By: Matthew Greenacre


When one thinks about eating and body image disorders, the picture of a muscle bound behemoth benching twice his weight is one that rarely springs to mind. Rather, extensive public health campaigns focussing on anorexia and bulimia have planted the image of a skeletal teenage girl in the public consciousness to exhibit the gravity of a previously ignored and very real disease. This image isn’t untrue – despite the fact people of both sexes, of any age can be sufferers – the majority of cases of anorexia and bulimia occur in young women. Thus, for many people it may be difficult to consider the antithetical case of a young man with an uncontrollable desire to gain muscle mass as a similar type of disease.

Muscle dysmorphia is the term given to individuals who have intense anxiety about their physique, driving them to undergo strict dieting, obsessive weight lifting and exercise regimes. However, a person striving to sculpt not just a six or eight but a ten pack does not necessarily have dysmorphia. Like many psychological disorders, it can only be defined as a disease when it disrupts a person’s life or is a source of unhappiness. For example, if a person’s concern about his or her muscularity is extreme, negative, or interferes with his or her social or professional life, there may be an issue. It is not just a question of whether one takes steroids or lives in the gym. Regardless of how much muscle persons with dysmorphia develop, or fat they trim off, they remain self conscious and unhappy with their appearance.

The criteria that are used to diagnose muscle dysmorphia can be found in a brief questionnaire called the Muscle Dysmorphia Disorder Inventory, and the similarity to anorexia is undeniable. Unsurprisingly, muscle dysmorphia affects men more than women. It closely mirrors anorexia in that it is more prevalent among a specific gender in a defined age range. There is a genetic component to muscle dysmorphia, and it usually begins in mid to late adolescence. Also, both disorders manifest with the same extremely rigid routines of diet and/or exercise, and overbearing shame and guilt if this regimen is broken.

For those of us who were not lucky enough to be handed a six-pack along with acne and social awkwardness, worrying about one’s physique is a normal part of male adolescence and young adulthood. But why does the mild nagging sense of insecurity that many of us feel turn into an obsessive addiction to the gym for some? Just as glossy images of pencil thin models and photoshopped actresses have been blamed for anorexia, cultural values and popular media play a role in propagating muscle dysmorphia by fuelling the inadequacy that one study claims 95% of young men feel.

Aspirational advertising for men has been used long before the Bowflex infomercials placed an unused hunk of metal in everyone’s garage. From the 1920s onwards, the Italian bodybuilder Charles Atlas made a fortune selling the Dynamic Tension muscle-building program to millions of people. Part of his advertising was the story of how he turned himself from a “97 pound weakling” into a “muscleman” after having sand kicked in his face by a bigger, stronger boy. This almost laughably cliché story is actually reminiscent of case studies of muscle dysmorphia in which an incident, such as an offhand comment about a person’s appearance heightens his or her insecurity, triggering an obsessive anxiety about their body image. The sheer success of this industry suggests that it takes little more than a bodybuilder with a shake-weight to trigger men’s anxiety about the state of their biceps.

For the majority of people this anxiety is kept in perspective and does not govern our lives or prevent us from spending time with friends, as is the case for some. Though this disorder is only just being recognized and few people have been treated, case studies of patients that have received counselling and cognitive behavioural therapy show that these measures can be effective and eliminate sufferers’ misconceptions about their body. For some such men, it might be helpful to keep in mind a study that showed that women do not prefer broad shouldered, body builder body types any more than slim and slight male bodies.



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