Nov. 7, 2001 -- Under the glare of fluorescent neon lights in a flashy Manhattan gym, Michael Dawson (not his real name) wriggles to complete one more military press. Dawson's personal trainer, Aaron Bonaventre, spots him from behind, extending his muscled arms to carefully remove the barbell from his weary client's grip.
"I hate this," Dawson sighs, with a nervous laugh. "But I have no choice if I want to build my body." Dawson, a magazine editor, confesses later that his main reason for working out is that he's unhappy with the way he looks. "My stomach comes out farther than my chest, and I can't stand my nose," he says. "I consider getting liposuction and plastic surgery, as well as taking steroids, on a daily basis. But I've decided to see how far I can get with a personal trainer first."
Many would be shocked that an otherwise healthy 30-something man like Dawson is so concerned with his body and appearance. After all, these concerns are typically associated with women, not men. But it's no surprise to Katherine A. Phillips, MD, associate professor of psychiatry at Harvard University and co-author of The Adonis Complex: The Secret Crisis of Male Body Obsession (Free Press). According to Phillips, while women are more likely to express unhappiness with their looks, "men suffer body-image problems in silence -- and some suffer tremendously."
Phillips and her co-authors, Harrison G. Pope Jr., MD, and Roberto Olivardia, PhD, coined the term "the Adonis Complex" to describe a wide spectrum of anxieties ranging from slightly excessive worries about physical appearance to potentially life-threatening, pathological obsessions. In their book, the authors assert that millions of men suffer serious body-image disorders, including eating disorders, and note that three million American men have abused steroids.
In one extreme form, men have such a distorted and negative view of their own appearance that they're frequently anxious or depressed, a condition psychiatrists call "body dysmorphic disorder." Other "Adonises" starve themselves of needed calories and nutrition or exercise compulsively, sacrificing relationships and career goals in the process.
While intense concerns about body image may seem more stereotypical of gay men, "it may not be more pronounced, just more announced," says Olivardia. In fact, the authors maintain, most men with body-image problems are straight. Olivardia also notes that if gay men tend to be more open about their problems, they may have an advantage over straight men because they'll be more willing to discuss them.
For instance, Dawson, who is gay, often talks to his close friends about his anxieties. Bonaventre, who is straight, says he rarely discusses it.
Bonaventre, a lean and muscular 28-year-old with Roman good looks, never used steroids, yet he has gone to drastic lengths to achieve his chiseled physique. He lifts weights nearly every day and used to diet so strictly that his body fat dipped below 2% of his weight. He now believes that he weakened his immune system, because he caught colds almost weekly. He also drank so many protein shakes that he suffered chronic diarrhea and may have injured his digestive system as well.
Yet whatever damage he inflicted on his health, no one could dispute that Bonaventre has indeed achieved the body of a fitness model. No one, that is, but himself.
"For hours every day, I'd worry about how skinny my calves looked," he says, glancing down at his legs as he speaks. "I was so embarrassed of them that I'd wear long pants no matter how hot a day it was." He would even wear long pants to the beach, slipping them off to reveal his bathing suit only when he was lying down on his back.
While it may be difficult to sympathize with the insecurities of a buffed 20-something with a washboard stomach, Olivardia says there is little correlation between actual looks and people's perceptions about their own features. "When I run counseling groups for men with body dysmorphic disorder, the guys usually think everyone in the group looks great -- except for them," says Olivardia.
Olivardia and other experts stress that there is nothing wrong with wanting to look good. Weightlifting and low-fat diets are generally healthy practices. Plastic surgery can be a reasonable solution for people looking to fix a particular cosmetic problem. "These practices are only pathological when men think that fixing their cosmetic problems will fix their entire life," says Olivardia. "Or when their pursuit of muscularity or physical perfection impairs their life, rather than improves it."
Why are so many young men now attaching so much of their self-worth to their bodies, much as many women have long done? Kevin Thompson, PhD, author of Exacting Beauty (American Psychological Association) and a professor of psychology at the University of South Florida in Tampa, puts the blame on media images directed at men over the last 15 years -- the magazine covers, the buffed male models in fashion ads. "The more a man endorses the media images he sees, the more dissatisfied he's likely to be with his body," says Thompson, based on a study he and his colleagues performed at Kenyon College in Ohio.
According to Thompson, once a man becomes fixated on his appearance, overall self-esteem is likely to suffer. Dawson concurs. "When I'd go out with friends and see how much flatter their stomachs were than mine or that their faces were more handsome, I'd become distraught about how much uglier I was than them," he says. "I'd come home from a party that should have been fun and feel devastated. Sometimes, I'd feel so defeated I couldn't get out of bed in the morning."
Recently, Dawson embarked on a combination of therapy and the antidepressant Prozac. To Phillips and her co-authors, such an approach makes sense for people with serious body-image disorders. In such cases, she recommends combining medication with cognitive behavior therapy -- in which people learn to identify and challenge their own obsessive thoughts and fears. Dawson, for one, feels his treatment is helping. "I still wish I looked better, but I don't get so upset about it."
But while medication and therapy may be necessary for extreme cases, most men with an "Adonis complex" can overcome it on their own, Phillips says. She suggests that men avoid measuring themselves against ideal body types and, instead, focus more on what they do like and value about themselves. "Men need to remind themselves that there are a lot more important things than their muscularity -- especially to their partners," she says.
For years, says Bonaventre, his concerns about his muscles made him feel insecure with his partner. "I worried she wouldn't like me as much once she saw my thin legs, that she'd realize I wasn't as good as she thought I was," he says. But the truth, as he discovered, was that his girlfriend was far more concerned about how her own body measured up.
"It made me realize that everyone has insecurities," says Bonaventre. "My girlfriend is beautiful and makes a sincere effort to let me know she likes how I look, too. Feeling bad about our bodies isn't worth the time or energy for either of us."