Definition of bigorexia
When asking, "What is bigorexia?" it can be challenging to find the answer since there is no official definition of bigorexia. The condition is a type of muscle dysmorphia.
Muscle dysmorphia is still a relatively new medical classification involving a fixation with gaining muscle or achieving a muscular body shape. It manifests as countless hours at the gym or money spent on supplements to build bigger muscles. Disordered eating patterns or substance abuse—including the use of steroids—can also occur, especially in more serious cases.8
However, behavior represents only the visible symptoms of a disorder. In the case of bigorexia, the workouts and other related activities stem from a preoccupation with body weight, shape, and size—much like with anorexia nervosa, bulimia nervosa, and other eating disorders.8
Someone with bigorexia may view themselves as small or weak despite their actual body composition, and they'll take bodybuilding to an unhealthy extreme in their pursuit of the "perfect" form.
Bigorexia, muscle dysmorphia, and body dysmorphic disorder
The definition of bigorexia may be tied to muscle dysmorphia, but muscle dysmorphia is itself a form of another condition called body dysmorphic disorder (BDD).
Unlike bigorexia or muscle dysmorphia, BDD is outlined in detail in the Diagnostic and Statistical Manual of Mental Disorders (DSM), specifically involving:7
- A preoccupation with one (more more) perceived flaws in physical appearance
- Repetitive behaviors or mental acts made in response to these perceptions
- Clinically significant distress or impairment related to these perceptions
Body dysmorphic disorder is technically considered an obsessive-compulsive disorder.7 That means it's driven by obsessions—unwanted or unpleasant thoughts that repeatedly occur—and compulsions—repetitive behaviors or mental acts done to help alleviate the discomfort of obsessions.9
This is also true of people with bigorexia, meaning they experience obsessive, unpleasant thoughts about their body and feel compelled to work out to alleviate these thoughts.
Bigorexia causes and risk factors
Bigorexia is still a newly understood medical condition. While there’s a growing awareness of and concern around the behavior, research on the subject is still needed, including examinations on what causes bigorexia. Several risk factors seem likely, however.
Studies have found people with muscle dysmorphia are more likely to have a concurrent or past psychiatric diagnosis and have attempted suicide. They’re also more likely to have had or observed a traumatic event in their past, such as a sexual assault or domestic violence, or been a victim of bullying for perceived shortcomings, such as being small, weak, non-athletic, or not smart.2
Cultural expectations about masculinity and wanting to conform to those constructs are also key factors. In one study, participants reported being influenced or pressured by fathers, siblings, sports coaches, peers, and romantic partners.2
Other reports have shown that males—particularly male athletes—are more susceptible to developing the condition. While bigorexia in females also happens, current data shows the highest risk is for men who participate in sports that stress size and strength, such as football, wrestling, and competitive bodybuilding—much like the connection with bodybuilding and eating disorders.8
Signs of bigorexia
In a society that glamorizes the kind of lean, muscular bodies people with bigorexia fixate on building, it can be challenging to spot the condition. The line between a gym enthusiast and someone struggling with muscle dysmorphia can be thin and blurry.
But these are some signs that someone's workout routine may be a sign of a deeper problem:8,10
- Constant desire to have bigger muscles or be leaner
- Obsessive rumination on, examination of, and critique of muscles
- Compulsive working out for several hours
- Anger, agitation, poor self-esteem, and frustration when a workout session is missed
- Anger, agitation, poor self-esteem, and frustration when a strict diet is not followed
- Distorted perception of body size as small, even though muscle mass is increasing
- Negative body image and extreme self-consciousness
- Excessive desire to eat “healthy” foods and large amounts of protein
- Serious disruption of daily life–frequently skipping social activities or missing work or school because of diet requirements or workout schedule
- Working out despite an injury
- Use of steroids, protein powders, or supplements to gain muscle mass
What this may all look like is someone who spends hours in the gym every day, going as far as disrupting their work, school, or social obligations to have enough time to work out. They also may avoid social or public situations because they feel ashamed of their bodies.
Someone may also fixate on diet, obsessing over macronutrients and other dietary information, using abnormal eating patterns to “bulk up," or becoming upset when their eating regimen is interrupted.
Possible health risks of bigorexia
Unfortunately, bigorexia and the behaviors it encourages can have several negative impacts on the body and mind.
Excessive exercising robs the body of a chance to rest and recharge, leading to extreme fatigue, damaged muscle tissue, and a higher risk of injury or broken bones.3,4
Numerous other health concerns may be in play for those who use supplements, depending on the type of supplement they choose and how they use it. For example, bodybuilders are known to take supplements, including chromium and vanadium. Still, excess vanadium has been related to kidney and liver damage and the development of diabetes, among other concerns.5,6
People who have bigorexia also frequently struggle with co-occurring mental health conditions, including anxiety, depression, obsessive-compulsive tendencies, disordered eating, and substance use.8 These can manifest as effects of the thoughts and behaviors involved in bigorexia or work to drive and maintain these thoughts and actions.
Treatment for bigorexia
Like any other eating disorder, bigorexia can be potentially dangerous if left untreated. Seeking appropriate care is crucial for recognizing and safely working through these thoughts and behaviors.
A common treatment for eating disorders and related body image disorders is cognitive behavioral therapy (CBT). This method helps patients see how their thoughts and behavior patterns may be harmful and works to teach them different life and coping skills.
How we see our body is much deeper than aesthetics. It's how we generate meaning, organize our life experiences, and shape our social identity.6
When these deeper issues are addressed, it can help someone create a more positive relationship with their body and independently seek greater balance, health, and joy in their lives.
