Muscle Dysmorphic Disorder (MDD) is a type of Body Dysmorphic Disorder (BDD). It is popularly known as “Reverse anorexia” or “Bigorexia” in the media. It consists of a preoccupation with not being sufficiently muscular or lean (when this is not rooted in reality). Sports wrestling and body building gyms are a breeding ground for muscle dysmorphic disorder.
Their preoccupation with muscle size and gain results in compulsive exercise and weight training, even when if they are injured. This will interfere with social life, relationships, work and family life. Some men may resort to using illegal steroids or other muscle building medications or products, even though they may be fully aware of the dangerous consequences. This behaviour is a result of low self-esteem and lack of confidence which is also linked with cultural and societal influences e.g. social media and magazines promoting the unrealistic perfect body ideal.
Signs of Muscle Dysmorphia:
- Excessive time and over-exertion in weightlifting to increase muscle mass
- Preoccupation and panicking over workout if unable to attend
- Overtraining or training when injured
- Disordered eating, using special diets or excessive protein supplements
- Steroid abuse and often other substance misuse
- Distress if exposed leading to camouflage the body
- Compulsive comparing and checking of one’s physique
- Significant distress or mood swings
- Prioritizing one’s schedule over all else or interference in relationships and ability to work
- Often other body concerns, hair, skin, penis size
Treatment will always be individually tailored to suits the needs of each person. The NICE Guidelines recommends CBT, which is specific for BDD, when the problem causes mild functional impairment.
Cognitive Behavioural Therapy
CBT will be used to address and challenge negative thinking patterns and beliefs. These will be focused on and challenged in order to help develop a healthier and more positive relationship with their body. Other areas of work will often focus on reduction of reassurance seeking behaviours, body checking behaviours, building distress tolerance and emotional regulation work.