Can Women Have Muscle Dysmorphia (Bigorexia)?

Muscle dysmorphia (bigorexia) is a type of body dysmorphic disorder in which the person falsely views themselves as too weak or thin despite not being so. They may falsely believe that they have too low muscle mass or are not lean enough despite being muscular or having a normal physique.

Muscle dysmorphia is particularly common in bodybuilders, athletes, and people involved in resistance training.

Such false body image may be associated with:

• Having a poor body image
• Doing excessive workouts including heavy weight lifting
• Taking a lot of supplements including anabolic steroids to bulk up
• Being too rigid about their diet
• Tending to repeatedly look into the mirror because of not being confident about how they look
• Avoiding social interactions so that their diet or exercise routine is not disrupted
• Being too obsessed about how they look and how to achieve their desired physique
• Constantly comparing their physique with others
• Having a constant need to seek reassurance about their looks

A person with muscle dysmorphia may have low self-esteem although exaggerated or high self-esteem may also be seen. The constant indulgence in getting “big” may result in social isolation and a higher risk of depression, anxiety, or suicidal tendencies. The affected person may even resort to risky procedures or surgeries to correct their falsely perceived defects.

The exact cause of muscle dysmorphia is unknown; however, certain factors may increase a person’s likelihood of getting this disorder, such as:

• Being bullied or teased for one’s looks during childhood
• Peer pressure for getting an “ideal” physique
• Being too obsessed with the social or cultural norms of good looks
• Being influenced by the way media portrays “perfect” bodies
• Having mental or emotional issues such as anxiety or attention deficit hyperactivity disorder
• Being brought up in a family where parents or caregivers were too critical of the person’s appearance
• Being rejected or betrayed on grounds of looks
• Having a history of traumatic events during childhood

Muscle dysmorphia can be effectively treated with psychological therapy and family support. Medications may be added when required.

• Psychotherapy: It involves counseling provided by a qualified mental health professional. The provider generally uses cognitive behavior therapy to help the person realize the issue, what is causing it, and how to deal with it.
• Exposure and response prevention: Here, the person is made to realize that their negative perceptions about themselves are false with the help of thoughts and real-life situations.
• Group or family therapy: Here, the person’s family or friends may be involved in the therapy to help them recover better.
• Medications: Muscle dysmorphia is often associated with depression and anxiety. The doctor may prescribe medications (such as antidepressants) to treat these disorders.