What Is Muscle Dysmorphia?

Medically Reviewed by Smitha Bhandari, MD on February 23, 2024
4 min read

Muscle dysmorphia (MD) is a psychopathological condition — which means that it affects your thoughts and behaviors in problematic ways. People with muscle dysmorphia are obsessively concerned with their muscularity and leanness. 

People with muscle dysmorphia usually believe that their bodies are small and weak — even though many of these people are in very good shape with well-developed muscles. This means that if you have this condition, it’s likely that the idea of your body in your head and the reality of your body — specifically in terms of your muscles — don’t match. 

Muscle dysmorphia is one of a larger category of conditions that are called body dysmorphic disorders (BDD)

All kinds of body dysmorphic disorders involve this mismatch between body image and reality and a compulsion to create an “ideal” body by fixing this supposed flaw. The main difference is that BDDs can include harmful and negative thoughts about all parts of your body — including your hair, skin, nose, and weight — not just your muscles.

All BDDs — including muscle dysmorphia — are a type of obsessive-compulsive disorder (OCD). In these cases, the obsessive thoughts and behaviors are all focused on your body image. 

Muscle dysmorphia affects men more often than women. It’s common among athletes. Sports where weight and strength matter — like football, wrestling, and bodybuilding — have the most cases of MD.  

Cases of muscle dysmorphia are increasing. Approximately 100,000 people worldwide meet the psychological criteria for muscle dysmorphia. But most experts agree that we are currently underestimating the number of cases because it’s difficult to diagnose. 

There isn’t a definite cause for body dysmorphia in general and muscle dysmorphia in particular. But there are a number of situations that are associated with people who develop the condition, including:

  • Bullying or teasing early in life
  • Low self-esteem
  • Feeling lonely and isolated from others
  • Being surrounded by unrealistic body image ideas in society and the media

There could also be underlying biological reasons for why some people develop muscle dysmorphia and others don’t. We need more research in order to determine these exact causes.  

Muscle dysmorphia symptoms typically start to appear in the late teens — but can also start later in life. 

It’s difficult to tell that someone has muscle dysmorphia by looking at their body, because people with the condition are often in very good shape. Instead, the symptoms that are the most obvious are behavioral changes.

The exact symptoms of MD will be different from person to person. In general, symptoms include: 

  • Repeatedly studying yourself in the mirror to judge your body for negative attributes or to attempt to evaluate your physical prowess
  • Avoiding mirrors because you have already decided on a negative body image
  • Sticking firmly to a strict and excessive exercise routine
  • A willingness to continue exercising even when you’re injured and in pain
  • Maintaining a very strict diet
  • A willingness to sacrifice important events in order to maintain your diet and exercise routine
  • Taking too many dietary supplements — often more than the recommended amount
  • Using steroids — often taking more than the recommended amount
  • Depression
  • Anxiety
  • Extreme social anxiety — particularly among bodybuilders

In a few cases, people with body dysmorphic disorders may be so convinced that they’ll never reach their idea of a “perfect” body that they become suicidal. If you or anyone you know experiences this symptom it’s important to immediately get medical help — either by calling 911, contacting your doctor, or calling the suicide hotline.    

Treatments for muscle dysmorphia mostly include psychotherapy and education. The problem is getting people with muscle dysmorphia to recognize that they need this kind of treatment.

In many cases, people with muscle dysmorphia won’t or can’t admit that they have a problem. People will often refuse all suggestions that they get help for their mental health. Many people will want to try plastic surgery instead. 

Sometimes people with MD may become defensive and angry when confronted. They may even withdraw entirely from the friends or family members who try to point out a possible issue. 

The best way to help someone you suspect of having any type of body dysmorphic disorder is to keep their best interests at heart and to talk to them about it in a non-confrontational way.

With therapy, they can learn about: 

  • The dangers of over-exercising
  • Proper nutrition
  • What counts as a healthy body image
  • The dangers that steroids pose to mental and physical health

In particular, cognitive behavioral therapy tends to help people with muscle dysmorphia. This type of therapy teaches you to recognize compulsive behaviors and turn them into healthier habits. It also teaches you to recognize when you’re having negative thoughts about yourself and change these unhelpful thought patterns.   

There are also support groups to help people with muscle dysmorphia and other types of body dysmorphic disorders.