Muscle Dysmorphia & Compulsive Exercise

Muscle dysmorphia (MD) is described as a pathological pursuit for muscularity marked by distorted thinking that one is small and weak despite well-developed muscularity. This is often seen as an equivalent in males to females who see themselves as grossly fat despite evidence to the contrary. While seen predominantly in males, this experience is reported by individuals across the gender spectrum. This disorder is often combined with disordered eating patterns and compulsive exercise (CE) that make this diagnosis more accurately seen as an eating disorder.

Compulsive exercise (CE) is characterized as a need to physically train and work out despite harmful consequences such as injuries, medical complications, loss of social interactions, and worsening mental health.

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Some signs and symptoms.

At Eating and Body Image Therapy Center, we understand that eating disorders come in all varieties, including those that don’t meet the classic definitions of anorexia, bulimia, and binge eating disorders. Here are some questions to ask to see if this sounds like you or your loved one is struggling with muscle dysmorphia or compulsive exercise. Note this is not an extensive list, just sample questions that may help you think more about these concerns.

Do you:

  • Think your body is too skinny/slender?
  • Feel like you have too much body fat?
  • Feel anxious when you miss one or more days of exercise?
  • Cancel social activities because it conflicts with a workout schedule?
  • Wish you could be heavier?
  • Think your arms and legs are too weak?
  • Work out despite being injured

Researchers have found most of those identified with MD and CE don’t typically score high on eating disorder evaluations. The problem is the language is different. Instead of fixation of thinness and beauty, the questions need to be geared toward muscularity, masculinity, dominance, perfectionism, and performance. Rather than meeting some aesthetic aspirations, the drive is to exceed it.

To reach those goals, individuals will turn to many different behaviors including the use of appearance and performance enhancing drugs (APEDs), intensive nutritional binge and restrict cycles with food to gain muscle and reduce fat, hyper-focus on “healthy foods” and proteins, and excessive use of food supplements.

When these behaviors start to lead to constant and excessive self-scrutiny, emotional dysregulation, loss of social supports, declining performance, physical injuries, injuries that won’t heal, and the like, it’s time to seek help.