Bigorexia
Many people have heard of "anorexia nervosa", a condition mostly affecting young girls that alters the perception they have of their bodies. They will feel they are too fat, even when their body weight is already life threatening low.
What less people have heard of is "bigorexia", also called "vigorexia", "muscle dysmorphia" or "Adonis Complex". Sometimes referred to as the opposite of anorexia nervosa, it is an illness that predominantly affects men: They feel they are too small, no matter how muscular they already are.
But, contrary to anorexia nervosa, bigorexia often has a problem being recognized as an illness. "What's wrong with wanting to get bigger?" some people say. Well, when you are never satisfied with your body, it WILL become a problem, because you will NEVER feel you are big enough. And this leads to frustration, social isolation and ultimately to damage to your body. Frustration because you will always feel inadequate; social isolation because you will be obsessed with working out and, in severe cases, avoid displaying your "tiny" body in public; damage to your body because it is very likely that you will work out too hard and try illegal and possibly dangerous drugs in order to get bigger.
How can you tell that you suffer from bigorexia?
- You check yourself in the mirror ten or more times a day
- You frequently skip meeting with friends or other social events to not interrupt your workout schedule
- You are obsessed with controlling the amount of food you eat and what it consists of
- You use steroids or keep using them even if you already suffer from their side effects (gynecomastia, aggression, acne etc.)
- You avoid going to the beach or other places where you wear little clothing, because you are ashamed of your body
- You avoid having sex, out of fear it will drain energy necessary for your workouts
- You think people that tell you you are quite muscular and big are lying to you or don't understand you
- You chastisize yourself for not working out hard enough
If you find yourself saying "yes" to four or more of these points, you may have bigorexia.
Where does it come from?
The symptoms were first recognized in a 1993 study, but it took until 1997 that the actual term "muscle dysmorphia" was coined. Since then it has been classified as belonging to a group of illnesses called "Body Dysmorphic Disorder" (BDD) that in the International Classification of Diseases (ICD-10) can be found under F45.2: "Patients manifest persistent somatic complaints or a persistent preoccupation with their physical appearance".
The recognition as an illness came quite late, most likely because until the last couple of decades it was mainly women who were concerned with their physical appearance, while for men looks were much less important. These days men experience much the same pressure as women, as now they too are the target of advertisements and commercials that focus on their look.
This play on one of the core ingredients of BDD: low self-esteem. Those who suffer from a low self-esteem may get obsessed with a defect they perceive about themselves and feel that if just that defect was cured, they would feel well. But they won't, because they never get to the true core of the problem. Women with a BDD will often get plastic surgery after plastic surgery, because once one defect is cured they will almost immediately detect another one. People with BDD are also highly likely to suffer or have suffered from mood, anxiety and eating disorders.
What to do about it
The first course of action is taking a deep, hard look at yourself and admitting something is going wrong. If you can't acknowledge the fact there won't be anyone in the world able to help you. If your family, friends and peers already tried to convince you about having a problem, then this might be a good time to stop and think about it, instead of brushing their concerns aside.
Once you are willing to find help, you should seek out a psychiatrist, psychologist or mental health counselor and describe your feelings and behavior and how much distress they cause for you. Even professionals sometimes have problems recognizing bigorexia, because the muscular and healthy looking facade hides the turmoil and stress going on inside that body.
Treatment usually consists of a cognitive behavioral therapy where you learn how to respect your body and yourself. This can also be aided by medications that decrease the obsessive-compulsive behavior.
Resources
Muscle Dysmorphia in Weightlifters - A study by Roberto Olivardia et al.
The Adonis Complex - Book by Harvard psychiatry professor Harrison G. Pope, Jr. et al.
Bigorexia Documentary - A YouTube video about the subject
References
Pope, H., Katz, D & Hudson, J. (1993). Anorexia nervosa and "reverse anorexia" among 108 bodybuilders. Journal of Comprehensive Psychiatry, 34,406-409.
Pope, H.G., Gruber, A.J & Choi, P. (1997). Muscle Dysmorphia: an underrecognised form of body dysmorphic disorder. Journal of Psychosomatics, 38 (6): 548-557.
Olivardia, R., Pope, H.G, Hudson J.I. (2000). Muscle dysmorphia in male weight lifters: a case control study. American Journal of Psychiatry, 157(8): 1291-6.
Leone, J., Sedory, E., Gray, K. (2005). Recognition and Treatment of Muscle Dysmorphia and Related Body Image Disorders. Journal of Athletic Training, 40 (4): 352–359.