A New Type of Body Image Disorder: Muscle Dysmorphia

A new type of body image disorder is on the rise. Known as Muscle Dysmorphia (MD) or
“Bigorexia,” the disorder centers around a fear that one’s body is too small and an obsession with maximizing muscle mass. Considered a subtype of Body Dysmorphic Disorder, and also a form of obsessive-compulsive disorder (OCD), those with MD could have biceps the size of the neighborhood dog and still think they’re no more muscular than the string cheese in my fridge—and to no fault of their own. Their perception of their body doesn’t match up with reality. Normal, even well-muscled individuals look at themselves as “puny,” weak, or small. Because of the obsession with gaining lean muscle mass, those struggling may begin to engage in harmful behaviors like rigorous amounts of exercise, constant body checking, and extreme dieting.

How Does This Happen?

While there isn’t one specific cause that leads to someone having MD, there are several
experiences and situations that can play a role in its development:

• Being bullied, shamed, or teased about your body in your early life.
• Perfectionism.
• Lots of social media exposure, especially to idealized, muscular body types, body-checking content, fitness or body-building culture that leads to comparison.
• Low self-esteem.
• Heavy involvement in body-building or weight-lifting environments.
• Feelings of loneliness or being socially isolated.

How Does It Show Up?

An obsession with obtaining the “perfect” body can lead to negative, obsessive-compulsive behaviors. Those with MD often repeatedly evaluate themselves in mirrors,
scanning for perceived flaws or defects and sizing up the amount of muscle tone they have. Unfortunately, no amount of checking or working out will ever feel like it’s brought the right amount of satisfaction. Due to an inability to accurately perceive their own physical form, someone with MD could be a walking muscle and still fall short of their own standards. While body checking is common, sometimes people with MD may also avoid mirrors because they worry they’ll dislike what they see.

Preoccupation with muscularity can also turn into a fixation with exercise—evolving into
strict, excessive exercise routines that are seen as the “path” to feeling satisfied with their body. Exercising can become so central to life that other important events are skipped or put on the back burner for the sake of a solid pump. Holidays, birthdays, time with loved ones, and important milestones are thrown to the wayside or shortened. Exercise might even persist through burnout, injury, or when the body needs rest—becoming more of a compulsion than an outlet, hobby, or pastime.

In this equation, exercise’s vindictive partner in crime becomes dieting. To accompany their exercise routines, people with MD might restrict their diet and focus on eating large
amounts of protein and other foods rich in vitamins and minerals. This goes beyond having eggs for breakfast and chicken and rice for dinner. Along with dieting, some individuals take a laundry list of dietary supplements—even more than the recommended amount. In more severe cases, the desire to achieve muscle mass might result in steroid usage to enhance muscle growth at a faster rate despite the negative, permanent side effects that can come with it.

I don’t believe anyone is truly happy when they’re falling short of their own (unrealistic)
standards. So it’s no surprise that symptoms of depression and anxiety are also pretty common in people who struggle with MD. Compulsive exercising, body checking, dieting, and possible use of supplements are all seen as keys to achieving the idea of a “perfect body.” Unfortunately, no matter how many bicep curls someone does, ounces of chicken they eat, or pounds of muscle they pack on, people with MD will never reach fulfillment with what their body looks like through these behaviors. In essence, they are chasing a finish line that is constantly moving, leading to feelings of defeat, exhaustion, and helplessness.

It’s not about just being “obsessed with the gym”— it becomes more about trying to
finally feel valuable within themselves.

While the internal impact is huge, the longer someone struggles with MD, the more their external world is affected as well. Growing further immersed in diet and exercise culture, people with MD often begin to drift away from the social support they do have. Their relationships become strained, and they isolate themselves socially, believing that those around them “don’t understand” what it might take to live their kind of “lifestyle.” That feeling of being misunderstood contributes to irritability, which can cause individuals to lash out at those who care for them.

MD thrives off of insecurity and social isolation. The obsession becomes so great—the
thoughts so loud—that those struggling with the disorder are unable to realize they’re pushing those they care about away. Without proper help, they can eventually find that their only company is the disorder itself.

Modern Day Reinforcement

MD has found a sick home on Instagram Reels, TikTok feeds, and other social media platforms. The exercise scene has blown up online as kids, teens, and adults are being exposed to unrealistic body ideals, strict exercise routines, and rigid diets online. Comparison culture is more prevalent than ever, and while MD occurs across populations, teen boys are especially vulnerable. In many online spaces, those with lean or muscular builds are praised—creating an illusioned connection between physical appearance and self-worth. To feel worthy, receive praise or attention, or to be likeable, those with MD believe they have to be muscular. That muscularity often comes with praise online, only further reinforcing this concept.

How Therapy Can Help

Therapy offers a space for individuals with MD to change their idea of what self-worth
means. Cognitive Behavioral Therapy (CBT) is especially effective in treating MD. CBT teaches individuals how to identify negative thought patterns they might
have about themself and restructure them in more balanced, self-compassionate ways. Therapy doesn’t ask those with MD to break up with the weights—it supports them as they build a new, healthy outlook on what personal value looks like. Therapy helps shift the compulsive MD behaviors into more sustainable, healthy habits.

If you struggle with MD, know that you don’t have some personal defect. You don’t need to be a certain size or have a certain body fat percentage to be seen. Getting back to real life is possible, and reaching out for support is a brave first step.