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Body Dysmorphia among Male Teenagers and Men: What to Know

Editorial Staff
Editorial Staff
The editorial staff of American Addiction Centers is made up of credentialed clinical reviewers with hands-on experience in or expert knowledge of addiction treatment.


Everyone has some kind of imagined bodily flaw. Hair might be too kinky, feet might be too wide, or eyes might be spaced too far apart.

For most people, this sort of thing is an annoyance. People might notice it, and they might even try to use makeup or styling products to cover up the issue, but it might not be the most important thing in the person’s life. Unless there is a mirror handy, people might not even notice the issue at all. That just isn’t true for people with body dysmorphia.

For people like this, there is one physical defect that is so huge and so overwhelming that it consumes the person’s thoughts, 24 hours per day, seven days per week. This disfigurement is often all the person can think about, and almost everything that person does concerns how to eliminate or deal with that defect.

The Anxiety and Depression Association of America suggests that about 1 percent of the population in the United States has this disorder, and it tends to impact women and men at equal rates. But men and adolescent boys who have body dysmorphic disorder (BDD) may have very different symptoms than their female counterparts might have. That means men with BDD may need specialized treatment plans that can address their very individualized needs.

Manifestations in Men

Body Dysmorphia in MalesBDD has been recognized as a mental illness by psychiatric professionals, but those professionals report that men and women who have BDD often have very different symptoms. In a review of research published in Depression and Anxiety, researchers report that men were more likely than women to be concerned with issues involving muscle, and they were less likely to work due to the distress the BDD caused within their lives.

Put another way, men with BDD often develop something called bigorexia. These men are fully focused on how many muscles they have, and how many muscles they see on the bodies around them. They may think of themselves as tiny, weak, or puny, even when they are able to pick up hundreds of pounds of weight. To them, their bodies will always be just a little bit too small.

Men like this may not be able to keep a steady job simply because they must spend so much time on the development and maintenance of muscles. They may need to spend hours and hours at the gym, lifting weights and working out, even when there are other demands upon their time.

In addition to this time component, the BDD Foundation suggests that men with bigorexia can:

  • Continue to train, even when injured
  • Use protein supplements or special diets to boost muscle mass
  • Abuse steroids or other supplements
  • Attempt to camouflage the body in order to look bigger
  • Spend a great deal of time measuring muscle mass or looking in the mirror

Men who are interested in bodybuilding and weightlifting may develop a few of these symptoms, too. For example, competitive body builders might use protein shakes to beef up before a competition, or men like this might devote a few moments of every morning to measurements of weight and size.

But men with BDD devote much more time than would be considered prudent by any reasonable adult. These are not men who might lift in the evenings and then go about business as usual. These are men who spend all day lifting and who get up in the middle of the night to cram in one more workout. The level of attention paid is excessive.

As the International OCD Foundation points out, the feelings associated with BDD can be intense and all-consuming. Men who are convinced that they are much too small can have negative self-talk from the moment they get up in the morning to the moment they head to bed at night. These are people torn apart by their concerns, and their attempts to correct the issue do not bring them joy.


How Men Try to Deal with BDD

As mentioned, men with BDD that focuses on muscles tend to spend a great deal of time in the gym. They do not enjoy their workouts. Where someone with a healthy sense of fitness might look forward to a morning jaunt on the treadmill or an evening session with the dumbbells, someone with bigorexia may hate each and every minute of the workout but might think of the exercise as necessary.

In addition to workouts, some men use dietary changes to assist with their BDD. According to the National Association of Anorexia Nervosa and Associated Disorders, at least 30 percent of people with BDD also have an eating disorder. Men with BDD may use laxatives or dietary restrictions to ensure that they do not develop pockets of fat, or they may become so discouraged at the lack of changes they see after a workout that they are driven to binge on comfort foods.

Many men who have BDD resort to surgery in an attempt to correct the flaws they see. A report in Psychology Today suggests that about 5 percent of people who ask for plastic surgery interventions have BDD.

Men with bigorexia may ask for:
  • Pectoral implants
  • Liposuction
  • Calf implants
  • Bariatric surgery
Any or all of these techniques could, in theory, reduce fat pockets and/or make the body appear much more muscular. Unfortunately, these surgeries do not get to the root of the mental illness that causes people to see their bodies in an unflattering light. That mental illness remains, even as the body heals from surgery. Those concerns can reappear just moments later.

According to an analysis by the BBC, less than 10 percent of people with BDD are happy with the results they get from plastic surgery. Some head back for yet more surgery, while some grow even more interested in diet and exercise interventions in the aftermath of a surgery.


How BDD Develops

Men who spend a great deal of time in gyms, modeling agencies, locker rooms, and other spots in which male attractiveness is both measured and remarked upon are at greater risk for BDD. The more time they are encouraged to spend with people who might judge them, the more likely it might be that they will begin to judge themselves.

There may also be a link between bigorexia and bullying, experts say, as men who have been victimized early in life may become convinced that added muscles will help them to fend off future attackers. Men who have been criticized for a small physique may similarly be interested in changing muscle mass, and since they do not address the trauma the bullying caused, they may always be at risk.

Finally, according to Mayo Clinic, some men with BDD develop the disorder through genetic influences. Having a biological relative with BDD can up the risk of developing BDD, although the specific genes involved in the disorder have not yet been identified.


Help for BDD

ocd and bddMen with BDD may use gyms, surgeons, diets, and self-help books in order to bulk up their muscles and correct the “defect” they are certain is both present and powerful. But there are much more effective ways to deal with this disorder.

BDD is, according to some clinicians, part of obsessive-compulsive disorder (OCD). People with OCD also struggle with intrusive and untrue thoughts that stick in their minds for days, weeks, or months. People with OCD may feel as though taking action on those thoughts is the only way to make the thoughts stop. It’s easy to see how an obsession with muscles, translating to hours in the gym, could be considered part of an OCD lifestyle.

Medications made for OCD could be helpful for some men with BDD. The medications could soothe chemical imbalances that cause thoughts to stick, and that could allow a man to break his connection with the gym, so he can focus on other parts of his life.

Therapy is another effective component of treatment for men with BDD. Men are typically asked to identify and examine the trauma that stands at the beginning of the behavior, be that an assault, teasing, or something else altogether. In therapy, people can come to terms with that trauma, so they do not feel compelled to change their bodies in order to address something that happened long ago.
In therapy, too, men with BDD can learn how to handle an urge to check, change, or abuse the body. When they feel the need to bulk up or exercise, they might be encouraged to identify what emotion or memory triggered that urge. They might use meditation, art, or massage in order to soothe the distress that thought causes. In that way, they might be able to skip the workout and still feel good about the self.

There is no question that BDD can cause men, both young and old, a great deal of pain and distress. But it is also clear that men with this condition can get the help they need so they can forget about bulking up and focus on self-acceptance. With therapy, that healing can come.

Last Updated on February 25, 2022
Editorial Staff
Editorial Staff
The editorial staff of American Addiction Centers is made up of credentialed clinical reviewers with hands-on experience in or expert knowledge of addiction treatment.
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