When healthy habits go haywire: monster zits, bloody shinsplints, freakish muscles, and the attack of bigorexia!

Men's Fitness, Nov, 2003 by Jacob Ditkoff

Samuel Fussell was a scrawny, Oxford-educated bookworm who at age 26 decided to put on some muscle as "protection" from the mean streets of New York City. Then his simple desire grew into an obsession. Four years later he found himself a 257-pound behemoth who had given up his academic ambitions for a life of constant eating, lifting, and amateur bodybuilding contests. "The inflated cartoon I became relieved me from the responsibility of being human," he recalled. "It was in the gym that I was most alive."

NOW, YOU'RE never going to hear Men's Fitness say there's anything wrong with building your muscles or spending time in the gym. In fact, since more than half of all Americans are overweight and exercise less than your average houseplant, guys who do take exceptional care of their bodies have reason to be proud.

Unfortunately, like Fussell, that health-minded bunch contains an obsessive minority who take things too far, to the point where otherwise positive activities become positively harmful. And according to Harvard psychiatrist (and weightlifter) Harrison Pope, M.D., that group--men who not only want to look and feel better but also assert a high level of control over their lives--has been growing for the past 20 years. As a result of books such as The Adonis Complex, co-written by Pope, for the first time serious attention is being paid to the male side of something that women have been warned about for decades.

What follows are some of the more dangerous traps men fall into when beneficial activities develop into unhealthy obsessions. Take the quiz to see if you're in danger of crossing that line. Or if you've crossed it already.

GROOMING

STARTS AS a way to improve appearance, self-confidence, and to reduce risk of acne, hair loss, and disease.

BECOMES a psychotic regimen focused on one or more features of the face or body, a condition known as body dysmorphic disorder. Many with BDD seek multiple cosmetic-surgery procedures (does the name Michael Jackson ring a bell?). According to Harvard psychologist Roberto Olivardia, Ph.D., nearly one out of every five who suffer from BDD attempts suicide.

SUPER-GROSS CASE STUDY Katharine Phillips, M.D., an associate professor of psychiatry and human behavior at Brown University School of Medicine, recalls a patient who became so obsessed with picking at a neck pimple with fingers and then tweezers that the carotid artery became exposed.

MF EXPERT WEIGHS IN Not all cases of BDD are so extreme, Olivardia says. "There are some people who struggle with it but they can kind of go on with their daily lives ... but it still nags on them." In other cases the symptoms can gradually increase. "They might start taking 30 minutes grooming, and a month later they're taking 35 minutes grooming, and before you know it, it's four or five hours a day."

FIXING THE PROBLEM If you avoid social situations because of how you look, most of your self-esteem is based on your appearance, or you see things wrong with your face or body that others don't see, you could have BDD. The Web site bddcentral.com has referrals to specialists.

WORKING OUT

STARTS AS a way to look good, release stress, improve strength, increase muscle size and tone, gain confidence, and lower blood pressure.

BECOMES a disorder often called "bigorexia," a sort of inverse anorexia, in which a man cannot be satisfied with the size of his physique. This can lead to steroid use and the risks of heart disease, liver failure, and erectile dysfunction that are associated with it. According to Cedric Bryant, chief exercise physiologist for the American Council on Exercise, roughly 10% of habitual exercisers can be classed as compulsive.

CASE STUDY One patient regularly did squats with a 405-pound barbell. He suspected that he had given himself a hernia but couldn't face the possibility of a break in his training, so he continued until his pain became so severe he was bedridden for five weeks.

MF EXPERT WEIGHS IN Bryant says that in most cases, exercise addiction "tends to be a gradual, progressive phenomenon." The results can be extreme: "You'll see symptoms of withdrawal or dependence. They develop a tolerance to a certain level of exercise, so they need to have more and more to try to get that same effect."

FIXING THE PROBLEM Muscle growth depends on rest between sessions, so there's no point in overworking any muscle group. Since delayed-onset muscle soreness usually occurs the day after you exercise, any pain you feel immediately after lifting could be a cause for concern. Redness or swelling also signals an injury, which means taking a few days off and consulting a doctor. If you find yourself unable to resist "working through an injury," then consider seeing a sports psychologist.

RUNNING

STARTS AS a meditative way of being alone with your thoughts, as well as a proven method to lower blood pressure, lose weight, and help prevent heart disease.

BECOMES an all-consuming obsession that is more important than work and family. While running can be a heart-healthy activity, those with weak hearts may increase their chances of a heart attack if they overdo it. Most running addicts eventually suffer bone and joint injuries that worsen over time.