Understanding Muscle Dysmorphia
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Anabolic steroids and some supplements can cause serious heart, liver, hormonal, and mood effects. Speak with a doctor about any use, and seek urgent care for chest pain or severe symptoms. If body image distress has led to thoughts of suicide, call or text 9-8-8 at any time, or call 911 in an emergency.
Muscle dysmorphia is a form of body dysmorphic disorder in which a person is preoccupied with the belief that their body is too small, too thin, or not muscular enough, even when they are muscular or of average build. It is sometimes informally called bigorexia. People with muscle dysmorphia may spend hours exercising, follow rigid diets, and constantly check their appearance. The condition is more commonly reported in men and among people involved in bodybuilding or weight training, but anyone can be affected. Muscle dysmorphia can cause significant distress and health risks, and it responds to treatment.
What Muscle Dysmorphia Looks Like
- Persistent belief that your body is too small or not muscular enough.
- Spending many hours at the gym, and feeling intense distress when a workout is missed.
- Training through injury or illness.
- Strict diets, high-protein eating, and rigid meal timing.
- Frequently checking mirrors or measuring body size.
- Covering up with baggy clothing, or avoiding situations where your body is seen.
- Disliking how you look in photos, despite others' reassurance.
- Using anabolic steroids or supplements to build muscle.
- Skipping social events, work, or time with family to train or keep to the diet.
Why It Happens
Muscle dysmorphia develops from a mix of biological, psychological, and social factors. Like other forms of body dysmorphic disorder, it involves differences in how the brain processes visual information about one's own body, with a tendency to focus on small details. Perfectionism, low self-esteem, anxiety, and a history of teasing or bullying about size or strength are common risk factors. Cultural ideals linking muscularity with strength, attractiveness, and worth, often reinforced by fitness media and social media, add pressure.
The condition often starts with a genuine interest in fitness, which gradually becomes rigid and compulsive. Exercise and diet can become ways of managing anxiety or a sense of inadequacy. Because muscle-building is widely admired, the problem can go unrecognized by others and by the person themselves for a long time.
Muscle dysmorphia often overlaps with disordered eating. Rigid eating plans, cycles of bulking and cutting, and distress about deviating from the diet share features with eating disorders. Some people also experience depression, social anxiety, or obsessive-compulsive symptoms. Attention to these related concerns is an important part of care.
What It Is Not
- Not simply dedication to fitness. The difference lies in distress, rigidity, and harm to health and life.
- Not vanity. It is a recognized mental health condition driven by distorted body perception and anxiety.
- Not limited to bodybuilders. People with any level of fitness can experience it.
- Not fixed by building more muscle. Changes in size rarely relieve the preoccupation.
How It Is Assessed and Treated
A clinician will ask about body image, exercise, eating, checking, substance use, and how the preoccupation affects life. A physician may assess physical health, especially if steroids or supplements are used. Cognitive behavioural therapy adapted for body dysmorphic disorder is the most studied treatment. It helps people challenge distorted beliefs, reduce checking and comparing, and gradually face avoided situations. Exposure and response prevention may target compulsive behaviours. Support from a dietitian can help restore flexible eating. Medications used for body dysmorphic disorder may help some people. Treatment often addresses self-worth beyond appearance.
Getting Support at Pacific Maple Psych Centre
If feeling too small or not muscular enough is driving your life, therapy can help you loosen the grip of body image worries and build a more balanced relationship with exercise and food.
Pacific Maple Psych Centre offers individual therapy for body image concerns, including muscle dysmorphia, in Vancouver and virtually across British Columbia.
Book a SessionCommon Questions About Muscle Dysmorphia
Can someone who is already muscular still feel too small?
Yes. Muscle dysmorphia is a form of body dysmorphic disorder involving a preoccupation with being too small or not muscular enough.
Is muscle dysmorphia the same as bigorexia?
Bigorexia is an informal name for muscle dysmorphia.
Who is most affected by muscle dysmorphia?
It is more commonly reported in men and people involved in weight training, but anyone can be affected.
How can I tell whether my gym routine has become unhealthy?
Warning signs include training through injury, distress when missing workouts, rigid diets, and skipping social or work commitments to train.
Can muscle dysmorphia lead to steroid use?
Yes. Some people use anabolic steroids or supplements, which carry serious health risks.
Is muscle dysmorphia an eating disorder?
It is classified as a form of body dysmorphic disorder, but it often overlaps with disordered eating.
Why do I still feel small even though people say I look muscular?
Muscle dysmorphia involves distorted body perception, so reassurance and physical changes often do not relieve the belief.
How does social media affect muscle dysmorphia?
Fitness content and comparison can reinforce unrealistic ideals and intensify preoccupation with size.
What treatment helps muscle dysmorphia?
Cognitive behavioural therapy for body dysmorphic disorder, exposure and response prevention, dietitian support, and sometimes medication help.
How can I support a friend with muscle dysmorphia?
Avoid commenting on their body, express concern about wellbeing rather than appearance, and encourage professional help.