically time-consuming and difficult to re sist or control. Common behaviors are com-
paring one’s appearance with that of other individuals; repeatedly checking perceived
defects in mirrors or other reflecting surf aces or examining them directly; excessively
grooming (e.g., combing, stylin g, shaving, plucking, or pull ing hair); camouflaging (e.g.,
repeatedly applying makeup or covering dislik ed areas with such things as a hat, clothing,
makeup, or hair); seeking reassurance about how the perceived flaws look; touching dis-
liked areas to check them; excessively exerci sing or weight lifting; and seeking cosmetic
procedures. Some individuals exce ssively tan (e.g., to darken “pale” skin or diminish per-
ceived acne), repeatedly change their clothe s (e.g., to camouflage perceived defects), or
compulsively shop (e.g., for beauty produc ts). Compulsive skin picking intended to
improve perceived skin defects is common and can cause skin damage, infections, or
ruptured blood vessels. The preoccupation must cause clinically significant distress or im-