Body dysmorphia is defined as “a mental health disorder in which you can’t stop thinking about one or more perceived defects or flaws in your appearance — a flaw that appears minor or can’t be seen by others. But you may feel so embarrassed, ashamed, and anxious that you may avoid many social situations.” 
For males with Body Dysmorphia Disorder (BDD), this perceived flaw often has to do with the idea that they are not muscular enough. It may result in an obsession with getting six-pack abs, building a bigger chest, or growing their biceps. Despite believing that they are too small, men with muscle dysmorphia are often very muscular. 
Eating disorders and muscle dysmorphia share some common factors. Both include a disturbance in body size and shape, disordered eating, and excessive exercising. However, those will BDD are not necessarily concerned with bodyweight or fear of being fat. To better understand BDD, we spoke with several professionals who help clients make changes.
Joy Zelikovsky, a clinical psychologist in New Haven, Connecticut, comments that the men she works with “generally aren’t focused on losing weight… They’re often focused on going to the gym, gaining muscle, and willing to do dangerous things to make that happen.” She continues, “they tend to be focussed on the perception of the gender in which they are interested in dating.”
Yet, muscularity is only one aspect of the issue. Gina Garrett, a registered dietitian practicing in Hillsboro, Oregon, observes that men “middle-age to senior-age are convinced they should weigh the same or fit in the same clothes as when they were 18.
Even if they are dying of heart failure, liver failure, etc. there is just something about that senior in high school weight [that feels compelling].”
In addition to concerns about muscularity, males with body dysmorphia anxieties can include acne, facial features (such as the size of one’s nose), and body hair. These concerns can result in avoiding mirrors or, on the flip side, spending excessive amounts of time in front of the mirror while trying to hide or fix the perceived flaw.
The Body Dysmorphic Disorder Foundation reports, “men are mainly worried by their body weight, penis size, and height and, to a lesser extent, on muscularity, head hair, and body hair. Thus some men feel they should be lean and muscular, have a large penis, be tall, have a full head of hair, and little body hair. The body part may be related to the degree to which it is (a) visible (b) controllable and (c) a symbol of masculinity.” 
While women have historically faced societal challenges regarding body image that revolve around thin bodies, men face unique challenges as well. When scrolling through social media, men see ads on how to regrow hair or cut fat while adding lean muscle mass.
Visit websites that men frequent, and you will also see advertisements for protein powders, testosterone supplements, workout regimens, and products to increase sexual size and performance—all promising that their products will make users feel more confident.
However, it would be naive to think that all men experience body dysmorphia in the same way. Males with body dysmorphia experience it in different ways. It is unique to their personal history, sense of identity, and cultural setting.
Kayti Protos, a licensed clinical social worker at the Bucks LGBTQ Center in Newton, Bucks County, Pennsylvania, observes that for many trans-masculine clients, “the body dysmorphia is impacted significantly by their gender dysphoria. For example, clients may endorse significant distress about the size of their chest or the presence of curvy body parts.”
She continues, “We see a lot of clients who engage in restrictive behaviors to remove the curves from their body and present with a more masculine, androgynous appearance.
The fear of gaining weight is related to a fear of being perceived as feminine rather than a fear of being perceived as fat. Similarly, we have clients who binge eat, so they are perceived as round rather than as feminine in appearance.”
If your concerns about your appearance, take up a significant amount of time and cause you to feel depressed or hopeless, reach out to a therapist to discuss these issues. The most common treatment approaches for males with body dysmorphia include some form of cognitive-behavioral therapy supplemented with medication. Antidepressants, specifically SSRIs, can be prescribed to help relieve the obsessive thoughts and behaviors associated with the disorder.
REFERENCES: Mayo Clinic. (2019, October 29). Body dysmorphic disorder. Retrieved December 18, 2019, from https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/symptoms-causes/syc-20353938.  Royal Australian College of General Practitioners. (n.d.). Body dysmorphic disorder in men. Retrieved December 18, 2019, from https://www.racgp.org.au/afp/2015/november/body-dysmorphic-disorder-in-men/.  Body Dysmorphic Disorder Foundation. (n.d.). Retrieved December 18, 2019, from https://bddfoundation.org/muscle-dysmorphia-body-image-in-men/.
About the Author:
Travis Stewart, LPC has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future. Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help.
This includes a special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety, and perfectionism. Specifically, he has worked with eating disorders since 2003 and has learned from many of the field’s leading experts. He has worked with hundreds of individuals facing life-threatening eating disorders in all levels of treatment. His website is wtravisstewart.com
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published January 1, 2020, on EatingDisorderHope.com
Reviewed & Approved on January 1, 2020, by Jacquelyn Ekern MS, LPC