Written by Michelle Silverman
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Sometimes referred to as “bigorexia” or “reverse anorexia,” muscle dysmorphia is a subtype of body dysmorphic disorder (BDD), in which people, mostly males, are obsessed with the size of their muscles. They worry that they are not muscular or lean enough or that their bodies are too underdeveloped and weak. Their symptoms cause significant distress and hinder their ability to socialize, go to work, and/or participate in daily activities. In many cases, people with muscle dysmorphia have average or above average muscularity.
Because of their perceived flaws, people with muscle dysmorphia spend an excessive amount of time working out (e.g. weight lifting, cardio exercise, push-ups), dieting or binge eating, examining themselves in the mirror, comparing themselves to others, and seeking reassurance about their appearance from friends and family (e.g. “Do you think my calves look too small?”). Individuals may also take dietary supplements or anabolic steroids in an attempt to reduce body fat or build muscle mass.
What are the signs and symptoms of muscle dysmorphia?
The reality is that many people exercise on a daily basis in order to stay fit and healthy. The amount of time spent working out depends on the individual and their personal goals. For example, many people enjoy lifting weights. However, there are some common warning signs that may indicate that you or someone you know has muscle dysmorphia.
- Do you constantly worry about the size of your muscles?
- Does the amount of time you spend working out obsessing about your muscles interfere with your social or occupational functioning?
- Do you examine your muscles in the mirror or weigh yourself several times per day?
- Do you go to great lengths to avoid looking at yourself in the mirror or having your body seen in public?
- Do you feel anxious or distressed if you miss a session of working out or experience even a slight deviation from your strict diet?
- Do other people say that you are too concerned with your appearance or that you work out too much?
- Do you take supplements/drugs (e.g., anabolic steroids) in order to build muscle mass or reduce body fat?
What treatment options are available for people with muscle dysmorphia?
The good news is that muscle dysmorphia can be treated with help from an experienced clinician. As with other forms of body dysmorphic disorder, cognitive behavioral therapy (CBT) is the treatment of choice for people with muscle dysmorphia. CBT is a type of a therapy in which the clinician teaches the patient how to identify and modify distorted thoughts (e.g. I am not muscular enough) and replace negative and destructive behaviors (e.g. weight lifting for 2 hours, 7 days a week) with healthy behaviors.
Certain antidepressant medications known as serotonin-reuptake inhibitors (SRIS or SSRIs) can also be used to treat muscle dysmorphia. Both SSRIs and CBT have been shown to help people obsess less about their appearance and gain better control over excessive behaviors, such as working out or mirror checking. In addition, they can help reduce the anxiety and distress associated with muscle dysmorphia.
If you suspect that you or someone you know may be suffering from muscle dysmorphia, we strongly encourage you to call our clinic at (617) 726-6766 or e-mail Barbara Davidson.
For further reading:
- Pope, H. G., Gruber, A. J., Choi, P., Olivardia, R., & Phillips, K. A. (1997).Muscle dysmorphia: An underrecognized form of body dysmorphic disorder. Psychosomatics: Journal of Consultation Liaison Psychiatry, 38(6), 548-557.
- Pope, H.G., Phillips, K.A., Olivardia R. (2000). The Adonis Complex: How to Identify, Treat, and Prevent Body Obsession in Men and Boys. New York: Touchstone.
- Phillips, K.A. (2005). The Broken Mirror: Understanding and treating Body Dysmorphic Disorder. New York: Oxford University Press.
- Phillips, K.A. (2009). Understanding Body Dysmorphic Disorder: An Essential Guide. New York: Oxford University Press.
- Wilhelm, S. (2006). Feeling Good About the Way You Look A Program for Overcoming Body Dysmorphic Disorder. New York: The Gilford Press.
© 2011 Massachusetts General Hospital OCD and Related Disorders Program | Reprint only with permission