Bigger Isn't Always Better - muscle dysmorphia in men

American Fitness, Jan, 2001 by Jessica Bartlett

Males across America who suffer from muscle dysmorphia are taking their workouts to unhealty extremes.

Breathing heavily and fast, he picks his towel up from the floor and wipes the sweat pouring down his face. He turns to the mirror to stare at his reflection, pushing up the sleeves of the baggy sweater he wears to hide his body Flexing his muscles, he lets out a sigh of dissatisfaction and disgust at the body he hates, longing to look like the bodybuilders he admires.

He makes sure no one is watching as he obsesses over his physique. He returns to the bench, telling himself, "I have to do it again." His arms shake as his veins pop out of his skin. All he can think of is a cut body with defined muscles, a firm chest and a true "six pack"--an image that makes him push even harder. After much difficulty, he completes the set.

He seems like a typical guy working out at the gym, but is he? "He" is one of the many males suffering from "muscle dysmorphia," a disorder affecting thousands of men across America. "He" could be a friend, a colleague or someone passing on the street. The problem, in fact, is not evident from their appearance. According to a number of psychologists studying the disorder, men who have muscle dysmorphia believe they have small bodies when they are actually big and muscular. To counteract this belief, however, these men take their workouts to an unhealthy extreme.

Muscle dysmorphia is described in the new book, The Adonis Complex: The Secret Crisis of Male Body Obsession, co-authored by Dr. Harrison G. Pope, Jr., Chief of Biological Psychiatry at McLean Hospital in Belmont, Massachusetts. The book describes the Adonis Complex as encompassing many different body obsession disorders, muscle dysmorphia being one of them.

"These concerns range from minor annoyances to devastating and sometimes even life-threatening obsessions--from manageable dissatisfaction to full-blown psychiatric body image disorders," writes Pope and co-authors Dr. Roberto Olivardia, a Clinical Fellow in Psychology at Harvard Medical School, and Dr. Kathleen Phillips, Associate Professor of Psychiatry at Brown University, Director of the Butler Hospital's Body Dystrophic Program and author of The Broken Mirror.

Muscle dysmorphia, also referred to as reverse anorexia" or bigorexia nervosa because of its analogous similarities to women with anorexia nervosa, is what one former bodybuilder named Ken(*) has struggled with for years. Ken says he was overweight as a child and was teased by other kids. Through bodybuilding, he could change the way he was perceived by sculpting a socially accepted and desired body image. However, during 10 years of working out, it turned into an obsession.

Onset of Obsession

Ken's life became very regimented, revolving around his training and the pursuit of being bigger. He had to do the exact same workout every day, sleep the same number of hours each night and eat a specific diet. This eventually began to affect relationships and other areas of his life.

"I didn't go on vacations for many years," he says. "I always had to be near a gym." If Ken couldn't complete a workout, he would become extremely anxious, thinking about it the whole day or until his next workout. "I needed the feeling that I had just done it," he says.

Not only did Ken's workouts change his lifestyle, he also began to suffer physically. He developed back and shoulder problems, eventually heading toward procedures like knee surgery. He continued to work out even when he was injured or sick.

Admitting The Problem

Feeling frustrated by his obsession, Ken confided in a close friend who helped him realize that working out should be a hobby, not a job. Fortunately, he also met Dr. Pope after responding to a poster he saw in the gym targeting people who struggled with body preoccupation. Ken then learned that there is a name for his problem and other people suffered from it, too.

According to Dr. Pope, Ken did not display the worst case of muscle dysmorphia. Dr. Pope says some sufferers lose entire careers, marriages and relationships. According to the book, one male wouldn't kiss his girlfriend for two weeks in fear she would transmit calories to him through her saliva, while another would only have sex twice a month to avoid any "unnecessary physical labor in order to conserve energy for working out." Another man kept a blender at his desk to make himself a protein shake every 90 minutes. Due to the noise, he was given an ultimatum of choosing between the blender or the job ... he chose the blender.

Influential Factors

Dr. Pope says that to develop a full-scale case of muscle dysmorphia, one must have a biological predisposition. Biologically, sufferers have a type of obsessive-compulsive disorder. According to Dr. Pope, a person who washes his hands 10 times a day is normal, but washing your hands a hundred times per day and having it interfere with the rest of your life signals a problem. He uses this example to show that "there isn't anything pathological about going to the gym regularly or dieting," but there is a problem when "a huge number of boys and men work out beyond a normal range so that it becomes a source of distress" and affects all areas of their lives.