The findings underscore the importance of recognising and treating this "often secretive" psychiatric disorder, Dr Katherine Phillips, the study's co-author, said.
Individuals with body dysmorphic disorder, or BDD, have a distorted body image and think obsessively about their appearance, often for hours a day, explained Phillips, who is at Butler Hospital and Brown Medical School in Providence, Rhode Island.
The disorder frequently leads to self-loathing and social isolation, she added. It is not uncommon for people with BDD to tell no one about their condition, even a spouse or very close friends.
"I've worked with these patients for about 15 years now," Phillips added. "In my clinical experience they're often thinking about suicide. They're an unusually distressed group of people."
Philips and her colleague William Menard conducted the first investigation in which a group of patients with BDD were followed over a period of time, and report the findings in the American Journal of Psychiatry.
During each year of the study, 58 per cent of the 185 study participants reported thinking about suicide, and 2.6 per cent tried to kill themselves. Two people completed suicide attempts, making the suicide rate among the patients roughly 45 times greater than for people in the general population.
Studies have suggested that up to 2.4 per cent of people have BDD, Phillips said. While most of us have concerns about appearance, she added, a person with BDD obsesses about these concerns and is virtually crippled by them.
"It's easy to trivialise BDD, it's easy to confuse it with vanity," she added.
Most people with BDD can be helped by treatment with antidepressant drugs known as selective serotonin reuptake inhibitors, which include Prozac and Zoloft, or a type of counselling known as cognitive behavioural therapy, Phillips said.
"The good news is that there are two forms of treatment that seem to be helpful for most people with this disorder," she added. "This just underscores the importance of recognising this illness and recognising that it's a severe illness that can potentially respond very well to mental health treatment."
(Dr Katherine Phillips is the author of The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder, and for more information on BDD you can purchase her book from Amazon.