Can Muscle Dysmorphia Be Considered An Eating Disorder?

Updated February 26, 2020

Medically Reviewed By: Avia James

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Muscle dysmorphia is a disorder that can affect both men and women, but it is most commonly known as being problematic mainly for males, especially adolescents and younger adults. Informally known as "bigorexia" to some, muscle dysmorphia is categorized by an obsession with being lean and muscular to the point of being detrimental. This disorder can be triggered by outside influences like media (especially fitness-related ones) or sports and performance.

Issues involving body dysmorphia generally fall underthe obsessive compulsive category. Muscle dysmorphia, however, can be classified as an eating disorder, as well.

Overall, muscle dysmorphia is not entirely understood or recognized by society just yet. This article aims to provide readers with an overview of muscle dysmorphia, explain why it is an eating disorder, and discuss what treatment options are available, as well as how BetterHelp.com can lead you in the right direction.

Origins Of Muscle Dysmorphia

Compared to body dysmorphia (as a general umbrella-term) and similar issues, muscle dysmorphia is a relatively recentcondition. Even though, people have been havingconcerns regarding their looks since the dawn of time, muscle dysmorphia had not been clinically recognized until the 1990s. Despite its recent onset, muscle dysmorphia has been largely studied since around 1997, in an effort to explain this condition better.

We know that muscle dysmorphia does have its roots in sports and bodybuilding. Many sports stress the importance of being bigger, faster, and stronger. While being powerful and dominant can be beneficial for those who want to become successful athletes, some people tryto improve on those traits even more, in their pursuit if feelingadequate.

While sports and athleticism are notexclusively responsiblefor this condition, the values they stress at their cores, including being largeand muscular,can be triggers or gateways to the problem.

Muscle Dysmorphia Definition

Specific criteria are taken into account when examining a possible case of muscle dysmorphia. A strong desire to be big and muscular is not enough to make a diagnosis. Here are the factors that a physician will look at before making a professional diagnosis:

  1. a) Preoccupation with the thought that one's body is not sufficiently lean or muscular. The individual may spend hours on end at the gym or dieting.
  2. b) Must contain two out of four of the following:
  1. The neglect of social, occupational, and recreational activities to compulsively maintain a workout schedule and diet routine.
  2. A person may avoid exposing his or her body. Anxiety or distress may occur if the individual is placed in such a situation where they feel exposed.
  3. The preoccupation of body size causes significant distress to other areas of life.
  4. Continuing to work out, diet, and use substances despite understanding the risks or consequences.
  1. c) The individual's primary preoccupation is with feeling too small or inadequate. Anorexia patients will primarily be preoccupied with being too large (fat), in contrast.

Do You Know Someone Who Might Have Muscle Dysmorphia?

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On the surface, muscle dysmorphia may be hard to spot in individuals, especially males. This is because having muscle and leanness are generally associated with masculinity and being healthy. Therefore, it can be difficult to identify someone who may be experiencing muscle dysmorphia at first glance.

However, there are specific behaviors and characteristics that one may observe in individuals with muscle dysmorphia. These muscle dysmorphia symptoms or indicators, have been observedby athletic coaches, specialists, and clinicians,and canhelp identify someone with muscle dysmorphia:

  1. An individual may either wear very tight or baggy clothing, even in hot temperatures. Anxiety or embarrassment may be evident when required to take off the clothes.
  2. Ignoring a specific training regimen (such as functional fitness or strength) to prioritize and focus on muscular hypertrophy, especially on the "show" muscles, like the chest and biceps.
  3. The prioritizing of training over other important aspects of life such as work, school, and social relationships.
  4. The use of anabolic steroids and other supplementation that may be considered unhealthy, such as ones designed for quick fat loss.
  5. The use of mirrors or similar objects, to judge or criticize one's physique. The individual may seek reassurance by asking others to comment and approve of their physique.

Even if one is not regularly in the weight-room with someone whom may be of concern, it is possible to be able to see some of these muscle dysmorphia symptoms in other settings, including, home and school. Identifying the signs of the condition is first step in helping individuals with the condition get on the path to treatment.

