Muscular Dysmorphia

People with the clinical picture muscular dysmorphia pursue the ideal of an extremely muscular appearance. They try to achieve this obsessively. According to their disturbed view, they will never achieve that goal, that look.

Muscular Dysmorphia

What is muscular dysmorphia?

In general, muscular dysmorphia (MD), also known as bigorexia (biggerexia), Adonis complex or muscle addiction, is an expression of a disturbed self-image. It mostly affects men who consider their own muscular build to be insufficient because it does not correspond to their personal ideal. See electronicsmatter for Hypomenorrhea Definition.

One of the symptoms that define muscular dysmorphia is that those affected consider themselves too weak despite being in good physical condition and therefore often resort to anabolic androgenic steroids that are hazardous to their health. The trained muscle tone also does not appear to be sufficient and is continued to be trained as if under compulsion.

They believe they aren’t muscular, despite having superior muscle mass. The negative effects of excessive physical training, which refers in particular to weight lifting, are accepted by those affected because they believe that they are beneficial to their physical appearance.

In 1997, researchers Pope, Gruber, and Choi found a subclass of body dysmorphic disorders. Her research results indicate that those affected felt less attractive and healthy compared to their fellow athletes who were also training.


According to the psychologist Roberto Olivardia, four factors are responsible for muscular dysmorphia: a very pronounced perfectionism, low self-esteem, one’s own body image does not appear satisfactory and a negative or no relationship with the father.

If psychological conflicts are not processed at all or only insufficiently, over time it can happen that those affected transfer their conflicts to their own bodies. With this behavior they give their conflicts the desired expressiveness. In short: muscle building serves to reduce psychological suffering.

Those affected quickly realize that it is easier to control the body than one’s own emotionality. External images (muscle-bound bodybuilders in the print media) can also act as triggers. In this case, these representations take on a role model function for those affected.

Maybe because they haven’t had any role models in real life so far. A biological inclination is also considered possible. In the area of ​​stress -related symptoms, emotional and physical stress as a trigger for muscular dysmorphia should be reconsidered.

Symptoms, Ailments & Signs

Even among specialists, the course of the disease is often only recognized as muscular dysmorphia after many years. However, paying attention to a wide range of symptoms can lead to a corresponding diagnosis much earlier. Symptoms include severe weight loss and craving for performance-enhancing products (substances).

Another indication is the practice of not just regular but excessive sport, accompanied by an increasing loss of reality in relation to one’s own body image and appearance. Hormonal disorders and the formation of acne caused by anabolic steroids also occur more frequently.

Social as well as professional contacts lose priority and are subordinated to an excessive training schedule. Eating binges caused by not eating many foods in favor of diets that support muscle building are also symptomatic. Public changing rooms where those present can see their bodies are avoided.

In summary, it can be said that in the advanced stage it is no longer the maximum musculature and the washboard abs that come to the fore, but personal victory in the form of self-discipline over one’s own emotional world.

Diagnosis & course of disease

Since muscular dysmorphia is a psychologically disturbed perception, the symptoms mentioned are the basis for a diagnosis. In addition, those affected deal excessively with the topic of food and still eat one-sided food (everything has to serve to build muscle). Weight loss with simultaneous muscle building is another indication. Changes in the nipples are also common.


First and foremost, those affected with muscular dysmorphia suffer from a very strong weight loss. This loss can have a very negative effect on the health of the person concerned and lead to various ailments. It is not uncommon for the patient to have a greatly reduced resilience and permanent fatigue.

The everyday life of those affected is significantly restricted. Furthermore, most of those affected suffer from acne and thus from reduced self-esteem or inferiority complexes. Those affected are often ashamed of the symptoms and also have hormonal disorders. Anabolic steroids in particular can also lead to psychological complaints or a loss of reality if no treatment is initiated.

The eating behavior of the patients is severely disturbed, so that there are also deficiency symptoms. Those affected can also lose consciousness. Likewise, muscular dysmorphia can also have a negative effect on social contacts and lead to tension or exclusion.

The treatment is carried out with the help of a psychologist and nutritional advice. The sufferer must follow a strict diet to counteract the weight loss. However, the success of this treatment is highly dependent on the will of the patient. For this reason, there is not always a positive course of the disease in muscular dysmorphia.

When should you go to the doctor?

Muscular dysmorphia develops gradually over months or years. The disease can often only be diagnosed years later, usually after there is already a concrete suspicion. If there are indications such as a pathological self-image or hormonal problems, medical advice is required. Those affected should speak to their family doctor at an early stage. The doctor will first take a medical history and then conduct a physical examination.

Since muscular dysmorphia is difficult to diagnose, a psychologist is also consulted if there are no physical causes. People who suffer from psychological problems or pronounced personality disorders should inform the responsible doctor or therapist. In addition, the possible intake of medication should be checked and adjusted if necessary.

