Is it possible to have body dysmorphic disorder and be actually ugly?

Eye of the beholder: To be diagnosed with body dysmorphic disorder one must be preoccupied with an imagined defect in appearance. If a slight physical anomaly is present, the person's concern is markedly excessive. And, the preoccupation causes significant distress or impairment in important areas of functioning.

Of course: Here's the key. Many of the "beautiful people", men and women, waste much time on romance and worthless stuff when they're young and end up in dead-end jobs / marriages. If your friends actually comment on a particular feature, consider plastic surgery. Otherwise, fitness is the key to good looks, not face. Today, ugly athletic guys enjoy being "unconventionally handsome".