OCD Related Conditions Bigorexia or Muscle Dysmorphia By Jerry Kennard, PhD Jerry Kennard, PhD Jerry Kennard, PhD, is a psychologist and associate fellow of the British Psychological Society. Learn about our editorial process Updated on November 21, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print PeopleImages/Getty Images Being preoccupied with muscle development may involve a disturbance in body image similar to anorexia. Bigorexia (muscular dysmorphia) is now affecting hundreds of thousands of men. For some men, muscle development is such a complete preoccupation that they will miss important events, continue training through pain or broken bones, even lose their job rather than interrupt their physical development schedule. Muscle Dysmorphia The term "muscle dysmorphia" was coined in the 1990s to describe this new form of disorder. Other people refer to the condition as "reverse anorexia," and now more commonly "bigorexia." The causes are not known and researchers conceptualize it in different ways. Some feel it should be thought of as an eating disorder, some as a behavioral addiction, and others as a type of body dysmorphic disorder. Some believe a major factor is the media putting the same type of pressure on men to conform to an ideal shape in ways that has been the case with women for years. The Main Characteristic of Bigorexia The main characteristic of bigorexia is the thought that no matter how hard you try your body is never muscular enough. The condition is recognized as more common in men although some women bodybuilders have also been reported with similar symptoms. Most men with bigorexia are weightlifters, but this does not mean that most weightlifters are bigorexic. Compared to normal weightlifters who report spending up to 40 minutes a day thinking about body development, men with bigorexia report being preoccupied five or more hours a day thinking their bodies are under-developed. With the increase in gymnasium provision and attendance, there is some speculation that this alone accounts for increased awareness of physical imperfection in men and a quest to attain the perfect body. Conservative estimates put bigorexia as affecting hundreds of thousands of men. Mirror Checking One study described bigorexic men checking themselves out up to 12 times a day. This compares to roughly three times a day with other weightlifters. Diet Very strict diets are often involved in this syndrome. Bigorexics will rarely eat at another person's house or at a restaurant because they are unable to control the dietary balance or know exactly what has gone into food preparation. It has been known for men to develop eating disorders such as bulimia. Measuring Up Bigorexic men constantly compare their own physique with that of other men. Invariably their perceptions are incorrect. Even when observing men of equal physique they will judge themselves as smaller. Drugs The use of anabolic steroids is common amongst bigorexics. Men continue using steroids despite experiencing side effects such as increased aggression, acne, breast enlargement, impotence, baldness, impotence, and testicular shrinkage. Body Fat Men with bigorexia typically worry about the percentage of body fat they carry rather than being overweight. Psychological Factors Unlike many bodybuilders who enjoy the opportunity to show their physique in public, bigorexics do not. Many will hide away for days at a time because of embarrassment about their body shape. One study described a man who avoided sex with his wife in case it used up energy he could apply to bodybuilding. Typically, men with bigorexia have low self-esteem. Many report having been teased at school about their physique leading to a focus on "making good." However, the attempt to catch up is never achieved and results in a poor sense of self and feelings of emptiness. Studies also found that 29% of men with bigorexia had a history of anxiety disorder and 58% exhibited some other form of mood disorder. Treatment Options At the time of writing, no systematic studies have been produced to compare the effectiveness of one treatment over another, either individually or in combination. A particular problem with the condition is that, rather like anorexics, men rarely see themselves as having a problem and are unlikely to come forward for treatment. The condition itself occurs partly as a response to feelings of depression and lack of self-esteem so coming forward for treatment is admitting defeat. Where men have come forward a combination of educational and psychotherapeutic techniques has begun to show promising results. Cognitive-behavioral techniques place an emphasis on identifying and changing patterns of thinking toward more realistic and achievable goals. Treatment of co-morbid mood and anxiety disorders are important. Future treatment packages may well be informed by such approaches but more systematic studies are now required. Where Do Men Fit Into the Body Positivity Movement? 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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Cognitive behavioral therapy for body dysmorphic disorder. In: Petersen T, E. Sprich S, Wilhelm S, eds., The Massachusetts General Hospital Handbook of Cognitive Behavioral Therapy. Current Clinical Psychiatry. Humana Press, New York, NY: Humana Press; 2016. doi:10.1007/978-1-4939-2605-3_11 By Jerry Kennard, PhD Jerry Kennard, PhD, is a psychologist and associate fellow of the British Psychological Society. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for OCD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.