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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 

, bulimia, and binge eating disorder (BED), and even lesser known conditions like 

avoidant/restrictive food intake disorder (ARFID)

other specified feeding or eating disorder (OSFED)

. But when it comes to newer conditions like bigorexia—a form of body dysmorphia that predominantly 

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.

 bigorexia (formally known as bigorexia nervosa) as a type of 

 that’s characterized by an obsession with reducing body fat and increasing muscle mass. So while other eating disorders, like anorexia and 

, 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 

 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.”

Among the contributing risk factors to bigorexia are environmental influences like media images and peer pressure, as well as personality traits like 

. Kile explains that research is beginning to look into bigorexia among college students and bodybuilders specifically, as its prevalence is rising in these populations. 

 that the risk factors for bigorexia include:

Societal pressures related to body appearance

A history of being bullied due to body size

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 

 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)

A hyperfixation on one's diet and feeling the need to “work off” a meal

Extreme focus on protein intake for for muscle development, and/or avoiding non-protein food sources

Using supplements excessively or compulsively

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 

, 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 

 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 

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 

 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 

 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.”

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 

. “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.”

Arslan, Müge, Nurcan Yabancı Ayhan, Esra Tansu Sarıyer, Hatice Çolak, and Ekin Çevik. 2022. “The Effect of Bigorexia Nervosa on Eating Attitudes and Physical Activity: A Study on University Students.” Edited by Okan Aslantürk. International Journal of Clinical Practice 2022 (August): 1–11. 

Devrim, Aslı, Pelin Bilgic, and Nobuko Hongu. 2018. “Is There Any Relationship between Body Image Perception, Eating Disorders, and Muscle Dysmorphic Disorders in Male Bodybuilders?” American Journal of Men’s Health 12 (5): 1746–58. 

Lavender, Jason M., Tiffany A. Brown, and Stuart B. Murray. 2017. “Men, Muscles, and Eating Disorders: An Overview of Traditional and Muscularity-Oriented Disordered Eating.” Current Psychiatry Reports 19 (6). 

https://doi.org/10.1007/s11920-017-0787-5

Skemp, Karen M., Richard P. Mikat, Kyle P. Schenck, and Natalie A. Kramer. 2013. “Muscle Dysmorphia.” Journal of Strength and Conditioning Research 27 (9): 2427–32. 

https://doi.org/10.1519/jsc.0b013e3182825474

Is Bigorexia an Eating Disorder? Here’s What Experts Say — and How to Get Help

Disordered eating doesn’t just affect women—males account for one in three eating disorders—yet too often, 

 are overlooked or misunderstood. Equip’s latest research, based on a survey of over 1,000 men across the U.S., takes a hard look at how fitness culture, social media, and societal stigma are shaping disordered behaviors in men—and why many are still suffering in silence. 

Below, we unpack the survey’s findings, including key takeaways on exercise habits, supplement culture, treatment barriers, and the growing influence of 

. We also share direct insights from men who bravely opened up about their mental health struggles, and offer recommendations for where we go from here.

Understanding the goals behind the research

This study was designed to explore three critical areas:

 like cutting, bulking, and compulsive exercise.

The influence of social media and fitness influencers

The reasons men avoid or delay seeking treatment

We heard from 1,027 men from diverse backgrounds:

Age: 18–29 (27%), 30–39 (36%), 40–49 (25%), 50–55 (11%)

17% have received an eating disorder diagnosis; 11% are unsure if they have one

25% have sought help for body image or eating disorder concerns

We learned a lot from our survey, but there were three main themes.

1. Disordered behaviors often hide in plain sight

From skipping meals to “work off” food to 

 despite injury, disordered eating and exercise behaviors are being normalized—especially within fitness culture.

 of men said they feel anxious about missing a workout

 have avoided social situations due to body concerns

 but they signal deeper mental health concerns that too often go ignored.

