Why is body dysmorphic disorder (BDD) difficult to diagnose?

Why is body dysmorphic disorder (BDD) difficult to diagnose?

It can be hard to diagnose this disorder because people often feel shame and are secretive about their feelings and symptoms. They may be embarrassed and choose not to tell their providers about their symptoms. The disorder can go unnoticed for years. Many people with body dysmorphic disorder don’t receive a diagnosis.

One sign providers and family members may notice is a person repeatedly seeking plastic surgery for a physical defect they think they have.