Muscle Dysmorphia (Bigorexia)
Muscle dysmorphia is a psychological condition characterised by an obsessive preoccupation with being insufficiently muscular. Clinically classified as a form of body dysmorphic disorder, it shares the same underlying engine as anorexia: a relationship with the body that no physical change can satisfy.
The same preoccupation, a different expression
“For men I have never seen a lot of anorexia. What I see is bigorexia, men who have the same preoccupation as women: they want to be lean, they don’t want fat, but instead of being very skinny they want to become very big.”
Philippe Jacquet Where anorexia pursues thinness, muscle dysmorphia pursues size and leanness. The physical goal is opposite. The psychological structure is identical: a body that is never enough.
Why it is underdiagnosed
Training extensively, controlling diet rigorously, pursuing a lean and muscular physique, in most contemporary Western cultures, this is admired. The disorder hides in plain sight. By the time it presents clinically, it has often been present for years.
What this is like from the inside
Most men who end up working on this with me did not arrive to talk about it. They came for something else, low mood, a relationship in trouble, drinking, and it surfaced later, often by accident.
If any of this is familiar, it is worth knowing it has a name.
You train whether or not you want to. A missed session is not a missed session; it is a failure, and it costs you the rest of the day. You eat to a plan rather than to appetite, and eating outside the plan produces something closer to panic than regret. You know your numbers, macros, weights, body fat, the way other people know their own phone number.
You check. Mirrors, windows, the camera on your phone, the particular angle in the particular light. The checking never settles anything, because what you are looking for is not information.
You have turned down things you wanted to do because of how you would look, or because the food would be out of your control, or because it would cost you a session. Holidays. Dinners. Weekends with people you like.
And the thing almost nobody says out loud: you are bigger than you were, measurably, and it has not touched the feeling at all.
What it actually costs, which is rarely the body
The body usually looks fine. Often better than fine, which is part of the trap.
What erodes is further in. Many men describe a shame that is not really about appearance but about masculinity itself, a sense that they do not quite measure up as men, and that the body is the evidence. So they do not approach the person they are attracted to, or they do and expect to be refused. They need a drink before they can be seen undressed. Desire goes quiet, or the body does not respond, and that gets taken as the final verdict rather than as a predictable consequence of under-eating and over-training.
Which is the cruel part. The discipline being used to feel more like a man is quietly removing the thing it was meant to prove.
It reverses
This is the part I most want men to hear, and it is not reassurance, it is what happens clinically.
Eat more. Train less. The body comes back, and so does the rest of it, the energy, the interest, the responsiveness. The fear is always that letting go of the control means losing everything that was built. In practice the opposite is nearer the truth: the control was costing more than it was producing.
When it arrives with something else
It rarely arrives alone. Alcohol is often doing work alongside it. So are steroids and the various compounds that circulate in gyms without much being said about them, and the mood effects of those are frequently the reason someone finally seeks help, without the connection being made.
Depression sits underneath it often enough that I now assume it until shown otherwise. Addiction is one of this practice’s core specialisms, so where that is part of the picture it can be worked with here rather than referred on.
The eating disorder men present with
Eating disorders in men are systematically under-recognised. Muscle dysmorphia requires the same clinical attention, and the same compassionate, non-shaming approach, as any other eating disorder.
Anorexia inverted
In twenty-five years of practice focused on eating disorders, I have seen genuine male anorexia only rarely. What I see constantly is muscle dysmorphia. And it is the same mind as anorexia: the same fear of fat, the same pursuit of a “pure” body in which only lean muscle may show. Anorexia wants to disappear; muscle dysmorphia wants to gain mass and harden, but the mechanism is identical.
The gym, or the church of self-hatred
Thirty years ago the gym did not exist as it does now: you trained as a complement to a real sport, for football or karate. The gym has become an end in itself, and often a kind of church of self-hatred. You do not see the joy of play there: people watch themselves in the mirror, and a face falls when someone more sculpted walks in. The body is built for the gaze and judgement of other men, in a comparison between men, far more than for the preference of women, who most often lean toward a lean body rather than an enormous mass.
A powerful body as a bid for power
There is something here of the energy I call the Kronos energy, the devouring father-energy I describe in my work on the father-son bond: a powerful, heavily-muscled body is a way of making power visible. And this bid for power takes different forms in different milieus: strength and the body here, knowledge and education there, network, relationships and financial mastery elsewhere. It is the same energy, simply seeking whatever currency of power is within reach. Read this way, muscle dysmorphia is not vanity: it is a bid for power in the only currency available.
For the male-specific picture, see bigorexia at Men Who Heal, Dr Jacquet’s practice dedicated to men’s eating disorders.
The cultural side of this, the cult of youth and the industries behind it, is the subject of Dr Jacquet’s essay The Church of Self-Hatred.
The experience behind the training, the counting and the silence is described in The Jail of Discipline.
Getting help with it
The first step is an assessment, a real clinical session rather than an introductory chat. We work out what is actually driving it, and whether anything needs medical attention alongside the therapy.
Book a consultation with Dr Philippe Jacquet, psychotherapist and Jungian analyst, London and online. See also eating disorder therapy in London and why men do not seek help.