A sufferer of muscle dysmorphia will never be satisfied with their muscularity, no matter how large their muscles become. This is primarily due to misperceptions they have about their body image. They look at their huge frame and rippling muscles in the mirror with shame, analysing themselves and finding flaws. To anyone else they have an Adonis physique, but to themselves they are unattractive, disproportionate and ugly.
The Body Dysmorphic Foundation say the condition, also known as bigorexia, is present in one in ten male gym goers.
There are levels to muscle dysmorphia, with people experiencing it to differing degrees. At its worst, the condition breaks down daily life, destroys careers and relationships, and breeds dangerous uses of performance enhancing drugs which can result in severe health conditions.
However, this is only in rare cases. The majority of sufferers manage to live a life which doesn’t reveal their crippling body image worries.
The worries often manifest themselves as a result of anxiety. James from Virginia, who identifies as having dysmorphia, says: “it’s not actually the body image that’s bothering you, it’s just what you are assigning and it’s something that you do something about.”
James is six foot and, after 10 years of weightlifting, he weighs 205 pounds. His muscularity soars above the average man, with his chest measuring 42 inches, and huge 19 inch arms swinging by his side. In contrast, his waist tapers to just 35 inches. Even by the highest standards, James has an Adonis like physique.
And yet, James is unhappy with his body image.
“I always feel that I’m always too fat or too small” he says.
“I refer to the kind of situation that I have as body blindness. When I’m looking at a picture of myself, or when I’m looking in a mirror, it’s really difficult for me to actually see anything. I see the flaws very easily, but it’s very hard for me to see the good stuff.”
Behaviours vary between cases, and although many men won’t experience muscle dysmorphia to the extent that James does, they may unknowingly experience the same detrimental behaviours.
James has had body image concerns his whole life, but it wasn’t until he joined the army that he started working out.
“I’ve been worrying about my appearance my whole life. When I was a kid I was a tiny frail little guy which lasted all the way up through college, and even in university I remember wanting to be that guy, thinking one day I’m going to be the big guy that takes his shirt off at the beach and everyone oohs and ahhs.
“I was in the army and all the guys around me were big and in good shape. I was this pasty guy, I was kind of always thin and unfit and I decided I wanted to change it.
“It took me about six months for me to really notice any changes in my body. The first time I ever saw a change that’s what hooked me, and I said okay, I’m going to be doing this for the rest of my life.”
As a result of James’ mentality, he compulsively works out five to six days a week for several hours at a time, either at a gym, or at his house where he has extensive weight lifting equipment.
His reason for working out at home is that, when surrounded by fellow weight lifters, James is always comparing himself to them.
“In my head there’s sort of a ranking system. It’s great to a certain point, I’m sitting next to the guy, and I can see in a mirror that I’m clearly bigger than him, and I’m like awesome I’m bigger than that dude, but then he’ll get up and I’m like his waist is so trim. Then there’s the guy on the other side and I’m thinking this guy’s arms are the size of my torso, I’ll never look like that.
“Every person I see in the gym I’ll put in this ranking scale where I never fall anywhere near the top.”
Muscle dysmorphia, and extreme dedication to bodybuilding, often affects social life, and this is no different for James.
“I don’t really go to parties very often anymore. We’ve got a lot of friends who like to party, but I don’t really like going because when I go I can’t drink, because that’s empty calories and I’m not putting that in me.
“I can’t eat because they have cakes, and they’re going to want to stand around and talk, and I think why am I standing here talking? I need to get eight hours of sleep because if I don’t get eight hours of sleep I’m not going to grow.”
By exhibiting these behaviours, James is able to maximise muscle growth and place himself in an elite group in terms of his health. However, he is one of a few, admitting that: “It has become more difficult for me to relate to other people.”
“When I do go to a party and I very rarely run into someone who’s bigger than me, I don’t really want to talk to that guy, because what if he doesn’t work as hard as me, why does he get to be that big, that makes me feel bad about myself.”
