Muscle Dysmorphia in Males

Contributor: Authored by Dr. Gregory Jantz, founder of The Center • A Place of HOPE

Friends Meeting in City SquareBody Dysmorphic Disorder (BDD) is a body-image disorder that causes people to obsess over their real or perceived physical imperfections for hours. BDD affects both men and women. Severe BDD can cause major emotional stress and anxiety, and it can interfere with a person’s normal daily functions.

A person with BDD is consumed with negative thoughts about their physique, and often will avoid social situations because they worry others will notice their perceived flaws. BDD can cause people to seek out ways to alter their bodies, such as plastic surgery, and also can trigger eating disorders.

The Opposite of Anorexia – “Bigorexia”

One growing subtype of Body Dysmorphic Disorder is muscle dismorphia or “bigorexia.” This condition is, in some ways, the opposite of anorexia. People with muscle dismorphia are concerned that they appear too weak and frail, and particularly that their muscles are small and underdeveloped.

While muscle dysmorphia affects both genders, the majority of bigorexia sufferers are men. It is also important to note that many people that suffer from muscle dismorphia are often very muscularly developed; some are even body builders. Like any type of body-image dismorphia, sufferers oftentimes have a very warped image of themselves.

Social Pressures on Men Are Growing

a man walks with his horseThe social pressures causing eating disorders among men are on the rise. There is a greater emphasis on muscularity at a younger age than ever before. Images of muscular, perfectly toned men are rampant among media and social media.

Action figures, super heroes, and celebrities are often depicted with a perfect “V-shaped” torso, chiseled abs, a broad chest, muscular arms, large calves, and a low body fat percentage. Young male celebrities are even being photoshopped to adhere to this perceived muscular standard.

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The Growing Obsession with Body Image in Men

Because of this increasing social pressure, many men obsess over their body image and body composition. These men with muscular dysmorphia will take to extreme eating habits, have extreme workout regimes, use muscle enhancing drugs and steroids, and even seek out plastic surgery options such a pectoral and calf implants.

In addition to the physical trauma these extreme habits can cause, people with muscular dysmorphia often suffer from depression, anxiety, and other co-occurring disorders.

be93e4e9-3ce2-4694-af88-7d4d54ae50ecThese social pressures to meet an oftentimes unrealistic physical standard, mixed with the lack of diagnosis and treatment of men with eating disorders or body dismorphia, has created a perfect storm for male muscle dismorphia today. Here are some symptoms to look for:

  • Extreme weightlifting and exercise patterns
  • Excessive time weightlifting or exercising
  • Constant conversation revolving around their weightlifting or “bulking” habits
  • Negative, delusional comments about their physicality
  • Avoidance of social situations
  • Anxiety over missed-workouts
  • Obsession over diets, supplements, or eating habits
  • Use of steroids or other muscle bulking drugs
  • Choosing to workout over other responsibilities or spending time with family and friends

If you observe a loved one struggling with the above symptoms or are concerned that they might have muscular dismorphia, seek out profession help today.

A Professional Perspective

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.” [4]

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. [5]

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.”

Man concerned about Males with body dysmorphiaYet, 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.” [6]

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.”

Man lifting weights while suffering from Compulsive ExerciseShe 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.


Travis Stewart Headshot PhotoTravis 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


Authored by Dr. Gregory Jantz, founder of The Center • A Place of HOPE and author of 30 books. Pioneering whole-person care nearly 30 years ago, Dr. Jantz has dedicated his life’s work to creating possibilities for others, and helping people change their lives for good.

The Center • A Place of HOPE, located on the Puget Sound in Edmonds, Washington creates individualized programs to treat behavioral and mental health issues, including eating disorders, addiction, depression, anxiety and others.


  4. Mayo Clinic. (2019, October 29). Body dysmorphic disorder. Retrieved December 18, 2019, from
  5. Royal Australian College of General Practitioners. (n.d.). Body dysmorphic disorder in men. Retrieved December 18, 2019, from
  6. Body Dysmorphic Disorder Foundation. (n.d.). Retrieved December 18, 2019, from

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on April 10th, 2015
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