Many people focus on exercising as part of a healthy lifestyle. But for some, concerns about muscle building can become overwhelming, affecting their mental health.
Rogers Behavioral Health’s Dr. Sam Cares, PhD, LP, clinical psychologist, Eating Disorder Recovery residential care for adults, and Lauren Howard MS, LPC, eating disorder therapist, highlight five key features of muscle dysmorphia and explain who is most at risk.
What is muscle dysmorphia?
Muscle dysmorphia is a type of Body Dysmorphic Disorder (BDD) where a person is highly preoccupied with their body composition and overly focused on muscle size and appearance.
What are muscle dysmorphia symptoms?
Five key symptoms of muscle dysmorphia are:
1. A persistent belief that one doesn’t have enough muscle or is “too small”
2. A focus on achieving a high muscle mass with low body fat
3. A distorted self-perception which drives compulsive behaviors related to exercise, eating, and appearance
4. Restriction of certain foods and strict rules around eating
5. Research suggests it mostly impacts boys and men, though it can occur across the gender spectrum
It’s important to know that not everyone who focuses on muscle building or exercising is experiencing muscle dysmorphia. Enjoying strength training or working toward athletic goals isn’t inherently harmful. What matters is whether doing so negatively impacts how a person functions in everyday life.
What is the connection between muscle dysmorphia and eating disorders?
While it isn’t officially categorized as an eating disorder, muscle dysmorphia shares many of the same signs, especially in males and athletes.
For example, people with eating disorders may struggle with their body image, including concerns around weight, shape, or appearance. Muscle dysmorphia and anorexia nervosa can look very similar in some people.
Who is at risk for developing muscle dysmorphia?
People at higher risk of developing muscle dysmorphia include:
- Boys and men
- Bodybuilders
- Competitive athletes
- Social media users
What influences or causes muscle dysmorphia?
Being repeatedly exposed to idealized body types in the media is associated with increased body image distress. In the same way thinness is portrayed as beautiful and desirable, muscularity is promoted as a standard for physical appearance.
Consider Captain America, where Steve Rogers is transformed from a small, weak man into an enhanced super soldier with ripped biceps in mere minutes. Young boys read comic books or watch the film and learn from an early age that it is preferable, if not essential, to have a muscular body.
Increased body image dissatisfaction reported among males has been linked to:
- Eating disorders
- Body dysmorphia
- Steroid abuse
- Diminished quality of life
Because of the “halo effect,” we subconsciously connect physical attractiveness with other positive traits, such as intelligence. Someone struggling with muscle dysmorphia may associate muscularity with desirable traits, such as strength and courage.
Male body ideals are often tied to traditional ideas of men as protectors, warriors, workers, or athletes. The drive for muscularity is sometimes also linked to a desire for respect, virility, power/intimidation, and strength.
What are signs a person is struggling with muscle dysmorphia?
Individuals experiencing muscle dysmorphia may:
- Spend excessive amounts of time looking at themselves in the mirror
- Compare their physique to individuals with the desired body type
- Take muscle-building supplements or steroids excessively that exceeds recommendations
- Engage in restrictive eating
- Exercise excessively
- Hyperfocus on eating
How does muscle dysmorphia affect a person’s mental and physical health?
Muscle dysmorphia can affect daily life in different ways depending on the severity of the symptoms. It can look like avoiding social situations to being unable to leave the house.
Disordered eating aimed at gaining muscle can contribute to malnutrition, which can lead to other serious health complications. Use of anabolic steroids and similar drugs carry additional risks to physical health. Excessive exercise, especially weight training while undernourished, can increase the risk of injury.
How can loved ones offer support?
It’s important to compassionately share your observations and concerns. Provide empathy, recognize the pressures they’re likely facing to achieve an idealized body type, and listen closely to how it’s impacting their life.
Suggest seeking support from a multidisciplinary team to address the mental and physical aspects of this disorder. Ideally, this would involve working with a therapist trained in cognitive behavioral therapy (CBT), a medical provider, and a registered dietitian with expertise in eating disorders.
How can parents support positive body image at home for their teens?
Men are often not included in conversations around eating disorders and unrealistic expectations for physical appearance. For this reason, they’re less likely to seek mental health support or consider getting evaluated for an eating disorder.
Parents who notice any of the warning signs for muscle dysmorphia should approach their child with compassion and consistency. They should try and eliminate the stigma rooted in an outdated belief that men don’t need therapy. When confronted with their behaviors before they’ve acknowledged a problem, it’s common to see defensiveness. Parents should have open conversations early on about the pressures people across the gender spectrum face regarding weight and physical attractiveness, encouraging them to talk openly about insecurities and seek professional mental health support if their daily life has become derailed by body dysmorphia.
Men who struggle with muscle dysmorphia often excuse their rigid patterns because they can resemble something positive on the outside, such as going to the gym regularly to stay in shape, which is generally considered a healthy habit. Well-intentioned parents may even encourage these behaviors initially or even compliment the physical changes. We must be cautious not to reinforce that their personal worth is tied to their degree of muscularity.
Mental health treatment and muscle dysmorphia
Mental health treatment for muscle dysmorphia often involves cognitive behavioral therapy (CBT) to address distorted beliefs about body size, muscularity, and values. An important goal is reducing behaviors such as mirror checking, rigid exercise routines, and restrictive or rule-driven eating patterns. Collaborating with medical providers and registered dietitians is important to support physical health and recovery from nutritional deficiencies or supplement misuse.
The ultimate goal is to increase flexibility in how a person thinks about food, movement, and their body, while also increasing engagement in activities that align with their values. Rather than taking away meaningful activities like exercise, the goal is to help someone find balance and a sense of identity that extends beyond body composition.
Rogers provides mental health treatment
If you or someone you love is struggling with their mental health, we’re here to help. We’ve been providing effective and compassionate care for more than a century. We’ll be here when you’re ready.
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Muscle dysmorphia is a body image condition where someone is overly focused on not being muscular enough, even if they already have a muscular build.
Common signs include frequent mirror checking, comparing their body to others, strict eating habits, excessive exercise, and heavy use of supplements or steroids.
Fitness goals become a concern when they start to interfere with daily life, cause distress, or lead to rigid routines around food and exercise.
It can lead to anxiety, isolation, and avoidance of social situations, as well as physical risks like injury, malnutrition, or complications from steroid use.
Treatment often includes therapy such as cognitive behavioral therapy (CBT), along with support from medical providers and dietitians to address both mental and physical health.
