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Mark flexed, as hard as he could, and looked in the mirror. Each of his massive, sweat-covered, vascular, steroid-built biceps, measuring 21 inches in diameter, gleamed under the light in his bathroom. After a few moments he un-flexed them, allowing them to fall back down to his sides and he mumbled to himself “still not big enough Mark”. This, of course, is a ludicrous statement. How could a man with such large, muscular arms think that they were “not big enough”? The fact is Mark suffers from a mental disorder called Muscle dysmorphia, popularly coined “Bigorexia”, which is a “form of body dysmorphic disorder in which individuals develop a pathological preoccupation with their muscularity” (Olivardia, Pope & Hudson, 2000). In other words, those affected can never be big or muscular enough, and when they look at themselves in a mirror they see someone much skinnier than they really are. In essence it is the reverse of what someone suffering from anorexia nervosa would experience. This is a disorder that has not been diagnosed, treated, or examined until recently. However, with the growth in popularity of bodybuilding and physical fitness, there has been and increasing interest in this disorder. How is “Bigorexia” diagnosed? What causes it? How is it treated? And finally what is the future of “Bigorexia” in today’s society?

In order for “Bigorexia” to be examined and treated it must first be diagnosed and in order to be diagnosed, it must be characterized. In a study performed by the American Journal of Psychiatry comparing male weightlifters suffering from muscle dysmorphia to male weightlifters not suffering from muscle dysmorphia, the characteristics of muscle dysmorphia were identified. The disorder was first characterized by rating the subjects, whom were known to be suffering from the disorder, on their insight into their preoccupation in that they recognized that their perception of their own size was inaccurate. “(42%) were rated as showing "excellent" or "good" insight into their preoccupation in that they recognized that their perception of their own size was inaccurate. (50%) showed "fair" or "poor" insight, and (8%) subjects lacked insight altogether, in that they were completely convinced that they were small, even when repeatedly given evidence to the contrary” (Olivardia, Pope & Hudson, 2000). Thus one characterization or criterion, to be used in the process of diagnosing an individual in question with “Bigorexia”, would be whether or not the individual is aware of their physical size. Secondly, a body dysmorphic disorder modification to the Yale-Brown Obsessive compulsive scale was applied to the subjects. Using this scale it was found that, of those who suffered from the disorder, “(50%) reported that they spent more than 3 hours per day thinking about their muscularity. (58%) reported "moderate" or "severe" avoidance of activities, places, and people because of their perceived body defect. (54%) reported "little" or "no" control over their compulsive weightlifting and dietary regimens. Two subjects reported giving up well-paying professional jobs to work at gymnasiums where they could lift weights themselves” (Olivardia, Pope & Hudson, 2000). Therefore another criterion for the diagnosis of an individual with “Bigorexia” would be whether or not the individual’s perception of their muscularity affects them on a daily basis at the mental and/or behavioral level. Finally, one of the common behaviors exhibited in men with muscular dysmorphia is substance use/abuse, namely anabolic-androgenic steroid use. In the case of men with “Bigorexia” there is a high correlation between the men who have the disorder and whether or not they have used anabolic-androgenic steroids or AAS. In a study done by The American Journal of Psychology it was reported that 46 percent of male weightlifters, in the study, suffering from muscular dysmorphia, used steroids. By comparison, of the male...
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