Bigorexia is an issue which periodically appears in news cycles, and as it’s appeared again recently it seemed a good idea to jot down some thoughts here. This is an important matter because body dysmorphia is a devastating issue for many lives, so needs to be spoken about openly, but it’s also commonly misunderstood. Someone training 4-5 times per week, eating in order to fuel that properly and becoming agitated when they aren’t able to train when they want to is not necessarily indicative of a psychological disorder – and in my eyes the Bigorexia label is thrown around too readily. So what does it really mean?

Body image issues are classically considered to be a female issue, but this is a huge mistake. Men are under just as much pressure to appear a certain way and if anything these issues are more taboo in light of the focus on female body image issues (which I am in no way dismissing or reducing the importance of here). Male body image issues, much like females ones, stem from a pairing of socially constructed norms and evolved species-wide ideals. The media and Western society in general value certain appearances more highly than others, and sexual selection has ‘taught’ men over millions of years how to appear if they wish to be considered a suitable mate. While this latter point has at times been muddied by other means of showing authority and therefore higher social standing within moden society (monetary assets or career success, usually), it’s remiss to think that physical appearance matters for literally every other species on the planet but not us.

Male body image issues tend to focus on height, bodyfat and penis size but also muscularity – all of which can be grouped under generalised term “masculinity”. Penis size can (should?) be hidden in public and height is unchanging but body composition is malleable and therefore men who find themselves trying to improve their attractiveness (either to a healthy degree or a pathological one) tend to be disproportionately represented in gym culture. Note, before we continue – females CAN experience the issues presented here, too, but the prevalence is far, far lower.

Muscle Dysmorphic Disorder (MDD) is popularly known as ‘bigorexia’ in the media and there may be a good reason for the comparison between MDD and Anorexia Nervosa. Much like how anorexia isn’t about looking good, MDD is not an exercise in vanity and this is an important. Those with MDD often start out as someone with a healthy interest in improving their health and appearance but individuals with a genetic propensity for taking these things to the extreme, who find themselves in the wrong set of circumstances start to see themselves differently. Though they may be in great shape already, individuals with MDD genuinely see themselves as small/weak and will therefore make what they view as the necessary steps to remedy the situation.

Why is this a problem?

Working out is good for you, right?

Yes, to a degree, but this is where MDD and dedicated training differ: Being dedicated to training means that it is a voluntary undertaking. Though of course habits will form surrounding exercise and therefore some amount of irritation will arise in a dedicated trainer if they are coerced into missing training sessions or similar, it will be far less pronounced than in those with MDD. Individuals with MDD will experience extreme irritation and feelings of low self esteem if they are unable to exercise and eat in the manner that they would like to, and this is reflected in their behaviour where they will exercise compulsively, even if it isn’t in their best interests.

People with MDD will train through injury, will sacrifice social situations regularly so that they can train/eat the meals they think are needed to reach a goal, they will find that their preoccupation with their image interferes with relationships, careers and education, and will often refuse to take holidays or other multiple-day trips for fear that their gym regime will be interrupted. Steroid and other PED use amongst MDD sufferers is high.

Of course there is a spectrum, and we must be very careful when handing out ‘diagnoses’ because a powerlifter will always be stronger and a bodybuilder will always be bigger than the average person but may not be all that successful as far as their sport is concerned, and so it’s unfair to judge someone who wants to improve based upon an improper measurement of success. We must also bear in mind that someone with dedication and serious goals will have similar behaviours to those with MDD, only with very different outlooks. For example someone without MDD but who simply prioritises training may:

  • Train around injury
  • Train for multiple hours per week.
  • Choose to skip heavy nights out drinking or all you can eat buffets
  • Eat in a manner outside of the norm
  • Look to find a gym while on holiday
  • Spend a reasonable amount of time reading/learning about their hobby

None of these things are indicative of a problem per se. The problem arises when these behaviours are continued compulsively even if they are evidently impacting the person’s life in a negative manner.

"They aren’t just vain and they aren’t just narcissists".

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Some symptoms to look for

  • Excessive time exercising which impacts on day to day life or work
  • Genuine panic, distress or rage if something gets in the way of training
  • Un-planned overreaching or overtraining, and training through (rather than around) injury
  • Disordered eating habits (often very hard to define)
  • Compulsive checking of one’s physique multiple times per day
  • Excessive supplement use, and steroid use
  • If you feel that you or someone you know may have issues, the best thing to do is to talk to a professional. CBT is an extremely effective method for dealing with MDD, but just like any other body image issue the person must be ready to seek help. If they are not ready then forcing the issue may make it worse. The advice is to speak first to a GP who should be able to refer you for CBT, or to contact a private therapist in your local area.

Regardless: If you suspect a friend or loved one is being affected, my advice is to be supportive and understanding while informing them clearly of your concerns in a neutral and non-provocative place/manner. Remember that they aren’t just vain and they aren’t just narcissists, they have a recognised psychological disorder and must therefore be helped rather than judged.