Muscle Dysmorphia

Muscle dysmorphia can be defined as a medical condition, in which a person considers himself/herself to be too weak and small. In reality, the people who suffer from this condition are quite the opposite, meaning large and muscular. This condition is also known as reverse anorexia nervosa, bigorexia or megarexia, being considered as part of the body dysmorphic disorders. The name of Adonis Complex is given, as the individuals are highly preoccupied with their physical appearance (especially the muscles).The attention is constantly focused on the things that are perceived as defects, such as being too skinny or not having enough muscle mass. These individuals often choose an ideal that has to be reached and they are highly vigilant when it comes to even the smallest deviation from the set objectives. From another point of view, muscle dysmorphia is considered as part of the obsessive compulsive disorders. This condition is encountered more often in men than in women, reflecting the unreachable standards that modern society is trying to impose when it comes to the ideal of masculinity.

Who is at risk of Muscle dysmorphia?

These are the persons who are at risk for muscle dysmorphia:

• Men (in comparison to women), especially those who are over 19
• Body builders (approximately 10%)
• Athletes
• Weightlifters
• People who frequently visit gyms
• People who work in an environment where the emphasis is placed on the physical appearance (models, actors, bodybuilders etc.)
• Those who practice a sport that requires a high level of fitness (constant pressure to stay lean and develop muscle mass)
• Having a history of unresolved childhood conflicts, being bullied or teased
• Those who have suffered from trauma or abuse in the past (for example, those who have suffered from domestic violence)

Symptoms

These are the symptoms of muscle dysmorphia:

• Excessive preoccupation about one’s physical appearance (constant thoughts that one does not have enough muscles)
• Extreme physical activity – prolonged hours of weightlifting, intense exercises
• Excessive preoccupation in relation to the diet – obsessions with healthy food, constantly seeking protein sources
• The chosen workout and diet schedule interfere with the personal and professional life
• Even if injured, the person continues to work out just as intensively as before
• Excessive analysis of the physical appearance in the mirror (constantly finding defects); other people abstain themselves from looking in the mirror, as they are severely displeased with their physical appearance
• In the situation that one misses a workout, feelings of anxiety and depression might appear
• Food supplements might be used excessively
• Constant belief that one will never be muscular enough
• Feeling disgusted or disappointed with one’s physical appearance (vicious circle, as this leads to reduced self-esteem, which leads to similar feelings)
• Wearing clothes that are bigger in size, so as to hide the actual size of one’s body
• Taking steroids or other body building products in excessive quantities
• Avoid going to the beach or the pool – these are situations in which the person feels exposed (does not want others to see the way he/she looks without clothes or just in the bathing suit)

Causes

These are the causes that may lead to the appearance of muscle dysmorphia:

• Problems in the family (lack of harmony)
• Desire to be perfect (going as far as becoming an obsession – perfectionism)
• Intense stress or anxiety
• Constantly focusing on the physical appearance and comparing to others
• Negative influence of the societal stereotypes (ideal of masculinity)
• Negative appraisal of the internal body image – this is reflected through a negative opinion about the external physical appearance
• Unresolved conflicts from childhood (sexual, emotional, feelings of guilt, reduced self-esteem)
• Difficulties expressing one’s emotions
• Imbalance in the neurotransmitters of the brain (serotonin)
• Having been bullied or teased as a child

Diagnosis

These are the most common measures used for the diagnosis of muscle dysmorphia:

• Examination of the patient
• Identification of the symptoms outlined in the DSM (Diagnostic and Statistical Manual) for the body dysmorphic disorders
• History of the patient
• Identification of family members who may have suffered from similar problems or other disorders (depression, anxiety disorder)
• Childhood conflicts or bad experiences as a child – by identifying those, one is a step closer to confirming the diagnosis of muscle dysmorphia

Treatment

These are the most common treatment approaches recommended for muscle dysmorphia:

• Medication (pharmacotherapy)
• Behavioral therapy
• Cognitive therapy
• Psychological counselling

Regardless of the chosen method of treatment, the patient has to be guided and return to normal eating patterns. It is also important to bring the patient back to normal workout programs. The psychological counselling is essential, so one is able to address obsessional thoughts and unresolved conflicts from childhood. As many of the patients with muscle dysmorphia abuse steroids, these matters should be resolved as well. Cognitive-behavioral therapy can help with the substance abuse, reducing the addiction step-by-step.The psychologist can also provide the person with coping methods, helping with the improvement of the self-esteem. Adequate behaviors can also be learned – the person is taught to handle the daily stress in a more efficient manner. By learning how to deal with potential stressors, one can improve his/her self-esteem, overcoming the muscle dysmorphia and preventing eventual relapses.In conclusion, this is one serious condition and it should be treated as such. Unfortunately, this condition is very hard to diagnose, given the fact that most people who have such complexes do not seek out help. Instead, they have the tendency to shut out the rest of the world, avoiding social situations in which they are likely to feel exposed. Pressed by the ideals established by today’s society, they end up depressed, hating their bodies and diving even further into the problem. Excessive workouts, combined with the wrong diet, can have serious consequences on one’s health.The family and the friends are the only ones who can recognize the signs of the problem and suggest an intervention before it is too late. One has to be forced into starting the psychological counselling and seeking out help. Recognizing the signs of the problem is half of the equation; the constant visits to the psychologists are going to improve one’s self-esteem, reducing the risks for relapses.