What do psychologists say to people that really do have unappealing aspects to their appearance? BDD is always described as "perceived" flaws. Some people have actual ones. Our society is obsessed with looks. Magazines, television, the internet...you can't go 30 seconds without seeing or hearing something about appearance - especially women's. I've worked hard to accept things about myself, including therapy. It takes so much work, to put other people's comments and attitudes into perspective day after day. Things could be so much worse, and I know that I have superficial concerns. However, our society advocates mocking unattractive people. I think the focus should be on providing tools to people, to deal with the very real world. We shouldn't be told "it's all in your head, you're the one with the problem." That's not always the case.