Muscle dysmorphia

Muscle dysmorphia is a disorder in which a person becomes obsessed with the idea that he or she is not muscular enough. Those who suffer from muscle dysmorphia tend to hold delusions that they are "skinny" or "too small" but are often above average in musculature. Sometimes referred to as bigorexia or reverse anorexia nervosa, it is a very specific type of body dysmorphic disorder.

Muscle dysmorphia can cause people to:

• Constantly examine themselves in a mirror
• Hate their reflection
• Become distressed if they miss a workout session or one of six meals a day
• Become distressed if they do not receive enough protein per day in their diet
• Take potentially dangerous anabolic steroids
• Neglect jobs, relationships, or family because of excessive exercising
• Have delusions of being underweight or below average in musculature.
• In extreme cases, inject appendages with fluid (e.g. synthol) to simulate cartoonish muscular proportions.

To be diagnosed as muscle dysmorphic, the person must exhibit symptoms of the type and degree outlined in the Diagnostic and Statistical Manual for body dysmorphic disorder, and not merely appear over-interested in physique or engage in behaviors other people would find unwise. Muscle dysmorphia is fairly rare and simple obsession with working out. Bodybuilding does not fit the criteria of a body dysmorphic disorder.

In his 2000 book The Adonis Complex, the Harvard psychiatrist Harrison "Skip" Pope Jr. argues that muscle dysmorphia is fueled by the portrayal of overly fit characters of unattainable musculature in children's cartoons, such as G.I. Joe.

Muscle dysmorphia is most common in males and often starts in the late teens. Olivardia and others found in a 2000 study that the average onset age was 19.4 years. It most often occurs in those who are already considered by others to be muscular and is often accompanied by depression.