The term ‘bigorexia nervosa’, along with another synonym ‘reverse anorexia’, are nicknames for muscle dysmorphia. Muscle dysmorphia is deemed to be a sub-type of body dysmorphic disorder. It is seen primarily in men who usually perceive themselves as puny, or not muscular enough. The man or boy with muscle dysmorphia is bombarded with obsessive thoughts that their muscles aren’t big enough and feel small and weak, even though, in many cases, they may actually have large, strong muscles.
The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) describes body dysmorphic disorder (BDD) as a preoccupation with a defect in appearance. The defect is either imagined or minor, but if a defect is present, the individual’s concern about the defect is markedly excessive in comparison with the severity of the defect (Claiborn & Pedrick: 2002). Sufferers of Muscle Dysmorphia, like others with BDD, see parts of their body as defective. This excessive preoccupation with body size and muscularity causes the sufferer to feel small when they’re actually big.
In Paterson (2008), muscle dysmorphia is defined as a syndrome seen in both men and boys who feel dissatisfied with their bodies; not believing they are muscular enough. Morgan (2008) explains that at the ‘root’ of muscle dysmorphia is a distortion of body image. Body dysmorphia occurs almost exclusively in males and is a condition that consists of believing that one cannot be big enough (Andersen et al: 2000). In the Psychology Today magazine of 1997, it was reported that 43% of men interviewed were dissatisfied with their overall appearance; this is a dramatic increase form 15% in 1972 and 34% in 1985; so much so that Claiborn & Pedrick (2002) suggest that male body image dissatisfaction is catching up with that of women. Andersen et al. (2000) purports that more men than ever are dissatisfied with their weight, but unlike women, half of them want to get heavier, almost always in the form of increased muscle. In Phillips (2009) we discover that approximately one-quarter of men with body dysmorphic disorder are preoccupied with their overall body build.
Morgan (2008) suggests that muscle dysmorphia exists at the end of a spectrum of behaviours designed to reshape the body. A strong parallel with body dysmorphic disorder is the ‘imagined’ status of the defect in appearance; the brain of the bigorexic sufferer sees a perfectly normal body shape...
TABLE OF CONTENTS
1. Introduction
2. Bigorexics and their stories
3. Signs and symptoms of muscle dysmorphia
4. Psychobehavioural factors
5. The Media as a contributor
6. Co-occurring psychiatric disorders
7. Contributing factors
8. Obsessive-compulsive disorder and anxiety
9. Sexual orientation concerns
10. Intervention strategies and treatment
11. Advice for the family
12. Additional reading
13. APPENDICES
13.1 Appendix A – Diagnostic Criteria for Muscle Dysmorphia (Pope et al.: 2000, p 248)
13.2 Appendix B – Do I Have Muscle Dysmorphia? (Paterson: 2008, pp 47-48)
13.3 Appendix C – Clues to the Adonis Complex in Boys (Pope et al.: 2000, pp 194-195)
13.4 Appendix D – Drugs Abused by Athletes as Compiled from Underground Guides
14. References
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