Can Muscle Dysmorphia Be Considered An Eating Disorder?
Muscle dysmorphia is generally categorized by intense feelings of focus on one’s fitness—particularly with the thought of being lean and muscular for many. These thoughts can perpetuate themselves to the point of causing harm to one’s physical and mental health, among other symptoms.
This disorder can be triggered by outside influences like the media (such as fitness-related channels or platforms) or competitive sports.
Many experts believe that muscle dysmorphia, as a result, can also be classified as an eating disorder of its own.
Below, we’ll be providing readers with an overview of muscle dysmorphia, its appearance as an eating disorder in many as well as possible available treatment options.
Origins Of Muscle Dysmorphia: Where Did This Condition Come From?
While body image dissatisfaction is thought by many to have been a major concern for many people over time, muscle dysmorphia was not generally believed to be clinically recognized until the 1990s.
Since this point, researchers have hypothesized that the condition can occur as a result of intense focus on sports and performance. This may be because many forms of sports might stress the importance of being bigger, faster and stronger than competitors. While being powerful and dominant can be beneficial for those who want to become successful athletes, some people might try to improve on those traits even more, which can have negative effects.
Many now believe that athleticism might not be exclusively responsible for this condition. Social media pressures can also play a role in contributing to the pressure to be muscular or extremely fit. For example:
Non-heterosexual people may face heightened societal pressure to achieve a lean and muscular body, possibly putting them at a higher risk for developing body dysmorphic disorders.
How Is Muscle Dysmorphia Diagnosed?
A physician will generally look at specific diagnostic criteria when examining a possible case of muscle dysmorphia.
Specific criteria can include symptoms such as:
1. Preoccupation with the thought that one's body is not sufficiently lean or muscular: As a result, the individual may spend hours on end at the gym or dieting—the frequency of which might also be examined to confirm the presence of muscle dysmorphia.
2. Two out of five of the following symptoms:
a. The neglect of social, occupational, and recreational activities. As a result of this free time, someone may compulsively maintain a workout schedule and diet routine.
b. Avoidance of situations that may cause exposure of one’s body. Someone living with this disorder may experience feelings of nervousness or distress if they are placed in a situation where they feel exposed.
c. Preoccupation with body size. Intense focus in this area can cause significant distress in other areas of one’s life.
d. Continuing to work out, diet, and use substances. This behavior may continue despite understanding the risks or consequences associated with it.
e. The individual's primary preoccupation is with feeling too small or inadequate. In contrast, people who live with anorexia nervosa may be primarily preoccupied with weight gain.
Do You Know Someone Who Might Have Muscle Dysmorphia?
On the surface, muscle dysmorphia may be hard to spot in individuals, especially in people who may be athletic or involved in bodybuilding. Clinicians have put together several symptoms to watch for in those who you believe may be living with the disorder. If you observe these behaviors in yourself or someone else, you may choose to encourage or pursue the use of therapy.
Additional symptoms beyond those mentioned above may include:
- An individual may either wear very tight or baggy clothing, even in hot temperatures. This can occur due to the nervousness or embarrassment that can occur if someone is required to take off their clothes.
- Ignoring a specific training regimen (such as functional fitness or strength) to prioritize and focus on muscular hypertrophy. This can be seen more with certain areas of the body—such as the "show" muscles, like the chest and biceps.
- Prioritization of training over other important aspects of life such as work, school, and social relationships. This can degrade one’s overall quality of life and have lasting effects.
- Use of anabolic steroids and other supplementation that may be considered unhealthy. This can include supplements such as ones designed for quick fat loss.
- Excessive use of mirrors or similar objects to judge or criticize one's physique. The individual may also seek reassurance by asking others to comment and approve of their physique.
Even if one is not regularly in the weight-room with someone who may be experiencing symptoms of this condition it is possible to be able to see some muscle dysmorphia symptoms in other settings—including home and school.
Identifying the signs of the condition can be a helpful first step in helping individuals who are currently living with the condition experience a higher quality of life.
Why Is Muscle Dysmorphia Is Considered An Eating Disorder?
In the DSM-5 of the American Psychiatric Association, muscle dysmorphia’s parent disorder—body dysmorphia—is generally classified as an obsessive-compulsive disorder. However, many experts believe that it may be more nuanced than this singular category definition, holding the belief that it should be examined from different angles to validate the experiences of as many people as possible.
In the DSM-5, for example, anorexia nervosa is generally classified as an eating disorder. Throughout its history, muscle dysmorphia has been compared to and contrasted with anorexia. To understand this possible connection to the fullest extent, it can be helpful to review the process of weight and muscle gain and loss. We’ve summarized this below.
