Muscular Dysmorphia

Hundreds of thousands of men are now believed to suffer from a condition known as muscular dysmorphia. What makes these men unusual is the fact that they often have perfectly sculpted and heavily muscled bodies, yet they are embarrassed and unhappy with how they look. Far from being proud to show off their muscles these men hide away from physical exposure by covering up with clothing. The similarities with anorexia in this regard have given rise to some people calling the condition reverse anorexia.

Comparisons with Weight Lifters

Most men with muscular dysmorphia are weight lifters, but compared with normal weightlifters who report spending up to 40 minutes a day thinking about body development, men with muscular dysmorphia report being preoccupied 5 or more hours a day thinking their bodies are under-developed.

Other comparisons with weight lifters tend to reveal big differences. Although weight lifters take an interest in their body and check themselves maybe two or three times a day, the man with muscular dysmorphia will check themselves at least 12 times a day. Similarly, weight lifters will generally be interested in what they eat but the dysmorphic will be obsessed by food to the extent that they will not eat elsewhere due to their need for total control over dietary intake.

Men with the condition become completely preoccupied with their physique. They have been known to lose their job either because they are constantly late due to morning workouts, or they use breaks for exercise and take too long. Relationships can suffer or break down completely as free time is spent on preparing diets or exercising rather than socializing or spending time on nurturing relationships.

Psychological Factors

Low self esteem is a common feature of men with muscular dysmorphia. It is not untypical to find that many men had difficult childhoods and were teased about having a scrawny physique. But the attempt to compensate for these insults is never actually achieved and this results in a poor sense of self and feelings of emptiness. Research by Olivardia et al (2000) found that 29 per cent of men with muscular dysmorphia had a history of anxiety disorder and 59 per cent exhibited some other form of mood disorder.

Treatments

No systematic studies have been produced to compare the effectiveness of one treatment over another, either individually or in combination. A problem with the condition is that, rather like anorexics, men rarely see themselves as having a problem and are unlikely to come forward for treatment. The condition itself occurs partly as a response to feelings of depression and lack of self-esteem so coming forward for treatment is admitting defeat.

Where men have come forward a combination of educational and psychotherapeutic techniques show promising results. Cognitive behavioral therapy place an emphasis on identifying and changing patterns of thinking towards more realistic and achievable goals. Future treatment packages may well be informed by such approaches but more systematic studies are still needed.