Gym, eat, repeat: the shocking rise of muscle dysmorphia

Author: Sirin Kale

The idealised male body has become bigger, bulkier and harder to achieve. So what drives a generation of young men to the all-consuming, often dangerous pursuit of perfection?

It is difficult for Miles to pinpoint the moment his muscle dysmorphia started. It was just always there, a background hum. “As far back as I can remember, I wanted a better-looking body,” says the 35-year-old US soldier, now stationed in Mons, Belgium. When he was 13, Miles spent a summer cutting grass to save up for a secondhand Soloflex exercise machine. The machine cost $1,000 (£800), but as Miles was too young to join a gym, it was worth the expense. With the help of the Soloflex, Miles started weight training and never looked back.

When he returned from a posting to Afghanistan at 24, things spiralled. He began obsessively working out and regimenting his meals. “I went all in ... it was full, hardcore dedication to the lifestyle.” Miles set his watch to beep every three hours, to remind him to eat. If it beeped when he was driving, he would pull over. Slowly, he whittled his body into shape. His muscles became striated, every fibre visible. Not big enough. At 95kg (210lbs) and 1.8 metres (6ft 2in), Miles wanted to be more muscular; leaner. He lost 22kg and started competing in amateur bodybuilding competitions. There was virtually no fat on him. “You pinch your skin and it just stays pinched.” His girlfriend left him. “She began to realise that my body dysmorphia was like dating another person.” The pursuit of muscularity took over his life. “I just thought, I am so lean, and shredded, and veiny, and masculine – I don’t ever want to go back to how I was before.”

Yet by 33, single again – the dysmorphia had claimed yet another relationship – it had all become too much and he was in a dark place. “I did not enjoy life in any way, shape or form.” All day long, he would starve himself, struggle through punishing workouts, go home and binge-eat before throwing it all up. One evening, waiting in line at the burger chain In-N-Out for more food to purge, Miles finally decided enough was enough. “I woke up so happy the next day, knowing it was over.”

A subset of body dysmorphic disorder, individuals with muscle dysmorphia feel they need to become bigger or more muscular, regardless of their size. Sometimes referred to as “bigorexia”, it typically affects men. About 30% of people with muscle dysmorphia will also have a medically diagnosable eating disorder – although as you need to be in calorie deficit to be diagnosed with an eating disorder, many men with the condition won’t meet the clinical threshold, despite following extremely restrictive diets. Because men with muscle dysmorphia rarely seek treatment, estimating its prevalence in the general population is hard, but it is believed that about 10-12% of professional male weightlifters meet the criteria.
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And muscle dysmorphia may be on the rise. A study published in June found that 22% of men aged 18-24 reported muscularity-oriented disordered eating. “The drive for a bigger, more muscular body is becoming very prevalent,” says the lead researcher Dr Jason Nagata of the University of California, San Francisco. Not everyone who benches 180kg has muscle dysmorphia. It is when working out takes over your life, occluding all else – work, family, friends – that you have a problem. “Their entire day is spent at the gym trying to bulk up,” says Nagata. “They may also be taking illicit supplements like steroids.”

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