Muscle Dysmorphia

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by Roberto Olivardia, PhD; Aaron Blashill, PhD; & Jonathan Hoffman, PhD
Muscle Dysmorphia or MD is a form of Body Dysmorphic Disorder (BDD). MD is defined by:
MD mainly affects males, with symptoms usually beginning in the late teens or early adulthood. The number of individuals affected by muscle dysmorphia is unknown; however, research indicates that between 1.7% and 2.4% of individuals meet criteria for body dysmorphic disorder. One study showed that about 22% of men with body dysmorphic disorder also met criteria for muscle dysmorphia. This would suggesting that about 0.5% of men in general may meet criteria for MD. It is also important to highlight that these numbers may be underestimates, and additional research is needed in this area.
There is no specific cause known for MD, although factors such as biology, being teased or bullied while growing up, and problematic ways of thinking about wanting to be highly muscular are possible factors. In addition, cultural and media influences that create unrealistic models of bodily perfection as both attainable and necessary, may play a role as well. And finally low-self esteem and feelings of social isolation and loneliness can go hand in hand with MD.
Sometimes also referred to as “bigorexia” or “reverse anorexia,” MD may have some overlap with eating disorders, but is not an eating disorder. While individuals with MD often follow very precise, time-consuming, and painstakingly picky diets, their eating habits are driven by an all-consuming concern with improving the mass and leanness of their muscules, as opposed to issues relating to their weight or body fat percentage, as seen in individuals with eating disorders. And although people with MD certainly can appear vain or self-absorbed, they are different from narcissists because, far from having an inflated self-image, they are often plagued by doubts, insecurities, shame, and low self-esteem. In addition, they are specifically focused on perfecting their muscles whereas true narcissists need to feel like they are better than anyone else in all respects. It’s easy to not take MD seriously, but individuals with MD can be at risk for suicidal behaviors when they lose hope that their muscles will ever look the way they “should.”
In their desperation to achieve ever-larger and leaner, and more “perfect” bodies, people with MD exercise excessively, spending many hours at the gym, often risking injuries, or making them worse by refusing to stop, even when in significant pain. Many with MD will wear baggy clothing to disguise “imperfections,” whereas others will spend a great deal of time selecting, or tailoring, attire to accentuate certain body parts, or “uphold” an arbitrary “standard” of appearance.
Individuals with severe MD are known to sacrifice relationships, their other interests, financial stability, and careers to “get big.” They will often make important life decisions based upon how it will impact their work out schedules. If confronted by well-meaning partners, friends or family members, they may deny, rationalize, become angry and defensive, or start isolating or avoiding them. In the worst cases, the rest of life ceases, only the obsession with their muscles remains.
Muscle dysmorphia is associated with a number of thoughts and beliefs about one’s self and others, including:
There are also a number of behavioral signs of muscle dysmorphia, including:
Disorders commonly seen along with Muscle Dysmorphia:
How muscle dysmorphia is different healthy bodybuilding or fitness:
People with MD will often deny there is a problem and refuse to consider mental health treatment. In fact, they are often more likely to seek remedies like plastic surgery to “correct” their erroneously perceived “flaws” rather than psychological help.
For those who do consider psychological treatment, it can feel like a “catch-22” dilemma. Not seeking treatment means continued struggles with obsessive thinking and compulsive behavior; however, seeking treatment might include decreasing time at the gym and ceasing any steroid use, resulting in loss of muscle mass, which is scary for those with muscle dysmorphia. It is important that individuals with MD work with therapist who specializes in BDD, OCD or body image disorders. Education is important in helping to inform individuals with muscle dysmorphia about healthy body ideals, proper nutrition, and the dangers of over exercise. Cognitive behavior therapy or CBT can be helpful in addressing negative self-talk and unhelpful thinking patterns while at the same time targeting repetitive or compulsive behaviors and increasing healthy behaviors. Therapy can also be supplemented with attendance at support groups.
Yet another issue often plaguing those with MD pertains to the misuse and abuse of anabolic steroids, human growth hormones, and other substances that, in a sense, make false, almost magical promises that they are the solution to obstacles in creating perfectly ripped, v-shaped bodies. These substances are common in the body building culture and while they can undoubtedly “work” in terms of a short-term “fix,” they often feed into a vicious cycle of escalating anxiety, depression, even rage attacks. Ironically, these substances actually may detract from appearance and “masculinity” by creating eruptions of pimples and other dermatological problems as well as causing adverse affects on sexual organs and functioning. Ceasing steroid use is essential for physical and mental health, but should not be done abruptly and should occur under the care of a physician.
The Adonis Complex (2000). Harrison G. Pope, Jr., Katharine Phillips, MD, & Roberto Olivardia, PhD.
Roberto Olivardia, PhD, is a Clinical Instructor of Psychology at Harvard Medical School. He maintains a private psychotherapy practice in Lexington, MA, where he specializes in the treatment of BDD, OCD, and attention deficit hyperactivity disorder (ADHD). He also specializes in the treatment of eating disorders in boys and men. He is co-author of The Adonis Complex, a book which details the various manifestations of body image problems in men. 
Aaron J. Blashill, PhD, is a Staff Psychologist at Massachusetts General Hospital, and Instructor in Psychology at Harvard Medical School, Boston. 
Jonathan Hoffman, PhD, ABPP, is Clinical Director of the NeuroBehavioral Institute in South Florida, and is a member of the IOCDF Scientific & Clinical Advisory Board.
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Muscle dysmorphia is associated with a number of thoughts and beliefs about one’s self and others, including:
bdd.iocdf.org/expert-opinions/muscle-dysmorphi…
What does it mean to have muscle dysmorphia?
What does it mean to have muscle dysmorphia?
Muscle Dysmorphia or MD is a form of Body Dysmorphic Disorder (BDD). MD is defined by: Being preoccupied by worries that one’s body is “too small” or “not muscular enough” despite having a normal build, or in many cases, an objectively extremely “buff” physique.
bdd.iocdf.org/expert-opinions/muscle-dys…
Who is the best therapist for muscle dysmorphia?
Who is the best therapist for muscle dysmorphia?
It is important that individuals with MD work with therapist who specializes in BDD, OCD or body image disorders. Education is important in helping to inform individuals with muscle dysmorphia about healthy body ideals, proper nutrition, and the dangers of over exercise.
bdd.iocdf.org/expert-opinions/muscle-dys…
Is there a recovery village for muscle dysphoria?
Is there a recovery village for muscle dysphoria?
Muscle Dysphoria | The Recovery Village Often called bigorexia or reverse anorexia, muscle dysmorphia is characterized by distortions in body image. A disorder affecting mainly men, individuals with this mental health Muscle dysmorphia is an increasingly common condition that can have detrimental effects. Fortunately, treatment is available.
www.therecoveryvillage.com/mental-healt…
How many men have body dysmorphic disorder ( MD )?
How many men have body dysmorphic disorder ( MD )?
One study showed that about 22% of men with body dysmorphic disorder also met criteria for muscle dysmorphia. This would suggesting that about 0.5% of men in general may meet criteria for MD.
bdd.iocdf.org/expert-opinions/muscle-dys…
https://en.m.wikipedia.org/wiki/Muscle_dysmorphia
Ориентировочное время чтения: 8 мин
Опубликовано: 23.10.2004
Muscle dysmorphia is a subtype of the obsessive mental disorder body dysmorphic disorder, but is often also grouped with eating disorders. In muscle dysmorphia, which is sometimes called "bigorexia", "megarexia", or "reverse anorexia", the delusional or exaggerated belief is that one's own body is too small, too skinny, insufficiently muscular, or insufficiently lean, although in most cases, the individual's build is normal or even exceptionally large and muscular already.
Muscle dysmorphia is a subtype of the obsessive mental disorder body dysmorphic disorder, but is often also grouped with eating disorders. In muscle dysmorphia, which is sometimes called "bigorexia", "megarexia", or "reverse anorexia", the delusional or exaggerated belief is that one's own body is too small, too skinny, insufficiently muscular, or insufficiently lean, although in most cases, the individual's build is normal or even exceptionally large and muscular already.