To build muscle, one typically needs to be in a caloric surplus—which can occur when you consume more calories than your body burns in one day. Surplus calories and macro-nutrients can then be reserved for the purpose of rebuilding muscle that has been broken down, possibly allowing them to grow. If one does not work out, the excess calories will typically be stored as fat.
Conversely, to lose weight or achieve leanness, an individual may need to do the opposite and go into a caloric deficit. Doing so can result in weight loss as fewer calories are consumed.
Someone who lives with muscle dysmorphia symptoms might begin to experience difficulty in finding their perfect balance of muscularity and leanness—which can result in feelings of inadequacy. As a result, they may turn to unhealthy dieting habits to achieve a certain appearance or level of comfort. With this in mind, it can be helpful to acknowledge:
What Supportive Strategies Are Available?
For many, one of the most powerful first steps can be the recognition and acknowledgement of dysmorphia and its effects in one’s life. After, many may seek different forms of treatment or risk mitigation, such as:
- Online counseling
- Body check avoidance
- Accountability partners
- Peer support groups
- Dietary or activity support methods
How Can Online Therapy Support Those Who Live With This Condition?
Online therapy can support those who live with this condition in openly discussing their feelings regarding body-image, self-esteem and how it impacts their life. This can be a helpful first step for many, facing feelings that they may have attempted to otherwise disregard in the progression of the condition. Online therapy can be an ideal setting for this, as in-person intervention may not foster the same environmental level of openness or vulnerability as efficiently as online therapy settings can. BetterHelp can connect you with an online therapist in your area of need.
Is Online Therapy Effective?
One form of psychotherapy, known as online cognitive-behavioral therapy (CBT) can provide relief from muscle dysmorphia symptoms using cognitive-restructuring techniques and ritual prevention exercises—possibly helping a person focus holistically on their entire self as opposed to excessively focusing on details or minor flaws.
If you or someone you love might be living with the effects of muscle dysmorphia, reaching out for professional help can be a helpful step. Professional online therapy services are available through BetterHelp.
Is body dysmorphia OCD?
Body dysmorphic disorder (BDD), otherwise known as body dysmorphia, to many, is not generally considered the same as obsessive-compulsive disorder. While they do share some similarities in symptoms (such as rigidity around eating habits or compulsive behaviors), experts generally classify these as two separate diagnoses. The DSM-5 formally acknowledges the tie-in between the two, noting that they are related to obsessive-compulsive disorders. Despite this, many still categorize BDD as an eating disorder.
Raising awareness for both disorders can be important to enhancing the quality of life of those who live with either condition. Talk therapy, dietary support and other supportive strategies can help those living with body dysmorphic disorder, binge eating disorder, bulimia nervosa, or other eating disorders.
If you are living with eating disorders, body image disorders or undiagnosed disordered eating habits, you’re not alone. Consider reaching out to the Crisis Text Line by texting HOME to 741741.
Is muscle dysmorphia in the DSM 5?
Muscle dysmorphia is mentioned by name in the DSM-5 as it relates to eating disorders — specifically body dysmorphic disorder (or BDD). It can also accompany other forms of disordered eating, including binge eating disorder (BED). It may occur concurrently with body image concerns, or act as its own, standalone form of body dysmorphic disorder in some — possibly prompting “adonis complex” or feelings of low self-esteem about one’s muscle mass.
What are the long-term effects of muscle dysmorphia?
Muscle dysmorphia can have long-term effects over time, as can other eating disorders. Also colloquially known as reverse anorexia, these body image concerns can lead to:
- Muscle damage
- Ligament or tendon strain
- Cardiovascular variation or blood pressure concerns
- Inefficient recovery
- Symptoms related to over-reliance on performance-enhancing drugs*
*We do want to note: Not every person who experiences muscle dysmorphia will use performance-enhancing drugs. However, some may be prompted to in order to maintain their physique.
Those living with eating disorders may benefit from seeking treatment. Cognitive behavioral therapy and other supportive strategies can be helpful as one works to overcome symptoms related to the condition.
What is vigorexia?
Vigorexia is another term that is commonly colloquially used to define muscle dysmorphia.
What is reverse dysmorphia?
Eating disorders such as muscle dysmorphia may go by different names — such as reverse anorexia or vigorexia. Reverse dysmorphia is often used to describe the phenomenon that can occur when someone does not accurately see themselves, instead seeing an idealized, younger version of themself.
Regardless of what eating disorders you may be experiencing, therapy can be a helpful form of intervention and support.
Who most commonly suffers from muscle dysmorphia?
Research cited by the International OCD Foundation notes that muscle dysmorphia is statistically suggested to be predominantly experienced by those who identify as male. Additionally, data suggests that 0.5% of all men globally might meet the diagnostic criteria for muscle dysmorphia.
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