Eating Disorders: Bigorexia

In psychiatric circles, it is known as 'muscle dysmorphia' (an obsession about being muscular) but to the layman it's Bigorexia. (BIG.uh.rek.see.uh) is a mental disorder in which patients - typically men and typically bodybuilders - view themselves through a distorted lens and become obsessed about what they perceive as their physical inadequacies. It's the big brother disease to anorexia nervosa, except that bigorexia is to "huge" what anorexia is to "thin." This is an under-diagnosed condition because, for men, being big is acceptable. It isn't surprising that bigorexia is a growing disorder in gyms and health clubs given the hype about six packs, impressive pecs and large lats. Their muscles may be sculptured, bulging and rippling, yet no amount of persuasion will convince them their body is big enough. Rather than their bodies being thought of as functional machines, they become the objects of hate, resentment, fear and loathing.

No longer are body dissatisfaction and breast implants the domain of women. In a study of over 1000 men, over 50% were unhappy with their bodies and 40% said they would consider chest implants in order to achieve bigger pectorals. When asked to draw their ideal body, the body ideal was so muscular it could only be achieved by taking the risks associated with using anabolic steroids. When fevered by muscle mania, men may use steroids for nine or ten years - sometimes refusing to even take a break from them. 1993 study for the Department of Health looked at 1,300 men in a range of UK gyms and found that 9% were on steroids and GP surveys revealed that one in three doctors had seen steroid takers (i.e. takers that they knew of). Steroid use has long-term risks - potentially damaging changes to the liver, heart and muscles, raised cholesterol levels, possible dependence, mood swings, acne, breasts and "'roid rage". However the common (mis)perception is that, properly taken, they are safe.

At its most extreme muscle dysmorphia can have a devastating effect on men's relationships, careers and social lives.

Do this simple test to see if you suffer from Bigorexia:

• How often do you look at your body in the mirror? (One study found that men with this condition check themselves in the mirror an average of 9.2 times a day with the most extreme checking their reflection more than 50 times).
• Do you think your body needs to be leaner and more muscular? And does it drive you crazy thinking you are too small?
• Do you find yourself reading up on new training methods, diets and supplements?
• Do you eat special high protein or low fat diets or use food supplements to improve your muscularity or to help you bulk up?
• Do you disbelieve people who comment on how big you and find fault with your musculature?
• Do you ever wear baggy clothes because you wish to hide the body you feel is too small? Or do you avoid situations where your body might be seen such as the beach because you think you are not muscular enough?
• Do you still train and work out even when injured because you fear losing muscle mass?
• Do you find it difficult to cut back on the hours spent working out and training?
• Do you compare yourself to other men and feel envious when you see someone bigger than you and find yourself pre-occupied with this for sometime afterwards?
• Do you ever perceive that others are snickering at your puniness?
• Would you rather spend time and energy going to the gym than having sex and/or has your libido taken a dive?
• Have you turned down social events, taken time off work (or passed up on a higher-paying job), had relationship problems or skipped family responsibilities because of your need to work out? *typically men who have bigorexia will say yes to three or more questions

So before any big guys or health clubs get hot under the collar. I'm not saying there is necessarily anything wrong with working out regularly, or being an exercise enthusiast or even a body-builder. But looking in the mirror at 110kg and seeing a weedy weakling and being so consumed with your pursuit of muscle gain that it interferes with your every day life is something totally different. Sadly bigorexic tendencies are exacerbated, not alleviated, by more sessions at the gym. Wanting to be bigger is like running on a road to nowhere, because obsession breeds dissatisfaction. There will always be someone bigger and better.

It is estimated that probably 10% of the men in any hard-core gym have muscle dysmorphia, ranging from mild to crippling and that this figure could be three times as high if sub-clinical statistics were added. The hidden message is that your confidence, your desirability, your sense of being in control and your sex life will improve instantly when you get bigger muscles. However, just as anorexics lose control, so to do bigorexics and paradoxically, women interviewed liked toned muscles, but were put off by huge muscles. Huge muscles reek of self-absorption. Research shows that men's perception of the ideal body is typically around 8 kg more muscular than the stated female preference.

Standards for male beauty are changing, because we are bombarded with imagery in movies and television that portray men as larger than life. Action toys give the message that being mortal just isn't enough. Having super power and super strength is what counts. The muscle definition of chest and biceps measurements of 'GI Joe' and 'Star Wars' male action figures has sky-rocketed. For insecure children picked on and bullied at school, the supposed power exuded by these figurines can be alluring.

Men are catching up on the levels of body dissatisfaction that used to be the monopoly of the fairer sex. Ideas that men shouldn't care how they look have gone. It's no longer acceptable for a man to stand around the braai with a beer belly. What stands out is that what used to be women-talk is now man talk: "I constantly think I'm overweight and go into cycles of eating hardly anything and exercising like crazy. I can't eat sweets or cakes; I go to the gym every day. It takes willpower." Men are buying into the beauty myth, except that instead of being thin - Å“ it's BIG.

next: Eating Disorders: Muscle Dysmorphia
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