Muscle Dysmorphia: The Signs You Need to Know - Men's Health Magazine Australia

Muscle Dysmorphia: The Signs You Need to Know

It’s a syndrome affecting more and more of us, so it’s time to get acquainted with the facts.
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“Ahh no way bro, I’m tiny. Best be getting some tips off you big man!” As I walked past some fellow gymgoers, (bee-lining toward that last free bench) I’d overheard this statement, and it made me wonder. Throw away line gym buddies say to each other approximately 1.35 million times a day? Probably. Humble deflection of a compliment from fellow seeker of swole? Possibly. A dangerous core belief underpinning a mental health syndrome rapidly on the rise? Just maybe. 

Because truth be told the guy was anything even close to tiny, and he probably didn’t need any tips on working out either. Muscle Dysmorphia (deemed ‘The Adonis Complex’ or ‘Bigorexia’) is one that’s on the rise. So in this week’s MH Mind Matters we tackle what it is and how to pick up on the signs it’s there.

Muscle Dysmorphia, what is it?

Muscle Dysmorphia (technically, ‘Body Dysmorphic Disorder with Muscle Dysmorphia’) represents one of our newest mental illnesses. Within it, perceptions of how the body looks or feels start to become obsessional, distressing and out of touch. Whereas traditional Body Dysmorphia commonly centres on a feature like the nose or hair, Muscle Dysmorphia (MD) holds intense fears around muscle size, symmetry or leanness at its core. Overall estimates point to 1-2% of the population being affected, but rates are much higher for men and (particularly) those in bodybuilding, fitness modelling or certain sports. 

The Signs 

It’s incredibly common to have doubts or concerns about our bodies. For men in modern society, research shows those concerns increasingly involve how we stack up muscle wise. 

In MD, the body is seen as never big, lean or symmetrical enough, with this becoming a constant anxiety and behavioural drive. The points below in and of themselves don’t necessarily mean a mental illness (that’s important to say) but the ‘why’ behind them are the key. So, what exactly might someone with MD be dealing with each day? 

Someone suffering from it might find themselves: 

Constantly worrying about their size, shape, leanness or build. These thoughts are likely hard to control and drive a sense of disgust and anxiety when they’re there. There’s an overarching sense of deep distress and fear.

Negatively assessing how they stack up compared to others or rigid standards. MD hinges off a distorted belief in being smaller or not lean enough compared to how the body actually is in reality. 

Compulsively checking how lean, aesthetic or built they are compared to others. Anxious checking in mirrors, with measurements and weigh ins can be part of things, as can seeking constant reassurance.

Hiding their body from view due to high anxiety and shame. Those with MD often avoid getting their kit off around others or wearing gym gear that puts their body in view. 

Rigidly tracking workout routines, macro counts and food groups as a means of quelling intense anxiety about losing muscle, gaining fat or slowing gains.

Missing out on and losing drive for other important areas in life like work, family or social time if it gets in the way of gains (often feeling conflicted and guilty about it too). 

Risking health for more muscle or greater leanness like working on through significant injury, using performance enhancing drugs unsafely or utilising risky diets.

Wanting to change but not knowing how. Those with MD often feel a sense of ‘love/hate’ for the gym and their body. Rather than being a means of enjoyment and growth there’s a sense of anxiety or shame without being able to stop.

So, what now? 

Worrying about our body, wanting to be a bit bigger or chasing shredsville aren’t necessarily signs of something wrong. But when fear and anxiety rule the roost and the list above becomes a checklist then it’s time to seek support.

Particularly for those noticing red flags or feeing things might be shifting off course, some take home tips to help include:

Seeking balance in a weekly plan so working out equals important areas like rest time, work and socialising. Adjust things slowly week by week and plan it in advance. 

Talking out fears and anxieties with someone we really trust. Reality checking distorted beliefs and fears in an honest open way can start the shift. 

Slowly easing control around rigid schedules, diets or checking if the underlying reason is distress. Catastrophised outcomes of missing a day or not tracking macros are often far from reality, so gently test these with a day off here and there or easing up slightly to start. 

Getting help from a professional. Support is often needed as moving out of it on your own can be a tough one. Awareness has grown a lot in recent years, so opening up to your doc and thinking about seeing a psychologist or psychiatrist is well worth while.

By Kieran Kennedy

As a medical doctor and psychiatry resident, with degrees in psychology, physiology and medicine / surgery, Dr. Kieran Kennedy sees, first hand, the absolute importance in advocating for mental health. He is also writer & speaker, natural bodybuilder and fitness model.

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