Do I have an eating disorder if I'm obsessed with building muscle?

Dear Interested, 

Muscle dysmorphia, also referred to as megarexia, is a body dysmorphic disorder that’s characterized by a fixation on the leanness and muscularity of your body. This disorder can include obsessive thoughts about your body plus behaviors such as restrictive eating and strict exercising. These may interfere with other activities and responsibilities. Just as the disorder has many different symptoms, it’s influenced by many social and genetic factors. The type of treatment may depend on how the disorder presents itself and if you experience symptoms of other related disorders—such as social anxiety and eating disorders. Continue reading to learn more about muscle dysphoria and its connections to other disorders.  

What is muscle dysmorphia? 

Muscle dysmorphia—also referred to as bigorexia, megarexia, or reverse anorexia—is a condition that’s characterized by dysfunctional thoughts and behaviors concerning the leanness and muscularity of your body. Muscle dysmorphia is classified as a body dysmorphic disorder—a form of obsessive-compulsive disorder (OCD)—meaning that how you view your body isn’t in alignment with the reality of what you look like. Typically, people with this condition believe that their bodies are or appear to be weak, despite this often being untrue. 

While there is some existing research on the disorder, most focus on men, and more research is needed to understand potential gender differences in the disorder’s presentation and onset. 

What are the causes of muscle dysmorphia? 

Similar to other types of body dysmorphic disorders, muscle dysmorphia has both social and biological influences. Some of these include: 

• Growing up or spending time in an environment that emphasizes body strength. 
• Being around others who are competitive about strength and muscle growth. 
• Experiencing bullying for not being muscular. 
• Being exposed to beauty standards concerning body shape. 
• Having low self-esteem. 
• Feeling lonely. 
• Having a familial history of OCD or related disorders. 

List adapted from Brain Sciences and WebMD 

What are the symptoms of muscle dysmorphia? 

While muscle dysmorphia can show up differently from person to person, researchers and clinicians have identified some of the most common symptoms of the disorder, including: 

• Mirror-checking: scrutinizing your body in the mirror and focusing on your muscularity and leanness. 
• Mirror-avoiding: staying clear of mirrors because you don’t want to see your insecurities. 
• Maintaining a harsh exercise routine: these routines are excessive and strictly adhered to. Routines are fulfilled even at the risk of injury (or after being injured) and may take priority over other responsibilities. 
• Sticking to a strict diet: these diets are often restrictive, with the goal of promoting fat loss and muscle growth. 
• Overusing steroids and supplements: steroids and supplements are used more often than is recommended. 
• Experiencing symptoms of other disorders: symptoms of eating disorders, depression, and anxiety—general and social—may become present. 

List adapted from Life and Science and WebMD 

It’s important to note that these influences and symptoms aren’t all exhaustive.   

Is muscle dysmorphia related to eating disorders or other mental illnesses? 

Muscle dysmorphia is a disorder that’s usually accompanied by others, meaning that a person will often show symptoms of multiple disorders. Some of the most related disorders are: 

• Orthorexia nervosa: an eating disorder characterized by restrictively eating foods one perceives as healthy. Oftentimes, the quality of the food is prioritized over the quantity of it, which can lead to malnutrition. Someone with muscle dysmorphia may take on a restrictive diet of this nature to promote fat loss and muscle growth. 
• Anorexia nervosa: an eating disorder defined as an obsession with food and weight. Food consumption will typically be extremely restricted, often leading to weight loss and malnutrition. A person with muscle dysmorphia may similarly restrict food intake to lose fat while obsessing over their body’s appearance.  
• Social anxiety disorder: an anxiety disorder denoted by a strong sense of fear or anxiety when in social situations. People with muscle dysmorphia may fear being judged or rejected for the parts of their bodies they are fixated on and avoid social situations as a result. 

Are there treatment options available for muscle dysmorphia?  

Like other disorders under the umbrella of OCD, muscle dysmorphia has both therapeutic and medicinal treatment options. Since the appearance of a person’s body is an unreliable sign of muscle dysphoria, in the case of muscle dysmorphia, behavioral changes are often the focus of diagnosis and treatment. Therapy will usually incorporate education about exercise safety, nutrition, and body image. One form of therapy that's often recommended is cognitive behavioral therapy (CBT), which promotes changes in behaviors and thoughts. Additionally, selective and non-selective serotonin reuptake inhibitors (SSRIs) may be used as a medication option, however, more research is needed to understand how they interact with muscle dysmorphia symptoms. Discussing treatment options with a mental health care professional is advised. 

Hope this helps to build your knowledge of health and fitness,