Bigorexia is a body dysmorphic disorder in which someone believes that no matter how much he or she works out, he or she will never be muscular enough. The technical term for bigorexia is “muscular dysmorphia,” reflecting the fact that the focus of people who suffer from this condition is the muscles, but people also call it “reverse anorexia” or “bigorexia” because the condition involves growing as large as possible, rather than trying to get as small as possible, as is the case with anorexia.
Most bigorexia patients are men, reflecting a male beauty standard which places a heavy emphasis on being well-muscled, although women can suffer from this condition as well. Like other body dysmorphic disorders, bigorexia stems from a fundamental disconnect between the patient's perception of the body, and the actual body. Hulking men with perfectly chiseled muscles may look in the mirror and see a weakling, and then upbraid themselves for not working harder.
One of the key symptoms of bigorexia is a persistent hard training program which focuses on weightlifting with the goal of building muscle. Patients will train through pain and injuries, neglect work and family obligations to train, and obsess about training when they are not at the gym. People with muscular dysmorphia also tend to be very controlling about their diets, as they want to build their bodies as quickly as possible, and they also want to eliminate body fat; the goal is a lean, very muscular body.
Constant mirror checking is also common in muscle dysmorphia, although paradoxically, many patients are very shy. Like anorexia patients, they view their bodies as imperfect, and therefore they do not want to expose themselves to the judgment of others. Some bigorexics also use drugs to encourage muscle development, and they may develop eating disorders such as bulimia in an attempt to control their diets. Many also skip meals with family and friends because they want to have total control over what they eat.
Treatment for bigorexia involves long term psychological care. Counseling is usually recommended, and sometimes psychiatric drugs may be used to manage depression, especially in the early stages of treatment. Support from friends and family members is also critical. The weightlifting community has been slow to recognize muscle dysmorphia, although a growing realization of the situation has led some gyms to create support groups and buddy systems to catch bigorexia in the early stages and to support people in recovery.