Why Muscle Dysmorphia Is Also An Eating Disorder

Based on the muscle dysmorphia definition, as well as its symptoms and characteristics, it is evident that it is an obsessive-compulsive condition. In the DSM-5 of the American Psychiatric Association, its parent disorder, Body Dysmorphia, is also classified under the "Obsessive-Compulsive and Related Disorders" category. However, to fully understand this problem, it should be examined from different angles.

Throughout its history, muscle dysmorphia has been compared to and contrasted with anorexia. In the DSM-5, anorexia nervosa is classified as an eating disorder. Keep in mind that muscle dysmorphia is commonly, but informally, known as "bigorexia" or "reverse anorexia". While taking this information into consideration, we can now examine how it all plays out in actuality.

To build muscle, one typically needs to be in a caloric surplus. In layman's terms, you must consume more calories than your body burns throughout the day. The surplus calories and the macro-nutrients will be used towards rebuilding muscle that has been broken down, allowing them to grow. If one does not work out, the excess calories will typically be stored as fat.

To lose weight and achieve leanness, an individual needs to do the opposite and go into a caloric deficit. Doing so will result in weight loss because fewer calories are consumed. When someone mentions dieting, this is usually the method and goal.

Someone with muscle dysmorphia symptoms will often struggle with finding his or her perfect balance of muscularity and leanness, which often results in feelings of inadequacy. This feeling is often exclusive to the individual alone, and is not the one perceived by others.

While the disorder has obsessive-compulsive traits, we cannot deny that to reach the goals, food is mandatory, and its calories and nutrients are an extreme focus for these individuals.

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While a patient with anorexia will drastically reduce the number of calories they eat so that he or she can combat or avoid being overweight or obese, someone with muscle dysmorphia will do the opposite. To get big, one must eat big, which may explain the concept of bigorexia.

On the other hand, to lean out and be more defined, an individual may suddenly reduce their food intake. These examples show that eating habits play a big role in muscle dysmorphia, for which the condition can be classified asan eating disorder.

What Treatment Options Are Available?

While available, many people do not seek treatment for muscle dysmorphia. This is usually because individuals often do not recognize that they have a problem that requires professional help. Therefore, the very first step is to identify if there's a problem. Sometimes a family member, a close friend, or a coach will be the first to witness someone who needs help.

Next, an individual may decide to participate in therapy sessions where they can openly discuss their feelings regarding body-image, self-esteem, and how it impacts his or her life. BetterHelp.com offers counseling and therapy services to individuals seeking assistance. One form of psychotherapy, known as cognitive-behavioral therapy (CBT) can provide relief frommuscle dysmorphia symptoms by modifying an individual's thoughts and reactions to situations.

While therapy can be helpful, in some cases, psychotropic medications can help as well, when taken in combination. While there isn't an FDA-approved treatment, SSRI (selective-serotonin reuptake inhibitor) antidepressants, as fluoxetine, have been found effective for treatment of the condition, as well as similar and related conditions as OCD, anorexia, and anxiety.

Lastly, since muscle dysmorphia is consideredan eating disorder, food intake and consumption of supplements and drugs, must be addressed and monitored as well.

Conclusion

Even though muscle dysmorphia is not as well understood as otherconditions are, some research has been conducted in an effort to better understand this condition. At this point in time, it appears as though muscle dysmorphia is more complex than one might think. And while the DSM classifies muscle dysmorphia under obsessive-compulsive and related disorders, studies have shown that this condition has a lot in common with eating disorders.

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Thankfully, muscle dysmorphia symptoms can be treated. The first step towards treatment is to recognize that you or someone you know,is affected by the disorder. Therapy and medication are options for anyone who has muscle dysmorphia. Professional therapy servicesare available through BetterHelp.com at https://www.betterhelp.com/start.

References

Leone, J. E., Sedory, E. J., & Gray, K. A. (2005). Recognition and Treatment of Muscle Dysmorphia and Related Body Image Disorders. Journal of Athletic Training, 40(4). Retrieved August 22, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1323298/.

Tod, D., Edwards, C., & Cranswick, I. (2016). Muscle dysmorphia: Current insights. Psychology Research and Behavior Management, 9, 179-188. doi:10.2147/prbm.s97404

Murray, S. B., & Baghurst, T. (2013). Revisiting the Diagnostic Criteria for Muscle Dysmorphia. Strength and Conditioning Journal, 35(1), 69-74. doi:10.1519/ssc.0b013e3182723f24


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