Men Have Body Dysmorphia Too? - The less understood side of body image issues

HOW MEN EXPERIENCE BODY DYSMORPHIA DIFFERENTLY, WHAT MUSCLE DYSMORPHIA IS, AND WHY WE NEED TO TALK ABOUT IT.

That’s right. Body dysmorphia isn’t just women’s problem.

Sure, but a much smaller percentage of men experience this, right? Nope. In fact, the portion of men with body dysmorphia is almost the same as that of women.

So why isn’t male BDD (Body Dysmorphic Disorder) just as well-known?

Two primary factors: 1) men are less likely to see a therapist or share their mental and emotional struggles, and 2) the current standard psychiatric approach to BDD isn’t well-suited to detect the male experience of the condition.

That’s because men and women experience body dysmorphia slightly differently. While there is much overlap between the male and female experience (e.g. acne, dissatisfaction with facial features, etc.), female BDD is generally primarily concerned with weight loss and symptoms of anorexia. This has been more widely studied, and the standard diagnosis process has been optimized to spot it.

Male BDD, however, is generally concerned with body build, hair loss, genital size, and musculature. Anorexia isn’t as much of an issue, as many men are rather striving to gain weight. The diagnostic questions would be different to spot this, and so male BDD often falls through the cracks.

One of the most common types of male body dysmorphia is muscle dysmorphia, something I’ve rarely heard anyone talk about.

Muscle dysmorphia

If you're a guy, you've probably felt insecure about your looks at some point. Who hasn't stood shirtless in the mirror, wishing for a bit more muscle? But what if that wish warped into an obsession that took over your life?

That's the harsh reality for many men suffering from muscle dysmorphia. These guys dedicate endless hours to lifting, dieting and sculpting their bodies. But when they look in the mirror, they still see failure staring back.

I'm not talking about your average gym bros. These men, no matter how ripped or jacked they get, feel scrawny and weak. And if they buy into the redpilled manosphere, they would see their inferior physique as a sign they are beta males.

Their self-worth is trapped in a mirror.

Don't dismiss this as just vanity. The nonstop pursuit of an unattainable body drives men to depression, steroids, injury, even suicide. And the worst part? Most guys suffering feel totally alone.

Tormented by feelings of disgust, ugliness, and shame, these men would be preoccupied with their perceived defect, try to hide it with clothing or hair, and even avoid social activities. They may stop working, skip school, or even try to self-medicate. Consumed by feelings of inadequacy, they are often driven to spend excessive time weightlifting, sometimes to the point of over-training or injury.

Guys with muscle dysmorphia not only have higher social anxiety, but also more repetitive body-checking behavior.

They keep to highly restrictive diets, prioritize protein supplementation, and often turn to anabolic steroids - all in hopes of boosting muscle mass.

A study actually found correlations between muscle dysmorphia, high emotional dependence (addiction to a romantic partner), exercise addiction, and insecure attachment styles.

Crazy right?

It is theorized that insecure attachment styles partially give rise to muscle/body dysmorphia and emotional dependence. In fact, it explains 20-30% of the association between exercise addiction and emotional dependence. Insecure attachment leads to emotional regulation difficulties, and compulsive exercise is often used as a coping strategy. Plus, a high percentage of people with BDD grew up with hyper-critical or neglectful parents.

Then there are drugs.

Men are more likely than women to fall into substance abuse—steroids in this case. One study indicated a connection between men with severe muscle dysmorphia and those who are physiologically dependent on anabolic steroids.

These men tend to be preoccupied with size, symmetry, and body concealment.

Of course, excessive use of steroids brings a host of negative side effects: Heart problems, liver damage, mood swings, and aggression, to name a few.

But weaning people off of steroids, just like with any other drug, isn’t easy. Many struggle with depression, anxiety and sexual dysfunction for months due to withdrawal.

We need to be more comfortable with addressing male body dysmorphia.

Underlying muscle dysmorphia lies profound distress, insecurity, and shame. On top of the factor of insecure attachment, there is the tendency to view masculinity as inherently tied to muscularity. A major factor in this is social media and the popular content from fitness models.

Consumed with their insecurities, men with muscle dysmorphia will especially struggle with social and romantic relationships, leaving many of them in loneliness that may only reinforce their neuroticism.

Psychiatrists must work on updating their diagnostic models to better spot, understand, and treat this male version of body dysmorphia (and some are working hard to do so). Cognitive behavioral therapy seems to be quite effective in reframing a person’s self-perception. With help, men with body dysmorphia can silence the voice constantly trashing them in the mirror, find support groups, and unpack where this body hatred came from.

There is hope for living a fulfilling life not ruled by the mirror.

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Stay purposeful.

– Nathanael

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