This article provides an overview of the development of the body dysmorphic disorder in the context of various prevailing ideals of beauty. The distinction from simple body dissatisfaction is presented, also in view of brainorganic as well as neurochemical differences. Individuals with body dysmorphic disorder have an increased sensitivity to the detection of detail – instead of a holistic view -, making them more likely to notice flaws or blemishes that are unnoticeable to others. This distorted perception can be corrected in the context of cognitive behavioural therapy, provided that the body dysmorphic disorder is recognised as such. The concealment by comorbidities as well as the consequences for affected persons and treatment options are described.