What is bigorexia?

Do you spend hours in the gym? Obsessively focusing on calorie counting, tracking your macronutrients and hitting protein targets? Are you limiting areas of your life such as seeing friends or other interests because of the time you need to spend in the gym or prepping food? Yet you still feel unhappy with your body – your muscles are not big enough or you are not lean enough?

If any of the above sounds familiar, you may be experiencing ‘bigorexia’ – a term coined to describe psychological difficulties in which you are preoccupied by achieving a muscular and lean physique, often taking extreme measures such as excessive exercise, strictly controlled diet and even steroid use to reach this. Paradoxically, although many people with bigorexia may objectively be in good shape, they are often extremely anxious and self-conscious about their bodies. People with bigorexia may avoid situations where they fear exposure, for example, going to the beach, or dating. Life can become extremely limited because strict eating patterns – quantity, content and timing – need to be followed. 

There has been very little research on bigorexia or ‘muscle dysmorphia’ as it is more formally known, however, it appears to be most common in adolescent boys and men. A study of almost 5000 U.S. males aged 11-18, found a quarter reported high weight concern, mostly focused on muscularity (Glazer et al., 2021). Use of muscle-building products such as steroids or supplements was reported by 11%. A review of research in males in the Middle East also found high levels of body dissatisfaction and muscle dysmorphia (Devrim-Lanpir, 2023). Anecdotal reports from clinicians suggest increasing numbers of males experiencing high muscularity concerns. 

The role of social media

TikTok and other social media sites are flooded with images of muscular bodies and bodybuilders. Pre social media, we would see these bodies some of the time – for example, a film or pop star – now we only need pick up our phones to see them all the time. Many posts urge users to follow the poster’s example or gush about how life improved since they started working out. Transformation videos are ubiquitous. Extreme tips to bulk up are shared, without acknowledgement of the risks. Young boys, in particular, may be affected as they experience the physical changes of puberty while exploring their identity, alongside the drive to ‘fit in’ with peers. Social media can emphasize insecurities, creating a vicious cycle of chasing a physique unattainable to most people, resulting in low self-esteem.

The dangers of bigorexia

As the focus on a muscular physique intensifies, we can start to judge ourselves only on this aspect – how we measure our self-worth becomes very one dimensional. This may be enhanced if we are suddenly experiencing praise from those around us. Anxiety, depression, muscle dysmorphia and even an eating disorder may result as our focus becomes ever narrower with an increasing pressure to maintain progress. A plateau in progress may trigger a sense of failure. We may turn to more extreme and harmful strategies, such as steroid and supplement use, to reach our goals. There are increasing stories of young bodybuilders who have died linked to steroid abuse. Individuals who use excessive supplements (e.g., vitamin, mineral or protein supplements) may risk liver or kidney damage. Vitamin and mineral supplements cannot replace a healthy balanced diet. Children should not be using supplements at all, unless prescribed by a medical professional. Excessive exercise may also lead to injury.

What to do if you recognize a problem

Because having a good body can be highly socially desirable and lead to praise and admiration, it can often be hard to recognize it’s become a problem. It can also be hard to see it as a psychological problem – instead, you may tell yourself you just need to work out harder. Instead, we recommend you see a specialist in body image disorders for psychological therapy, who can help you understand how your difficulties developed and what keeps them going. Cognitive behavior therapy (CBT), which is used for eating disorders and body dysmorphic disorder, is recommended.  The goal is not to stop exercising if you enjoy this, but to help you reduce your obsession and achieve balance in your life.

Written by: Dr Victoria Mountford