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Could it be that the Austrian women chose the less muscular build so as not to look shallow? Pope doesn't believe so. "They answered in privacy with complete anonymity," he says. "If anything, they could have answered with their fantasy wishes for a big, strong hulk. They didn't."

So why do men keep striving for bigger and bigger muscles, sometimes to the point of obsession? As with anorexia, Pope says, the media and advertising are to blame for muscle dysmorphia. He notes that over the last 30 years there has been steadily increasing pressure on men to be leaner and more muscular.

"The most masculine movie stars from 30 years ago, such as Gregory Peck or John Wayne, looked like wimps compared to modern action superheroes," Pope says. "Even [the toy] G.I. Joe has bulked up." While muscle dysmorphia may not be as life-threatening as starving, Pope says, its victims are likely to take other risks with their health, such as using steroids or other body-building drugs.

According to Pope, a man with muscle dysmorphia can be identified by the following features:

  • He is preoccupied with the idea that his body is not lean and muscular.
  • He spends long hours lifting weights and pays excessive attention to diet.
  • This preoccupation causes major distress or impairs his social or professional life. The man may forgo important social, work-related, or recreational activities. He may avoid situations where his body will be exposed.
  • He continues to work out or diet even when he knows it could hurt his well-being.
  • He is most concerned about being too small or not muscular enough, as opposed to being fat.

Pope, who has written a book about male body-image disorders called the Adonis Complex, says there's nothing abnormal about the great majority of men who work out in the gym. "The problem is, some men go over the edge and it becomes a compulsion which undermines their occupation and social lives," he says.

Charles I. Staley, MSS, vice president of program development for the International Sports Sciences Association and a formal Olympic weightlifting coach, says he's noticed the disorder not just in weightlifters but also among track and field athletes. "Body-building can be a way for people with low self-esteem to call attention to themselves," says Staley. "Their whole self-image gets caught up in their body."

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