When it comes to discussing and understanding different forms of disordered eating and body image issues, we’ve come a long way. Generally, our society has a better grasp on the complexities of eating disorders like anorexia, bulimia, and binge eating disorder (BED), and even lesser known conditions like avoidant/restrictive food intake disorder (ARFID) and other specified feeding or eating disorder (OSFED). But when it comes to newer conditions like bigorexia—a form of body dysmorphia that predominantly affects young men—there is still a lot to learn.

Bigorexia is a growing and concerning issue, and so it’s worth taking the time to understand it. Read on to learn what experts have to say about bigorexia and its causes, as well as new research from Equip that reveals just how serious the problem can be—and why quick, effective treatment is so important.

What is bigorexia?

Researchers define bigorexia (formally known as bigorexia nervosa) as a type of body dysmorphic disorder that’s characterized by an obsession with reducing body fat and increasing muscle mass. So while other eating disorders, like anorexia and bulimia, involve a fear of weight gain and a desire to make the body smaller, bigorexia involves a desire to make certain parts of the body bigger, but only in a very specific way. It’s also important to note that wanting to build muscle itself is not a form of bigorexia—it’s when that desire becomes extreme and starts impacting other areas of a person’s life and health that problems arise. “Bigorexia is an extreme preoccupation with muscularity and engaging in exercise in a way that is disruptive to one's life,” explains Equip therapist Jalia Henry M.A., LMFT.

Equip registered dietitian Stephanie Kile, MS, RDN, explains further: “Bigorexia is a type of body dysmorphia—also called muscular dysmorphic disorder—where one believes their physique is ‘too thin’ or ‘too skinny’ and they desire more muscle mass and definition in their bodies. It is a deep desire to change their body to be more appealing for both themself and others to look at.”

Causes of bigorexia

Among the contributing risk factors to bigorexia are environmental influences like media images and peer pressure, as well as personality traits like perfectionism. Kile explains that research is beginning to look into bigorexia among college students and bodybuilders specifically, as its prevalence is rising in these populations. Studies show that the risk factors for bigorexia include:

• Negative body image
• Societal pressures related to body appearance
• Media influences
• Perceptions on dietary intake
• A history of being bullied due to body size
• Perfectionistic personality traits

Signs of bigorexia

Exercise is an important element of a healthy life, and building muscle to promote strength, mobility, and everyday function is usually a good thing. But when these fitness goals go too far, they can lead to problems like exercise addiction or bigorexia. To prevent yourself or a loved one from veering into dangerous territory, it’s important to know what red flags to look for.

According to Kile and Henry, signs of bigorexia may include:

• Workouts/gym use that becomes compulsive, increasingly extreme, and/or inflexible with daily activities (i.e., skipping events or rearranging schedules to exercise)
• An obsession with one’s appearance
• A hyperfixation on one's diet and feeling the need to “work off” a meal
• Constant dieting and food rules
• Extreme focus on protein intake for for muscle development, and/or avoiding non-protein food sources
• Cycles of “bulking” and “cutting”
• Using supplements excessively or compulsively
• Steroid use
• Extreme body dissatisfaction
• Depression

Is bigorexia an eating disorder?

While bigorexia is not an official eating disorder diagnosis, it is a form of body dysmorphia and can include characteristics that resemble certain eating disorder symptoms, and vice versa. “Body dysmorphia is defined as an extreme disparagement of some aspect of one’s appearance,” Henry says. “While people with eating disorders may have body dysmorphia as a symptom, body dysmorphia is not a type of eating disorder.”

Despite the fact that bigorexia isn’t considered an eating disorder, it is important to understand that someone with bigorexia may be engaging in disordered eating behaviors that require attention and treatment. “If one is regularly skipping meals, engaging in self-induced vomiting, or using laxative or diuretics to assist them in controlling their weight or shape, it‘s time to speak to a medical professional,” Henry says.

Equip research: what we learned about bigorexia

We know that eating disorders affect people of all ages, races, body sizes, and genders, and that there’s not enough research on eating disorders among people who don’t fit the stereotype of who gets these illnesses (i.e., young, thin, white females). We also know that bigorexia and disordered gym behavior is a growing concern, especially among men and boys. To better understand the problem and help spread awareness about this important issue, we recently conducted our own independent research on men’s fitness, body image, and eating behaviors. The results were illuminating and confronting.

“One in three eating disorder cases are males,” Kile says. “Equip’s current findings on this topic show how more men than expected are struggling with body dissatisfaction and disordered eating behaviors.” Below are some of the key takeaways from our survey.

Out of 1,027 survey respondents, we found:

• 76% of men feel anxious about missing a workout, and 59% exercise to "work off" a meal, classic signs of disordered eating behaviors.
• Most men turn to social media for fitness advice, but almost half (48.5%) couldn't identify a photoshopped image, showing how distorted their perception of "normal" bodies has become.
• 38% prioritize supplements or gym costs over meals; half believe supplements are safe, despite a lack of FDA oversight.
• Nearly half of the respondents believe eating disorders are not just a "women’s issue," but social stigma still prevents open conversations and early intervention.
• Only 25% have sought care; the most common reason for not seeking help was not thinking their issue was “serious enough.”

“Bigorexia is seen more frequently in boys and men,’” Henry says. “Disordered eating behaviors often arise from ‘bulking’ followed by ‘cutting’ to lean out, or feeling the need to ‘work off’ a meal. There is a huge influence from media and social media on what the ‘normal’ body looks like, and that there is a lot of pressure to conform to often edited media photos.”

Kile agrees that the proliferation of fitness-focused social media accounts targeting men are leading many to want to change their bodies by any means necessary. “This can lead individuals to health risks including depression, malnutrition, RED-s (relative energy deficiency in sport), injuries, and financial struggles,” she says. She adds that the survey results also indicate a greater need for healthcare providers to raise more questions around fitness behaviors, social avoidance behaviors, and supplement use.

It’s also important to remember that many fitness-focused social media accounts that praise restrictive food behaviors and overexercising are built on false promises and designed to capitalize on users’ insecurities. “There are countless accounts out there that highlight certain meal plans and fitness routines to ‘guarantee’ results, but remember, not all of these people are being fully honest,” Kile says. “Many accounts are using Photoshop, forgetting to tell the full backstory, or actually misusing peoples photos to sell their products.”

Getting treatment for bigorexia

Because bigorexia is still rarely discussed and so often misunderstood, it can be difficult to know when or how to get help. “If you feel you may be struggling with bigorexia, check out resources in your area of eating disorder-informed therapists and dietitians who can help you further explore your relationship with food, your body, and exercise,” Kile says.

If you have a loved one struggling with bigorexia, Kile recommends having a heartfelt, yet challenging, conversation to help them explore their behaviors. “Make sure it is coming from a place of curiosity over forcing them to see their wrongdoings,” she says. “Most people will not see that their behaviors can be harmful due to how highly praised and worshiped these behaviors and bodies are becoming.”

Henry adds that when assisting a loved one, it’s important to break the stigma that disordered eating behaviors belong to one gender. “Normalize that eating concerns or body concerns are a valid issue and that there are doctors, dietitians and therapists who are trained to assist in these difficulties,” she says.

If you are concerned that you or a loved one may be struggling with bigorexia or any form of disordered eating, it may be helpful to take Equip’s five-minute screener. “Bigorexia is becoming normalized in our world, to the harm of so many,” Kile says. “Young kids are coming across these accounts or messaging and feeling less than and like they need to to make extreme changes, rather than just being young and free. Bringing awareness and speaking up about the negative health implications of the bigorexia mindset is how we can shed more light on this topic and encourage people to seek out the help they need.”