body dysphoria and men's mental health: what you should know

Bigorexia, also known as muscle dysmorphia, is a type of body dysmorphic disorder (BDD) and is characterized by the intrusive preoccupation with being “too small” or not muscular enough.  Men are much more likely to suffer from bigorexia than women.  Males with bigorexia and other BDD  are commonly fixated on small build, genitals, body hair, thinning hair, and skin.  Interestingly, across both genders, studies have found that Caucasian, Asian, and Hispanic adolescents are less satisfied with their bodies than African-American adolescents. The age of onset for most body dysmorphic disorders is around 16 years old and if not addressed and treated, individuals can struggle with this disorder for the rest of their life.

What Does It Feel Like?

Individuals with bigorexia (and other BDD) tend to have a preoccupation with one or more defects or flaws in physical appearance that are not observable or appear slight to others. These individuals often engage in repetitive behaviors (mirror checking) or mental acts (comparing appearance to others) in response to appearance concerns. Often, social situations are avoided due to overwhelming distress. The preoccupation with appearance is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder, which is why the disorder can be misrepresented by those who do not experience these symptoms.

Mental disorders of all types are often accompanied by social stigmatization or misunderstandings, especially in regards to the control an individual has over their disorder.  For example, it may be difficult to see the difference between individuals obsessing over not being muscular enough and those who are bodybuilders. Simply put, someone who is a bodybuilder does not have a distorted body image and would not meet criteria for muscle dysmorphia. To meet the criteria for bigorexia, there are two factors: the individual must have a preoccupation with their muscles that are believed to be “too puny” and it must cause significant distress or interfere in their life.  This distress is characteristic of all body dysmorphic disorders.

Identity Issues

The day-to-day dysfunctionality caused by bigorexia is identified by the distress brought on by the obsession of gaining muscle mass and the formation of one’s identity around their body image.  This distortion of an individual’s body image can be quite fearsome and distressing for that individual, just as gaining weight is problematic for individuals with restrictive eating disorders, like anorexia nervosa. Raising awareness and destigmatizing bigorexia is important because individuals with body dysmorphic disorders, like bigorexia, are at an exponentially higher risk of suicidal ideation and completing suicide. Suicide occurs 45 times more in those with BDD than in the general population, especially those with bigorexia.

Additionally, ideas or delusions of reference (belief that others are taking special notice of their defect) occur in nearly 66% of patients with body dysmorphic disorders.  This is why it’s important to cautiously approach our understanding of bigorexia, whose symptoms extend beyond being muscular, but a concerning foundation for how a person sees themselves as an individual.

Getting Treatment

When someone is distressed with bigorexia, working with a mental health professional with a focus on BDD can be especially helpful and very effective. Often, underlying social anxieties and depression are at the root of BDD and are addressed as well. Individuals can improve their self-esteem by identifying other areas of strength and engaging in values-based activities, effectively dismantling the importance of body image as the determining factor of their identity as a person. From here, people can take control of who they are as individuals from the inside.

Written by Aiden Suttlehan

This article has been republished from Renewed Awareness Magazine.

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