The actual treatment is lengthy and consists of medicinal and therapeutic measures. To ensure a speedy recovery, nutritionists, sports physicians and, if necessary, an internist should be involved in the treatment. In the case of severe muscular dysmorphia, a stay in a specialist clinic is indicated.

Treatment & Therapy

Muscular dysmorphia requires professional therapy in a psychosomatic clinic. There, a targeted therapy can be carried out through a competence network that has specialized in the connections between mental, spiritual and physical complaints. It is important to build up normal eating habits with weight stabilization. Furthermore, under guidance, those affected learn how to focus their personal perspective on an autonomous and self-confident life orientation.

Outpatient or inpatient therapy comprises five essential points:

  • Weight gain while treating physical illnesses
  • parallel to this, individual psychotherapy
  • Nutritional counseling with accompanying therapy
  • Involving the family in therapy
  • Treatment of other disorders that have arisen over the course of time, sometimes over years

The duration of treatment is difficult to define in advance. Experience has shown that it is between one month and half a year. The scope of therapy sessions is usually determined by the therapist together with the patient. As a rule, 25 sessions are paid for by the statutory health insurance companies.

Applying for an extension is just as possible as requesting more hours from the outset. For example, if there is a need for psychoanalysis.

Outlook & Forecast

There is a good chance of recovery from muscular dysmorphia if the condition is treated professionally and diagnosis and treatment are early. Most patients see a significant improvement in their health as a result of behavioral therapy. Treatment can be inpatient or outpatient. When treatment is used in conjunction with drug therapy, patients quickly experience significant relief from their symptoms.

Administering medication alone without psychotherapy, however, has proven to be less successful. Most patients often experience a rapid recurrence of symptoms once prescribed medications are discontinued. Therefore, the best chance of a cure consists of a combination of therapy and the administration of drugs. The treatment often takes several months or even years. Complaints gradually recede until complete freedom from symptoms is achieved.

If left untreated, muscular dysmorphia can become chronic. This significantly worsens the prognosis. Spontaneous healing is rather unlikely. Symptoms of the disease can vary in intensity over the course of the disease. At the same time, the symptoms increase the longer the disease persists. As the symptoms increase, the risk of suicide increases for those affected. Timely therapy is essential to prevent a life-threatening situation from occurring.


Contacting a preventive youth welfare service for children, young people and families or specialist advice on addiction prevention from the responsible school authority can help. The Association for Labor and Educational Aid e. V. with its specialist center for prevention is considered a target-oriented contact point not only for young people. Children and young people should be accompanied on their way to self-discovery with the necessary seriousness. Not infrequently, the focus is on “standing out” from the crowd, which can quickly lead to an exaggerated cult of the body.

A healthy body and self-esteem, a secure self-efficacy and a realistic self-concept is considered the best prevention against excessive body cult.


The therapy of muscular dysmorphia is considered to be difficult. So far, the disease has been little researched and almost no generally applicable approaches to treatment have emerged. These circumstances – and since it is a mental disorder – often make lengthy aftercare necessary.

The easy accessibility of building substances and the ideal image of a man created by the media also require longer therapy. Patients experience long-term stabilization through follow-up care. Therapists try to prevent complications such as alcoholism, depression, and low self-esteem. The type and scope of the sessions depend on the extent of the muscular dysmorphia.

Many doctors also prescribe psychotropic drugs to increase the success of treatment. Basically, a successful therapy leads to the end of the medical examinations. However, since there is a likelihood of a relapse in certain mental illnesses, scheduled appointments are advisable.

Patients with past muscle dysmorphia should therefore see their doctor on a quarterly basis for the first few years. In the investigations that are taking place, it can be discussed to what extent they are falling back into old patterns. Regular participation in self-help groups for addicts is also recommended. A doctor arranges appropriate contacts. This results in a certain control by other affected persons.

You can do that yourself

Individuals suffering from muscular dysmorphia require professional therapy. The therapeutic measures can be supported by some changes in everyday life. First of all, the diet must be changed so that the weight can be stabilized quickly. An individually adapted diet also enables patients to develop normal eating habits. You can also take advantage of nutritional advice. With the guidance of a professional, those affected learn to develop a positive outlook on life.

Muscular dysmorphia is often the result of a mental illness or occurs in connection with other mental health problems. For this reason, further psychological counseling is always indicated to accompany behavioral therapy. The therapist can support the patient in dealing with deeper causes and thus contribute to a speedy recovery. Equally important is the help of friends and family. The therapy often takes place with the involvement of the family or the person concerned takes part in a self-help group in addition to psychological counseling.

What other measures the patient can take depends on the type and severity of the muscular dysmorphia. Therefore, before any therapy, a comprehensive anamnesis and a physical examination by the family doctor and a therapist should take place.