What is bigorexia?
Bigorexia, technically called muscle dysmorphia, is a disorder in which the person develops an obsessive concern about not being muscular enough, despite often having an athletic physique that is well above average. It is a form of body dysmorphic disorder that works as "reverse anorexia": while in anorexia the person sees themselves as fat despite being thin, in bigorexia the person sees themselves as weak and undermuscled despite being very muscular.
Although it is formally classified within obsessive-compulsive disorders, bigorexia shares many characteristics with eating disorders: food restriction, very rigid diets, supplement use, a pathological relationship with the body and food, and a significant impact on daily life.
It is estimated to affect approximately 10% of regular gym-goers, with a higher prevalence in young men (18-35 years), although it is increasingly diagnosed in women.
Symptoms of bigorexia
Behavioral symptoms
- Excessive training: spending hours at the gym daily, training despite being injured, ill, or exhausted
- Extreme diets: following very rigid high-protein meal plans, weighing every food, avoiding any "deviation" from the diet
- Substance use: consuming supplements in excess, anabolic steroids, growth hormones, or other dangerous substances
- Compulsive mirror checking: spending a lot of time examining the body in the mirror or, conversely, avoiding it completely
- Social avoidance: canceling social plans to avoid missing workouts or breaking the diet
Psychological symptoms
- Body image distortion: perceiving oneself as weak despite having a very muscular body
- Intense anxiety if a workout is missed or if something is eaten outside the meal plan
- Mood entirely dependent on physical appearance and gym performance
- Constant comparison with other muscular people (social media, competitors)
- Permanent dissatisfaction: it is never enough, there always needs to be "more muscle"
Causes of bigorexia
Psychological factors
Low self-esteem is the central factor. Many people with bigorexia have experienced bullying, mockery about their bodies during childhood or adolescence, or experiences of rejection. The muscular body becomes a psychological "armor": a way of feeling safe and invulnerable. Perfectionism, the need for control, and difficulties regulating emotions also contribute.
Sociocultural factors
Social media and the fitness industry promote an increasingly muscular and toned masculine body ideal. The images of influencers with highly worked bodies (often involving substance use, filters, and strategic lighting) create unrealistic expectations. The "no pain, no gain" culture normalizes excessive training and food restriction.
Health consequences
- Physical: chronic musculoskeletal injuries, liver and kidney damage (from steroids), cardiovascular problems, hormonal alterations (infertility, gynecomastia), weakened immune system
- Psychological: depression, generalized anxiety, obsessive-compulsive disorder, suicidal ideation (especially related to body dissatisfaction)
- Social: isolation, deterioration of romantic and family relationships, work problems due to the absolute priority given to training
- Nutritional: deficiencies from unbalanced diets, gastrointestinal problems, metabolic disorders
Treatment of bigorexia
Cognitive-behavioral therapy (CBT)
CBT helps identify and modify distorted beliefs about the ideal body, reduce compulsive behaviors (excessive training, constant mirror checking), and develop a healthier relationship with the body and exercise. The work focuses on tolerating "imperfection" and deconstructing the link between personal worth and physical appearance.
EMDR for underlying trauma
When bigorexia arises from traumatic experiences (bullying, mockery, abuse, rejection), EMDR treatment allows these memories to be processed and frees the person from the need to build a "body armor" as a protective mechanism.
The first step is to recognize it
One of the great challenges of bigorexia is that society often reinforces the problematic behaviors: intense training and dedication to the body are positively valued. If you feel that the gym and diet are controlling your life rather than improving it, I invite you to talk about it in a free informational session.