“Pushing yourself too much to the point of fitness/gym obsession can create problems and do more damage than good.” – 30–39 y/o bisexual respondent

2. Social media & supplements are reinforcing harmful ideals

Social media is fueling distorted perceptions of what a “fit” male body should look like. This distorted body ideal is pushing men toward unsustainable and dangerous habits—often without questioning the safety or science behind them.

 of respondents couldn’t tell when an image was photoshopped

 said they’ve skipped meals to afford gym memberships or supplements

“There’s a lack of focus on mental health in the fitness conversation. It’s often just about physical appearance.” – 18–29 y/o white respondent

3. Stigma is still a strong barrier to getting help

 increase among men, most aren’t seeking support. The reasons are complex—but stigma is a clear driver. On a more positive note, almost half of respondents acknowledged that eating disorders don’t just affect girls and women—but society and many providers haven’t caught up: the cultural silence around male body image and eating disorders is leading to delays in care—and missed opportunities for early intervention.

More than half who didn’t seek help said they “didn’t think the issue was severe enough”

 agreed that eating disorders are not just a women’s issue

“Men are conditioned by society to not speak of body image issues because it is seen as a sign of weakness.” – 40–49 y/o white respondent

This research is a wake-up call. Disordered eating among men isn’t rare. It’s just rarely recognized—and even more rarely addressed. To change that, we must:

Normalize conversations about male body image: 

Break the silence and challenge the idea that disordered eating is only a women’s issue.

Reframe “discipline” in fitness culture: 

Encourage healthy habits, not harmful extremes. Help men recognize when “grind culture” becomes a red flag.

Regulate supplement marketing and misinformation: 

With so many turning to unverified online sources, it’s critical to hold influencers and brands accountable for promoting unsafe or misleading content.

Men deserve care that acknowledges their unique experiences—including those in the LGBTQIA+ and BIPOC communities.

At Equip, we’re proud to not only be conducting research like this, but also to offer inclusive, individualized care that supports patients of all gender identities. If you’re concerned about yourself or a loved one, don’t wait to reach out for help.

Schedule a call with an Equip team member today.

New Equip Research Reveals How Fitness Culture Impacts Body Image and Disordered Eating Among Men

Going out to eat can feel fun, relaxing, and luxurious—a welcome break from the ordinary cooking and cleaning routine at home and a chance to connect with people you love. However, if you’re living with an eating disorder, going to a restaurant can feel like you’re being tortured—in many ways, restaurants are the ultimate threat to 

, since there’s much less ability to control food and its details (e.g. ingredients, preparation, and serving sizes). On top of that, there are the added pressures of having to choose from several options on a menu, 

, and potentially dealing with hard emotions in public.

The good news is, with the right tools and support, it’s possible to reclaim eating out as a joyful part of your life, or your loved one’s life. Today, we’ll explore why eating out can be tough, why it’s necessary to do it, and how to take steps in getting there.

Why eating out can be so hard in recovery

Since the stress of eating out in recovery is multi-faceted, let’s look at some of the most common reasons it can be difficult:

Eating at restaurants means letting go of control of how meals are prepared, as well as their ingredients, calories, and serving sizes, which feels scary when you’re struggling with an eating disorder.

Eating out in eating disorder recovery can be very difficult due to the unknown. A lot of eating disorders thrive on control and eating out takes away that control,” explains dietitian 

. “There are also more 'temptations' and 

, which can create an inner battle between what the person wants and what their eating disorder wants.”

For many people, getting to choose exactly what you want to eat is part of the pleasure of going out to a restaurant, but this can be extremely daunting to someone in recovery. Equip Lead Dietitian Shira Feldman, MPH, RD, LD says going out to eat with an eating disorder can cause “feelings of overwhelm with the menu, deciding what to eat, trying to order what you actually want versus what the eating disorder wants you to order, and worrying about what others will think of what you do or don’t eat.” Plus, she adds that this “all might be swirling in your head while those around you seem to easily choose the foods and drinks that sound best to them.”