Sufferers will go to extreme measures to hide the aspects of their body that they are ashamed of. The beach, locker rooms, and swimming pools are all avoided. This is worryingly common for lots of people, however, those with muscle dysmorphia often have a body most people would relish the opportunity to show off.
As with most people, bodybuilders want to highlight the best aspects of their appearance through their choice of clothes. With muscle dysmorphia however, this is taken to an extreme.
James said: “I know a lot of guys who have this problem will wear thick clothing to make their appearance bulkier.
“What I tend to do instead is that I will wear clothes that are tight across the top half, but loose across the bottom half. It will exaggerate my size because threads are clinging on for dear life because the shirt’s way too tight, but then it gets down to the bottom it loosens way up before it hits my mid-section, so you can’t see that I don’t have a perfect waist.”
Working out to the extent of which muscle dysmorphia sufferers feel compelled to, requires a large dedication of time and energy. This takes time away from aspects of life others prioritise. Careers, relationships and friendships are thrown aside for a pair of dumbbells.
With the fitness industry booming, some can get round the compulsion to be in a gym by coaching.
James was able to supplement a medical career without eating into company time by training for others.
“I’m not the kind of guy who’ll avoid work to work out, I do know those guys and I’ve seen those guys who’ve lost their jobs because they just had to get in an extra leg day, that’s not me. I’m not at that stage, and I hope I’ll never get to that stage.”
However, James hasn’t been able to fully balance life with the hours he spends in the gym. With four children from toddler to teenager, his family commitments weigh heavy.
“It definitely takes time away from them,” he admits, “I try to make that time up elsewhere, and my wife is not afraid to tell me that I need to cool it a little and spend more time with the family.”
Weight training for hours a day puts incredible strain on the body. Muscles won’t grow for advanced bodybuilders without intense stimulation and stress. Despite following best practices and form, injuries can occur, which for muscle dysmorphia sufferers, can be catastrophic.
James says: “I have several injuries right now that I’m training through, nothing devastating, and if I had a devastating injury I would like to think that I would not try to train through it.”
However, many who do critically injure themselves grit their teeth and work through it, only making it worse.
James’ AC (articular cartilage), located at the top of the shoulder, is in danger of significant damage. Despite this, he says: “I’m not going to stop lifting because of it, I’m going to take it easy, train around it and of course I’ve read tons of material on bodybuilders training around these sort of injuries.”
James relies on his family to a great extent, helping him to control his behaviours if they become too extreme and detrimental to daily life.
“I discussed it with my family and said, I’m pretty sure this is muscular dysmorphia and I need you guys to be aware that there’s some behaviours that if you see me exhibiting you should call me on them.
“My family are an amazing support network. When I come home and I feel trashy and decide I’m going to eat a bag of marshmallows, my wife will not allow me to because she’ll say you’ll feel terrible about it tomorrow.”
James is careful not to overspend in his pursuit of the perfect body. He only uses basic supplements, which for lots of athletes, are a huge financial drain.
“It’s not to the point where I’m spending tons and tons of money on it,” he says, “I’ve seen friends of mine go broke doing that, but my wife does watch, she’ll watch the statement. If she says you have three active gym memberships right now you need to cut down, then I will.”
Age will undoubtedly catch up with James, but he is fully aware.
“I decided three months ago that I’m nearly 40 and it’s going to get harder and harder to actually gain size, so I’m thinking that I’m going to get as big as I can one last time.
“I’m going to keep lifting, probably not as intensely as I am now, but I’m going to try. I used to train a guy in his late seventies, and if I’m still able and I’m still alive and I can still do it, I’m going to be working out.”
James sees the condition he is suffering from get little attention. He remarks that this particular form of dysmorphia is always associated with well known bodybuilders such as Jay Cutler, Arnold Schwarzenegger and Kai Greene’s, instead of men leading normal lives.
“You don’t ever think there’s a relatively healthy looking 215lb guy who also, every time he goes to the gym, looks at other guys thinking this sucks, I’ll never look like that I hate myself. Normal looking guys can also be affected by this.”