What is bigorexia?

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Bigorexia is another term for muscle dysmorphia, which is a mental health disorder that involves a fixation on building muscle mass. Lifting weights is a form of physical activity that can be good for the body and many people enjoy. But someone who has bigorexia views themselves as small or weak and takes lifting weights to an extreme, often to the point of physical injury and even self-harm. (1)

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What is bigorexia?

Bigorexia, or muscle dysmorphia, is a type of body dysmorphia, which is a body image condition characterized by an intense preoccupation with real or perceived flaws in appearance–in this case, muscles. This causes the individual immense distress and drives them to take extreme measures to change their appearance. (1) 

The disorder tends to occur in men more frequently, particularly bodybuilders and athletes, but also occurs in women. To gain muscle mass, they spend hours in the gym, often disrupting their work, school, or social obligations. They also may avoid social or public situations, because they feel ashamed of their bodies. They spend a lot of money on sports and food supplements and develop abnormal eating patterns in an attempt to “bulk up.” 

The quest for bigger muscles usually entails a strict food regimen that can include consuming an excessive amount of protein in the form of food, energy drinks and bars, protein powders, and supplements–far more than the body needs. 

People who have bigorexia often struggle with other conditions that tend to occur with it. These can include anxiety, depression, obsessive-compulsive tendencies, disordered eating, and substance use. Because of this, there are differing opinions among healthcare professionals about how bigorexia should be classified, as an eating disorder, as obsessive-compulsive disorder, or even as an addiction.

What causes bigorexia? 

At this time, there’s a growing awareness of and concern about bigorexia but uncertainty over the actual causes. 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. Participants reported being influenced or pressured by fathers, siblings, sports coaches, peers, and romantic partners. (2)

Signs of bigorexia

Here are some signs of bigorexia:

  • Constant desire to have bigger muscles or be leaner
  • Obsessive rumination on, examination of, and critique about muscles
  • Compulsive working out for several hours
  • Anger, agitation, poor self-esteem, and frustration when a work out 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

Effects of bigorexia

Bigorexia can have a big impact on the body and mind. Excessive exercising can cause extreme fatigue, damage muscle tissue, and weaken or break bones, because the body isn’t able to rest and recharge. (3,4) Serious effects may also result from taking supplements that cause imbalances in the body. For example, bodybuilders are known to take supplements of chromium with vanadium. For someone with low levels of these two minerals, the supplements may do some good. If the dose of vanadium in the supplement is too high, though, then kidney and liver damage and even diabetes can occur. (5,6)

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Treatment for bigorexia

Enjoying how you look and feeling secure about your body is something you can learn with help. However, many men with bigorexia believe they’re fine and don’t realize they need any help. Since bigorexia can lead to some serious health complications, such as joint and muscle damage, kidney damage, liver disease, diabetes, and heart problems, treatment is recommended. 

Treatment for bigorexia and muscle dysmorphia often consists of cognitive behavioral therapy (CBT), which has been found to be effective for changing distorted body image thoughts. This type of therapy helps patients see that some of their beliefs can cause themselves harm. CBT also teaches them different life and coping skills. 

How we see our body is a way we generate meaning, organize our life experience, and shape our social identity. (6) Often, how a person sees their body is based on experiences earlier in life that caused them physical and psychological harm, resulting in shame, embarrassment, and insecurity. When these deeper issues are addressed, a more positive relationship with their body results and harmful behavior patterns tend to stop.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Mosley, P. Bigorexia: bodybuilding and muscle dysmorphia. European Eating Disorders Review. 2009 May;17(3):191-8. https://pubmed.ncbi.nlm.nih.gov/18759381/
  2. Tod, D., Edwards, C., Cranswick, I. Muscle dysmorphia: current insights. Psychol Res Behav Manag. 2016;9:179-188. Published 2016 Aug 3. doi:10.2147/PRBM.S97404 Hussain Shah, S.Z., Rashid, A., Naveed, A.K., Khan, S.A., Jahan, S. Genotoxic and cytotoxic effects of oral vanadyl sulfate. Journal of Ayub Medical College Abbottabad. Oct-Dec 2019;31(4):522-526. https://pubmed.ncbi.nlm.nih.gov/31933303/
  3. Srivastava, A.K. Anti-diabetic and toxic effects of vanadium compounds. Molecular and Cellular Biochemistry. 2000 Mar; 206(1-2: 177-82. https://pubmed.ncbi.nlm.nih.gov/10839208/
  4. Domingo, J.L. Vanadium and tungsten derivatives as antidiabetic agents: a review of their toxic effects. Biological Trace Element Research. 2002 Aug;88(2):97-112. https://pubmed.ncbi.nlm.nih.gov/12296430/ 
  5. Urban, U., Antonowicz-Juchniewicz, J., Andrzejak, R. Vanadium: threat and hope. Journal of Trace Elements in Medicine and Biology. 2001;52(2):125-33. https://pubmed.ncbi.nlm.nih.gov/11761661/ 
  6. Riva, G. Out of my real body: cognitive neuroscience meets eating disorders. Frontiers in Human Neuroscience. 2014 May 6; 8:236. https://pubmed.ncbi.nlm.nih.gov/24834042/

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