Muscle Dysmorphia

While eating disorders have stereotypically been seen as a female disorder, a new form of eating disorder that affects primarily men has been identified: a pathological obsession with muscle building and extreme dieting, dubbed “muscle dysmorphia,” (sometimes referred to as “bigorexia” or “reverse anorexia”). It can affect women also, but does so at much lower rates. Men who suffer from muscle dysmorphia narrow the focus of their lives to the singular goal of developing the perfect body. However, in this case, the desired physique is big and muscular (versus the anorexic ideal of thin).

The disorder has yet to be recognized as an official disorder and there is controversy over whether it should be considered a type of eating disorder or a type of body dysmorphic disorder. Body dysmorphic disorder is a type obsessive-compulsive spectrum disorder in which an individual has excessive concern about and preoccupation with a perceived defect of their physical appearance. Muscle dysmorphia shares a number of features in common with anorexia and the main differences between them are consistent with the opposing physiques pursued in each condition.

Muscle dysmorphia is commonly under-diagnosed because in today’s society, muscular men and women are admired and viewed as strong and attractive. Muscle dysmorphia is very difficult to diagnose and is likely underreported. Many men who have the disorder do not see it as a problem and those that do may go to great lengths to hide it.

Early research showed that about 10% of body builders might have muscle dysmorphia. The rates for muscle dysmorphia in men may be similar to the rates of anorexia nervosa in women, in which case millions of men may suffer from muscle dysmorphia. The most common age of onset of muscle dysmorphia is reported to be 19.

Signs of Bigorexia

If you believe that you or a loved one may be suffering from muscle dysmorphia, it is important to determine if it might be more than just a dedication to healthy working out and weightlifting. If you recognize the following signs of muscle dysmorphia in yourself or another individual, it is important to seek professional treatment as soon as possible. Signs to look for include:

  • Preoccupation with the idea that one’s body is not lean or muscular enough
  • Maintaining an extreme exercise program, usually including long hours of weight lifting
  • Excessive attention to diet with focus on healthy foods and protein
  • Frequently giving up social activities or work obligations because of a compulsive need to maintain one’s workout and diet schedule
  • Working out in spite of injury
  • Constantly scrutinizing oneself in the mirror or avoiding looking in the mirror entirely
  • Extreme anxiety in the case of missed workouts
  • Excessive use of food supplements

Studies show that between 50% and 100% of men with muscle dysmorphia report steroid abuse.

Like other eating disorders, muscle dysmorphia is likely caused by an interaction of biological, psychological, and social factors. Some men are more predisposed to develop muscle dysmorphia based on their genetics. One psychological factor that has been studied is self-esteem. Men with low self-esteem are more likely to have muscle dysmorphia than those men with high self-esteem. Finally, society (e.g., media, sports) is placing greater pressures on men to have an ideal body.

Some of the risks of muscle dysmorphia include:

  • Frequent injuries due to overexercise
  • Damage to muscles, joints, and tendons
  • Kidney damage
  • Liver damage
  • Heart problems

Treatment For Muscle Dysmorphia

As previously stated, individuals with muscle dysmorphia do not often seek treatment so one of the biggest hurdles is to convince the sufferer to accept help. Muscle dysmorphia responds well to the same treatments that help other eating disorders. Treatment should initially focus on normalizing eating and exercise patterns and also on addressing obsessional thoughts. If steroid abuse is involved, extra care and caution is definitely warranted.


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Written by Dr. Lauren Muhlheim – 2014


Bigorexia: young men, body image and steroids
The perfect body? How eating disorders and body image are a threat to men’s health
A comparison of eating, exercise, shape, and weight related symptomatology in males with muscle dysmorphia and anorexia nervosa