Then, there’s the major issue of calorie counts on some menus, typically at larger restaurant franchises. As a registered dietitian, I believe calories on menus are unnecessary and unhelpful for everyone—for one thing, it sends the misleading message that calories are the most important nutritional aspect of food—but especially so those in recovery. Research supports this belief, showing that the addition of calories on menus can negatively impact people with eating disorders. One 

 found that for many people with eating disorders, calories on menus exacerbated behaviors like 

, participants with anorexia and bulimia consumed a lower number of calories when they were listed while those with binge eating disorder consumed a higher number of calories. Another 

 of people with eating disorders also showed mostly negative results from menu labeling, including strained relationships, exclusion of certain restaurants, social isolation, restricted freedom and inner conflict, disembodiment, and anger at 

. A small group of participants said they found calories on menus provided safety, comfort, and reassurance.

Going out to a restaurant usually involves eating with other people, and a hallmark symptom of an eating disorder is the 

 of central eating disorder fears showed that eating in social situations is one of the participants’ five central fears. Another 

 on eating disorder fears showed fear of judgement to be another core concern, particularly in those diagnosed with

 other specified feeding or eating disorder (OSFED)

. In my practice, I’ve witnessed several clients being afraid to eat a meal or snack with others because they’re worried what other people will say or think about their food choices, amounts of food, or simply the fact that they’re eating at all.

Dealing with difficult feelings in public

Eating experiences in recovery often come with 

, which can be hard enough to manage when you’re at home or in a familiar and safe space. Facing such big feelings in public at a restaurant can feel daunting and unsafe, especially if you’re early in the process and haven’t had much practice yet. “While eating out for someone without an eating disorder brings up emotions, they are typically ones of excitement for eating a favorite food, trying a new place, or even because they don’t have to cook or do the dishes that night,” Feldman comments. “For someone working through eating disorder recovery, there are a lot of emotions as well, but usually ones of stress and 

Why it’s important to practice going to restaurants during treatment

Eating disorder treatment can seem hard enough without adding the extra challenge of going out to eat. But the truth is that on the path to full recovery, it’s important to leave no stone unturned so you can enjoy the freedom of life without an eating disorder—and this includes going out to eat (and 

it). If the eating disorder prevents you from engaging in normal life experiences like going to restaurants sometimes, that means you’re still in its grips, even if you’re eating enough food at home.

“The more one listens to their eating disorder, the more power it is being given. It’s important to challenge 

 and challenge the unknown, because the more we hide from the fears, the more they control us.” De la Cruz says. “It can be helpful to have a food and not know all the ingredients, calories, or macros in that food, and then see later that everything is okay.” In treatment, 

 is an important part of the process towards freedom, so you can look at eating in restaurants as just that: exposure to something that feels scary so that you’re one day able to participate in eating experiences in restaurants with full freedom. With the guidance and support of your dietitian and therapist, you can take steps towards eating out at a pace that feels relatively manageable to you.

Going out to eat can also eventually be a way of reconnecting with yourself outside of your eating disorder, especially if it used to be something you enjoyed. “For many people, eating out was a regular part of their lives before the eating disorder, and something that many people want to feel comfortable with again,” says Feldman. She adds that it can also be a helpful way of connecting with other people, which is important because eating disorders thrive in isolation. “Having a level of comfort with eating out at restaurants or in social situations can provide opportunities for social connection, and a way to see food in a more enjoyable light,” she says.

As someone who lives in full recovery and used to dread going out to eat with my eating disorder, it’s now one of my favorite activities—few things bring me more joy than sharing a delicious meal out at a favorite restaurant with my husband, mom, or friend. Plus, exploring new cuisines while traveling or even locally helps me learn about different cultures and places on a global level.

