When Building Muscle Becomes a Problem: Understanding and Treating Bigorexia
Most people have heard of body image issues like anorexia, where someone fears gaining weight. But fewer people know about Bigorexia, also known as muscle dysmorphia. This is a condition where someone becomes obsessed with building muscle and never feels muscular enough, no matter how much they work out. It’s a form of body dysmorphic disorder (BDD), and it can have serious effects on mental and physical health.
Who Gets Bigorexia?
Muscle dysmorphia mostly affects men, especially those who spend a lot of time in the gym or follow strict fitness routines. It often begins in the late teens or early twenties and can affect athletes, bodybuilders, and regular gym-goers alike. Social media, fitness influencers, and unrealistic body standards in movies and ads may also contribute to the pressure.
Signs to Watch For
People with Bigorexia often don’t realize anything is wrong. They may appear extremely fit to others but see themselves as small or weak. Common signs include:
- Spending hours a day lifting weights
- Feeling anxious or depressed if workouts are missed
- Obsessing over diet and protein intake
- Avoiding social events because of their fitness routine
- Using anabolic steroids or other risky supplements
- Frequently checking mirrors or avoiding them altogether
- Injecting synthol or other synthetic fillers to mimic the appearance of large muscles
The Risks of Obsession
The drive to look muscular can become harmful. People with muscle dysmorphia may experience:
- Mental health issues like depression, anxiety, or low self-esteem
- Injuries from overtraining without rest
- Disordered eating such as extreme bulking or cutting cycles
- Steroid misuse, which can damage the heart, liver, and reproductive system
- Relationship stress due to rigid routines and body image concerns
What Causes It?
There’s no single cause. Like many mental health conditions, Bigorexia seems to result from a mix of:
- Biological factors, including brain chemistry
- Psychological traits, like perfectionism or past trauma
- Cultural pressure, especially around masculine ideals and appearance
- Early bullying or body shaming in childhood or adolescence
How We Approach Treatment
At the Performance Medicine Institute, we are experts in all things muscle. We also recognize that mental health is physical health. Our integrative approach to treating Bigorexia includes:
- Counseling and psychotherapy, especially cognitive behavioral therapy (CBT)
- Medication management if anxiety, depression, or OCD-like symptoms are present
- Supportive coaching to develop balanced fitness routines and eating habits
- Lab testing and use of medications to treat any hormonal disorders caused by excessive androgen use
- For patients who have used Synthol and wish to have this surgically removed, we help perform rehabilitation and restoration of function after surgery
Building a Healthy Relationship with Fitness
There’s nothing wrong with wanting to be strong, lean, or fit. But when fitness starts controlling your life instead of supporting it, that’s a red flag. We help patients redefine what it means to be healthy, which includes physical, mental, and emotional aspects. Our goal is to keep your strength and muscle, but restore flexibility and confidence in your approach.
Take the First Step
If you or someone you know is struggling with obsessive thoughts about muscle size or training, we can help. Call us or schedule an appointment online to talk with a clinician who understands both performance and mental health. Contact Us
References
Pope HG Jr, Gruber AJ, Choi P, Olivardia R, Phillips KA. Muscle dysmorphia: an underrecognized form of body dysmorphic disorder. Psychosomatics. 1997;38(6):548-557.
Tod D, Edwards C, & Cranswick I. Muscle dysmorphia: current insights. Psychol Res Behav Manag. 2016;9:179-188.
Murray SB, Rieger E, Touyz SW, De la Garza Garcia LY. Muscle dysmorphia symptomatology among men: the role of shame, guilt, and pride. Body Image. 2010;7(1):56-60.
Olivardia R. Muscle dysmorphia and the pursuit of muscularity: psychological and social implications. In: Pope HG Jr, Phillips KA, Olivardia R. The Adonis Complex. 2000. Free Press.