Bigorexia: When Strength Training Goes too Far

At the crossroads of eating disorders and body dysmorphic disorder lies the psychiatric condition called bigorexia.

Bigorexia, also known as “muscle dysmorphia” or “reverse anorexia,” is a psychological disorder where a person becomes preoccupied with wanting to increase the size of their body and muscles. A person with bigorexia may think that they are not muscular enough, despite evidence to the contrary or with reassurance that this is not true.

Symptoms of Bigorexia

Behaviors of bigorexia may include excessive exercise and body checking, high protein intake, low calorie intake and use of muscle building supplements or anabolic steroid use. Individuals who are struggling with bigorexia engage in behaviors to a point where if often interferes with normal functioning and leads to disturbances in normal relationships with exercise and diet.

If you are concerned your child has bigorexia or is at risk for bigorexia, look out for these signs/symptoms:

• Excessive preoccupation with body image
• Comments about being small or weak
• Excessive exercise
• Changes in diet, often increasing protein intake and decreasing other nutrients like dietary fat and carbohydrates
• Repetitive acts in response to appearance concerns such as muscle/body checking in the mirror, excessive grooming, comparison of appearance to that of others
• Impairment in social functioning such as isolation or difficulty engaging in normal conversation

What Causes Bigorexia?

Like other types of psychological disorders, there are multiple factors that influence its development such as genes, media, self-esteem, peers, diet attitudes, trauma, and traits like perfectionism. Bigorexia is more prevalent in males than females. In adolescents there is an additional risk with bullying by peers. Those struggling with bigorexia are at higher risk for depression, anxiety, substance use, and suicide risk.

Treatment of Bigorexia

Treatment for bigorexia may include:

• Individual therapy
• Family therapy
• Meeting with a Registered Dietitian
• Possible pharmacologic intervention.

If your child is showing signs of bigorexia, consult with your pediatrician.