Bigorexia…When Is Being Big, Big Enough?

By: Danielle Roberts
Date: May 2016

Bigorexia is the fairly new term for Body Muscle Dysmorphia, which is a disorder that causes a person to constantly obsess about how much muscle they have (and worrying that it is too little), and feeling too ”small”, or underweight. In most cases the person is in fact quite muscular, yet believes their muscles to be inadequate. Similar to Obsessive Compulsive Disorder (OCD), they constantly obsess about their imperfections, and similar to Anorexia in that they distort their self-image.
Bigorexia can therefore definitely affect one’s moods and emotions, causing depression and feelings of inadequacy. Men usually fall prey to Bigorexia with an estimated 10% of gym-obsessed men! They are usually the ones lifting very heavy weights, taking high protein products and often illegal substances to “get bigger”, and entering body building competitions.
Signs of Bigorexia to look out for
• Distorted self-image
• Missing social events or skipping work to exercise
• Never being satisfied with their muscle size, despite having large muscles
• Pushing weights despite injury
• Maintaining extreme workout programmes
• Following a strict high protein, very low fat diet
• Using excessive amounts of high protein powders
• Steroid abuse
• Unnecessary plastic surgery (e.g. Calf muscle implants)
• Suicide attempts

WHAT ARE THE RISKS?
The main consequence of Bigorexia is that it impedes a normal happy life. Those affected cannot relax and enjoy life as they are constantly worried and obsessing about their next gym workout, what they need to eat and how to get bigger. Having fun and being spontaneous can never be a high priority.
Health Risks of Bigorexia
• Frequent injuries due to excessive exercise
• Damage to muscles, joints, and tendons
• Kidney damage
• Liver damage
• Heart problems

Many people with this problem resist getting treatment and are afraid to admit that they take steroids or performance enhancing drugs. Some admit that they are afraid that if they give up the drugs and exercise, they will wither away and become skinny. Getting an assessment by a dietician, doctor, or psychologist can help focus on problems caused by obsessive behaviours, job loss (due to negligence), relationship problems and physical harm.
WHAT DOES TREATMENT INVOLVE?
For those who start treatment, cognitive-behavioural therapy combined with medication is helpful, especially if depression is present. Cognitive behavioural therapy helps a patient to identify triggers that makes the bigorexia thought pattern worse, and aims to change behaviours which are harmful. It also aims to assist in setting more realistic and healthy goals. Nutrition education on portion control, correct intake of protein foods, and meal timing can help a person understand food and /or protein foods better, and how they work to build muscle in the body, without having to consume excessive amounts. A valid point of Nutrition education for such clients also involves the risks of taking unsafe supplements, and the overuse of certain supplements.
However, just like anorexia, it is never about the food, but the obsession with body image. Once that is corrected, then a healthy, balanced lifestyle may be resumed.

If you suspect yourself or someone else to suffer from Bigorexia, contact Danielle Roberts, a Registered Dietitian working at the Sharks Medical Centre (www.sharksmedical.co.za) who together with a team of other health professionals such as a sports physician and psychologist can assist in treating someone with Bigorexia. To find another dietitian in your area, visit this website: www.adsa.org.za