If you are on the road to recovery and want to begin incorporating restaurant meals, it’s important to do so with the support of a team. Ideally, you’ll work with a registered dietitian and therapist to formulate a plan tailored to your specific needs, but here are some general tips to support your process:

If going out to eat feels unrealistic and too overwhelming right now, know that there are 

 you can take in that direction, without even setting foot in a restaurant. For example, you might practice exploring and choosing meals from menus online to help you become more comfortable with reading menus and making food decisions aligned with recovery. Other steps can include formulating a cope-ahead plan with your team or a loved one, naming a few restaurants you’d like to try in the future (it could be one you liked before the eating disorder or something brand-new), practicing ordering, and visualizing yourself eating a meal out.

If you’re ready to go to a restaurant, perhaps you start by ordering a meal that feels relatively safe, with the intention of eventually ordering the meal you 

even if it feels like the scariest option.

Join a restaurant meal group or simply eat with others

Eating out with others in recovery can create a feeling of common humanity and community, so check to see if any eating disorder dietitians or therapists offer restaurant group trips in your area. If you’re not quite ready for an outing and feel uncomfortable eating in front of others, start with gathering a small group of loved ones to share a meal.

This can help you get used to eating in front of more people, which can make restaurants feel more approachable.

Practice letting your healthy brain make decisions

When you look at a restaurant menu during the recovery process, it’s common to experience a mental battle between your eating disorder brain and your healthy brain. To prepare for this, work on learning the difference between your eating disorder brain’s preferences and 

. Then, practice choosing food options at home that 

want to eat (not your eating disorder), to get your brain more used to it. This might take some work and be difficult at first, but by paying attention and being mindful of the “why” behind your food choices, you’ll eventually tease out what you truly want to eat.

Use the mealtime strategies you usually find helpful

 can be used in restaurant settings, too. Some of my favorite ones include breathing exercises (at the table or in the bathroom), sense-engagement practices (like focusing on smells), and keeping conversations lighthearted (and off food). Feldman also recommends dressing comfortably and bringing objects that evoke a sense of grounding or distraction, like a fidget toy, affirmation card, or a seashell from a beach trip.

If you’re (understandably) not ready to face calories on menus, Feldman suggests eating somewhere at local restaurants rather than chain restaurants, as you’re less likely to encounter unwanted nutritional information this way. When you know calorie counts will be present, try looking at the menu beforehand with 

 and picking an option or two that feels doable, then have a loved one hold you accountable to choosing it when you’re out. Alternatively, De la Cruz recommends a family member read aloud menu options once you’re seated at the table. Eventually, you can work towards ordering what you truly want from menus with calories listed, but give yourself time and patience to arrive there.

Go with safe, supportive people and communicate

Eating at restaurants can feel scary, but doing so with safe people can make a huge difference and help create a feeling of safety that’ll support you through the meal. Feldman recommends “talking ahead of time with your support people about what you might need from them, and letting them know if you want them to pick something you used to eat or if you need to talk through your menu choices ahead of time to help determine if your eating disorder voice is playing a part in the order.” You can also choose a “safe word” together to use if you need help in the moment or for them to join you in a short break from the table. “For some, it’s even helpful to talk about what they might need to look for in your behavior if you’re having a hard time,” Feldman adds.

How loved ones can support someone in recovery at restaurants

Exactly how loved ones can help someone with an eating disorder handle restaurant meals depends on where you are in the recovery process. Feldman suggests loved ones ask the person in recovery what they need and let them know they’re available for support and preparation beforehand, too. “Don’t assume what might be stressful or overwhelming and don’t assume that something will be easy,” she encourages. “Sometimes your loved one might need a pep talk and for you to be the biggest cheerleader possible, and other times they might just need some space to work through emotions and would love a welcoming space to cry.”

Supporting someone in recovery at restaurants can often look somewhat like 

Avoiding commenting on anyone’s food or how much anyone ate.

Focusing on lighthearted table topics to provide healthy distraction.

Be sure not to talk about diets, weight, or bodies to avoid 

Offering to take breaks from the meal for a five-minute breather if necessary.

Holding non-judgmental space before and after meals for feelings to be shared, and co-regulation and emotional safety to occur.