Body dysmorphic disorder, first described in the medical literature more than a century ago, is a psychiatric illness worldwide. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), defines body dysmorphic disorder as a preoccupation with an imagined defect in appearance; if a slight physical anomaly is present, the person's concern is markedly excessive. The preoccupation must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. In addition, the appearance concerns are not better accounted for by another psychiatric illness, such as anorexia nervosa.