Muscle dysmorphia affects mostly males, particularly those involved in sports where body size or weight are competitive factors, becoming rationales to gain muscle or become leaner. The quest to seemingly fix one's body consumes inordinate time, attention, and resources, as on exercise routines, dietary regimens, and nutritional supplementation, while use of anabolic steroids is also common. Other body-dysmorphic preoccupations that are not muscle-dysmorphic are usually present as well.

Although likened to anorexia nervosa, muscle dysmorphia is especially difficult to recognize, since awareness of it is scarce and persons experiencing muscle dysmorphia typically remain healthy looking. The distress and distraction of muscle dysmorphia provoke absences from school, work, and social settings. Compared to other body dysmorphic disorders, rates of suicide attempts are especially high with muscle dysmorphia. Researchers believe that muscle dysmorphia's incidence is rising, partly due to the recent cultural emphasis on muscular male bodies.
https://bdd.iocdf.org/expert-opinions/muscle-dysmorphia
Перевести · Muscle Dysmorphia or MD is a form of Body Dysmorphic Disorder (BDD). MD is defined by: Being preoccupied by worries that one’s body is “too small” or “not muscular enough” despite having a …
Muscle Dysmorphia, Bigorexia & Body Dysmorphic Disorder
Muscle dysmorphia: when you’re never big enough
Muscle Dysmorphia & BDD Brain Research
Muscle Dysmorphia – The Male Eating Disorder | Scott Griffiths | TEDxSydney
Muscle Dysmorphia/Adonis Complex/Bigorexia explained
YouTube › Nick's Strength and Power
The impact of muscle dysmorphia | Q&A with Scott Griffiths | TEDxYouth@Sydney
https://pubmed.ncbi.nlm.nih.gov/27536165
Перевести · Since 1997, there has been increasing research focusing on muscle dysmorphia, a condition underpinned by people's beliefs that they have …
https://www.healthline.com/health/muscle-dysmorphia
Перевести · 13.11.2020 · Many men develop a subclass of BDD called muscle dysmorphia (MD). People with MD perceive themselves as less muscular …
https://www.therecoveryvillage.com/.../body-dysmorphic-disorder/related/muscle-dysphoria
Перевести · 29.12.2020 · Muscle dysmorphia is a psychological condition in which a person believes that their body and muscles are too small. Although typically associated with men, muscle dysmorphia …
https://www.healthyfood.com/advice/muscle-dysmorphia-the-silent-condition-affecting...
Перевести · 17.06.2021 · Muscle dysmorphia is linked to the belief that a muscular physique is ideal. So being exposed to these images and ideals in the media may cause concern and a distorted view of …
https://ru.xcv.wiki/wiki/Muscle_dysmorphia
При мышечной дисморфии, которую иногда называют « бигорексией », « мегарексией » или « обратной анорексией », бредовое или преувеличенное убеждение состоит в том, что …
Дисморфофо́бия, также известная как дисморфофоби́ческое расстро́йство, или теле́сно…
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