Expert Q&A: What is Muscle Dysmorphia

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What is muscle dysmorphia (MD)?

Andrew: MD is a disorder that is strikingly similar to eating disorders – but in reverse. So instead of never feeling thin enough, an individual suffering from MD perceives that he/she is never muscular enough. Some individuals are small, but others are huge and yet still act as if they are small. An individual suffering from MD would also have issues similar to eating disorders such as low self-esteem, guilt and shame.

On one hand, it can be challenging to know if someone has MD or not. There are many individuals who consistently train hard, follow a strict diet, have an impressive physique and yet can be totally healthy, have a meaningful life and lots of quality relationships.

 With muscle dysmorphia, things are taken to an extreme that can harm every aspect of one’s life.

One of the world’s leading experts on MD, Dr. Stuart Murray defined Muscle Dysmorphia as:

A pervasive sense of shame that you are not big enough and a significant impairment to the rest of your life, where you miss out on all the things you’d like to do because you can’t not train. ( interview, Sept, 2011)

What are some signs/symptoms that myself or a friend struggles with muscle dysmorphia?

Andrew: As mentioned before, the signs/symptoms may be strikingly similar to eating disorders and can include:

  • Excessive-compulsive exercising
  • Withdrawal from normal aspects of society and things that could in any way interfere with training or nutrition
  • Withdrawal from friends, family and loved ones
  • Wearing baggy clothing to hide one’s physique
  • Total preoccupation with building muscle
  • Extreme-compulsive diet regime – all the time
  • Complaining about “weak points” when having a great physique

What are some harmful effects of muscle dysmorphia?

Andrew: It depends on how the disorder plays itself out. Possible effects are:

  • Overuse injuries, nagging aches and pains
  • Illness
  • Injuries: disc herniation, sprains, strains, torn muscles, etc.
  • Malnutrition: individuals suffering from MD may follow ultra-strict diets to get super lean – thus showing off their muscles. This can lead to deficiencies of essential nutrients and cause various health problems. If an individual is trying to do the opposite (i.e. bulk up) there could be the opposite problem: tooth decay, high blood pressure, high blood lipids, and diabetes due to eating excessive amounts of high-sugar foods in order to gain weight.

The sad thing is that all of these things actually hinder your ability to build muscle.

While not everyone who uses steroids has MD, steroid use among those who suffer MD is very common. Steroid side-effects are controversial (i.e. some people believe they are not as bad as others make them out to be). However possible side-effects include:

  • High blood pressure
  • High cholesterol
  • Low natural testosterone levels
  • Testicle shrinkage
  • Reverse sexual characteristics
  • Liver damage
  • Accelerated aging
  • Acne
  • Baldness
  • Infection and disease risk (especially if injecting)
  • Addiction

What final words do you have for someone who is going through this?

Andrew: Because of the similarities between MD and eating disorders, I believe one could get a lot of help from the information you already have on Libero Network. I also believe the process of recovery for MD is very similar to ED. You need to start with the spiritual and psychological issues first. This often involves a trained therapist/counselor and supportive group of friends and family.

After dealing with this, having people who will regularly check up on you (in a good way) and who will hold you accountable can also be helpful.

When getting back into training, you may way to start slow and set limits on how many days per week you will train. Also, give yourself a time deadline (e.g. 1 hr) and leave the gym after that whether you are done or not. As with eating disorders, it may be best to switch your focus of training to health and performance and not use body weight, body fat % and girth measurements as evaluative tools of training progress.

At the end of your life when you are lying on your death bed, you will care about how you treated people and the impact you had on this world.

Remember: You are more than your muscles. Your self-worth is not based on your body.

Andrew Heming, MS, CSCS, NSCA-CPT

Andrew Heming works at Trinity Western University as an assistant professor and a strength and conditioning coach and performance nutrition consultant for Trinity Western’s Spartan Athletics. Andrew has a Master’s degree in Exercise Science and certifications in strength and conditioning, personal training and performance nutrition.

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