Going to the gym is good for your physical health and mind. We may find it encouraging, if not
relieving, when our loved ones start going to the gym every day for a couple hours. Nevertheless,
too much of a good thing can be bad for you. Most people have probably heard of anorexia.
People with anorexia nervosa fear gaining weight and have a distorted perception of their
appearance. People with anorexia nervosa engage in compulsive exercise and unhealthy eating
habits to avoid gaining size. However, a new phenomenon, muscular dysmorphia, more
colloquially known as “Bigorexia,” is on the rise.
Muscle dysmorphia is a specifier of body dysmorphic disorder. People with body dysmorphic
disorders see themselves significantly different than how they objectively look. People with the
specifier of muscle dysmorphia see themselves as too skinny, not muscular enough, and fear
losing size. These individuals will avoid going out in public. They will not take off their shirts
because they think they look too small. They will also engage in unhealthy behaviors impacting
their physical, mental, and social health.
Muscle dysmorphia was initially noticed in the late 80s and early 90s. It was seen a lot in
bodybuilders and powerlifters. These athletes wanted to be the biggest and strongest person in
the room, and they were dying at young ages. The medical and psychological community started
to recognize that working out to an extreme might be bad for you. Bigorexia, nowadays, is not
just something that affects athletes, and it's no longer about size. Bigorexia is taking on the form
of being very cut and having the muscle striations be clearly visible and is becoming more
common in young people. Researchers think the shift in what bigorexia looks like maybe
because social media pressures young people, in particular, to look good all the time.
With the increase in social media and the recent COVID-19 pandemic, body dysmorphia has
increased dramatically. One study in Australia saw a muscular dysmorphia prevalence of 2.2% in
boys and 1.4% in girls ages 11-19. The BBC reported that as much as 10% of UK male gym
goers may have bigorexia. In the military, the prevalence rate for muscular dysmorphia has been
found to be 12.7% in men and 4.2% in women. Furthermore, a recent study found that 22% of
adolescents report engaging in unhealthy muscle-enhancing behaviors. Unhealthy muscle-
enhancing behaviors included misusing Synthol injections, misusing steroids, overworking out
by skipping work or class to go to the gym, unhealthy eating, and dehydration.
Engaging in unhealthy muscle enhancement has long-term physical health impacts. Injecting
Synthol into the muscles can cause muscle death. Steroid misuse can cause severe organ damage
that can lead to death at a very young age. Although the thought of loved ones abusing Synthol
or steroids seems unlikely. Dehydration practices impact the body and brain by adding stress on
the heart and disrupting blood flow to the brain. Dehydrating can cause a lack of focus, increase
fatigue, and one could see mood issues.
It is not just the physical health that one should be worried about when it comes to bigorexia.
People with bigorexia have shown psychosis, roid rage, and manic behavior that can damage
relationships with others. They often fear leaving their home and will spend copious amounts of
time at the gym to the point they lose their jobs or start having issues at school. Additionally,
there are often high rates of depression, anxiety, and even suicidality if they are injured and can’t
work out because they have overtrained.
Even though bigorexia is a relatively new phenomenon, more research is coming out, and
treatment options are available. Medicine like SSRIs can be helpful to get a person engaged in
the therapy process. Still, it is not a long-term solution by any means. Engaging in therapy has so
far been found to be the most effective. It is crucial to assess what the person is motivated to do.
Are they looking to reduce workouts? Stop taking steroids? Do they have an eating disorder?
Furthermore, it is essential to manage expectations. People with bigorexia can still exercise and
look great; they just need to learn balance. If looking good is important to somebody, that is
alright. Still, in addition to aesthetics, we want the priority to be a healthy body and mind.
-Max Rizer, MS