What Is Bigorexia? The Hidden Struggle Behind Muscle Dysmorphia

“I just want to be ripped.”

It’s a phrase that’s become so common in gym culture, we hardly notice anymore. But what if that desire for muscle wasn’t just about strength or aesthetics? What if it masked deeper distress?

Today, we know that body image concerns aren’t limited to girls or women. They’re starting younger, showing up more often in boys, and manifesting in different, sometimes hard-to-spot ways. And as our understanding of eating disorders evolves, so do the terms we use to describe them, including bigorexia and muscle dysmorphia.

The Evolution of Eating Disorders: More Than Meets the Eye

In 2007, The Guardian ran a chilling headline about an eight-year-old that almost died from anorexia. It detailed stories of children, some barely in grade school, who had already internalized beliefs about weight, control, and self-worth [1]. Back then, eating disorders were still largely seen as problems that affected rich, white, teenage girls. The reality was always more complex.

Then, years later, another story in 2013. An NPR report spotlighted how boys with eating disorders often go undiagnosed because their symptoms don’t align with traditional criteria. Instead of striving for thinness, many boys fixate on muscle gain or body composition. More males were being diagnosed with eating disorders as their symptoms became recognized – but treatment models hadn’t caught up, eating disorder facilities did not (and do not) always accept males into their programs, and those that did were not equipped to provide adequate and individualized care. Programs were designed to treat desired thinness. To feed their patients, and send them home.[2]

Fast forward to 2024, and the American Psychological Association confirmed what many clinicians have long suspected: boys and men often exhibit different, more subtle symptoms, making their disorders harder to spot and even easier to dismiss [3].

 

Enter Bigorexia: The Obsession with Size and Strength

Bigorexia (short for bigorexia nervosa) is the colloquial name for muscle dysmorphia: a subtype of body dysmorphic disorder (BDD) where individuals become fixated on the belief that they are not muscular or lean enough, regardless of their actual physique.

For some, it’s called “reverse anorexia.”

The symptoms often include:

• Compulsive weightlifting or training, sometimes for hours a day
• Rigid, high-protein eating routines
• Supplement or steroid abuse
• Mirror checking or body comparisons
• Anxiety or depression tied to perceived body flaws
• Social withdrawal, especially if a workout is missed

Although not officially recognized in the DSM-5 as a standalone condition, muscle dysmorphia is categorized under BDD and is taken seriously by clinicians due to its significant overlap with eating disorders and obsessive-compulsive symptoms [4][5].

 

Who’s at Risk? It Might Surprise You

We now know that eating disorders affect people of all genders and backgrounds, but some groups are more vulnerable than others. Statistics show that:

• Up to 25% of people with anorexia nervosa are male.
• Approximately one-third of people with binge eating disorder are men.
• 15% of gay or bisexual men report struggling with an eating disorder.
• 5% of heterosexual men report the same [6].
• A 2022 study found that 22% of adolescent boys report engaging in muscle-enhancing behaviors like changing their diet or taking supplements [7].
• In a 2021 Canadian study, over 17% of adolescent boys reported being dissatisfied with their muscularity and attempting to change their body shape [8].

Gay and bisexual men often face additional pressures around appearance within certain social circles, and the ideal male body type in media and LGBTQ+ spaces often emphasizes extreme muscularity. But it’s crucial to clarify: muscle dysmorphia affects all genders, and bigorexia is not limited to gay men or even men in general.

Teen athletes and fitness influencers, and trans and nonbinary individuals seeking alignment with body goals may struggle with this condition, often in silence. An article published this September 2025 by TIME highlighted that toned arms are now being viewed as a new “status symbol” among women. The piece highlights how a new wave of weightlifting culture is redefining beauty standards, and how some women are feeling the pressure to chase this image, even at the expense of their health [9].

 

It’s Not Just About Appearance. It’s Mental Health.

These articles are a consistent reminder that these disorders aren’t rooted in vanity or narcissism. They are complex mental health conditions driven by cultural ideals, personal struggles, and systemic pressures. And they deserve care, compassion, and professional support. From the outside, bigorexia may look like “discipline” or “healthy goals.” But inside, it can be a storm of anxiety, perfectionism, and shame. Someone may seem confident but is quietly skipping meals, obsessing over macros, or isolating themselves because they missed a workout.

According to Eating Disorder Hope, people with muscle dysmorphia often report poor self-esteem, depression, social anxiety, and even suicidal ideation [4]. Steroid use, which is common in this population, adds risk for heart disease, liver damage, and aggressive behavior.

This isn’t about “just wanting to look good.” This is about a disordered relationship with the body, food, and self-worth.

The Karuna Approach: Rebuilding Body Trust Through Lifestyle Medicine

At Karuna Wellness Studio, we understand that mental and physical health are deeply intertwined. Our client-centered, lifestyle-based care model supports healing from disorders like bigorexia by addressing nutrition, movement, stress, sleep, and social connection.

Here’s how the Karuna Pillars support recovery:

• Nutrition: Compassionate, non-restrictive counseling that prioritizes nourishment over macros or body goals.
• Movement: Joyful, supportive exercise routines led by trauma-informed trainers.
• Sleep: Support for restoring healthy sleep, often disrupted by overtraining.
• Stress Management: Tools for managing anxiety and perfectionism without body control.
• Social Connection: A supportive community to replace isolation and shame.
• Green Space Interaction: Reconnecting with nature to support mental clarity and body peace.

You don’t need to hit rock bottom to deserve help. You don’t need to “look sick” to be struggling. You just need someone to listen.

If you’re a parent, partner, or friend who’s concerned, or someone who sees yourself in this post: You’re not alone. Karuna is here to support you with warmth, expertise, and care.

Let’s rewrite the story about what strength really means.

 

References:

1. Guardian. (2007). Eight-year-old boys treated for anorexia. https://www.theguardian.com/society/2007/nov/18/health
2. NPR. (2013). Treatment for Boys with Eating Disorders Can Be Hard to Find. https://www.npr.org/sections/health-shots/2013/10/07/229164585/for-boys-with-eating-disorders-finding-treatment-can-be-hard
3. APA Monitor. (2024). Eating disorders in boys and men are different and harder to spot. https://www.apa.org/monitor/2024/10/eating-disorders-boys-men
4. Eating Disorder Hope. Muscle Dysmorphia Disorder: What Is it, Who Does it Affect, and How to Find Help. September 21, 2024. https://www.eatingdisorderhope.com/information/body-dysmorphia/muscle-dysmorphia-males
5. Nagata, Jason MD, MSc. National Eating Disorders Association. Muscle Dysmorphia. https://www.nationaleatingdisorders.org/muscle-dysmorphia/
6. National Eating Disorders Association. Men and Eating Disorders. https://www.nationaleatingdisorders.org/men-eating-disorders
7. Eisenberg, ME, et al. (2012). Muscle-Enhancing Behaviors Among US Adolescents and Young Adults. JAMA Pediatrics. https://publications.aap.org/pediatrics/article-abstract/130/6/1019/30280/Muscle-enhancing-Behaviors-Among-Adolescent-Girls
8. Baker, JH et al. (2020). Body Dissatisfaction in Adolescent Boys. Developmental Psychology. https://pmc.ncbi.nlm.nih.gov/articles/PMC6586497/
9. TIME. (2025). Toned Arms Are the New Status Symbol. https://time.com/7317409/toned-arms-women-weightlifting/