Body Dysmorphia in Men: The Fitness Industry Hidden Problem

The day I realized something was wrong

I was standing in front of the bathroom mirror after a workout, shirtless, flexing from every angle. I had been doing this for twenty minutes. My wife walked in, looked at me, and said "you look great, babe." I turned to her and said, completely seriously, "I look small."

At that point I was 5'10", 195 pounds, roughly 14% body fat. I had been training for eight years. By any objective measure, I was in excellent shape. People at work made comments about my physique. Friends asked me for training advice. Strangers could tell I lifted.

And I genuinely believed I looked small. Not in a fishing-for-compliments way. I looked in the mirror and what I saw did not match reality. My brain was lying to me, and I did not know it.

That moment, the look on my wife's face when I said "I look small," was when I first thought maybe my relationship with my body was not healthy. It took another year before I actually did anything about it. But that was the seed.

I am sharing this because I think a lot of men in fitness go through some version of this and never talk about it. We joke about it. "Nothing makes you feel smaller than starting to lift." Ha ha. But for a significant number of us, it is not a joke. It is a genuine distortion in how we perceive our own bodies. And the fitness industry, the one we turn to for solutions, is often making it worse.

What muscle dysmorphia actually is

Muscle dysmorphia (sometimes called "bigorexia" or "reverse anorexia") is a subtype of body dysmorphic disorder (BDD) where the affected person is preoccupied with the idea that their body is not muscular or lean enough. It was first described by Pope et al. in 1997 and has been gaining recognition in clinical psychology since.

The key features, as outlined in the Diagnostic and Statistical Manual (DSM-5) under BDD:

• •Persistent preoccupation with the idea that your body is too small, too fat, or insufficiently muscular
• •This preoccupation causes significant distress or impairs your daily functioning
• •The belief persists despite evidence to the contrary (other people telling you that you look good, objective measurements showing progress)
• •Compulsive behaviors related to the preoccupation: excessive exercise, rigid dieting, mirror checking, avoiding situations where your body might be seen

Notice that last point. People with muscle dysmorphia are not just dedicated gym-goers. There is a qualitative difference between loving training and being compelled to train. Dedication feels good. Compulsion feels like you have no choice.

How common is this

This is harder to pin down than you might think, because men do not talk about body image struggles the way women do. There is a stigma. You are supposed to want to be big and lean and not have feelings about it.

But the research paints a concerning picture. A 2019 meta-analysis by Tod et al. found that muscle dysmorphia symptoms were present in about 6-7% of gym-going men. Among competitive bodybuilders, the prevalence jumps to somewhere between 17-54% depending on the study and how strictly they define it.

A 2005 study by Olivardia et al. estimated that about 100,000 people in the US meet the full diagnostic criteria for muscle dysmorphia. But subclinical symptoms (you do not meet the full diagnosis but you have some of the features) are far more common. I would bet that a majority of serious male lifters have experienced at least mild symptoms at some point.

If you have ever felt guilty about missing a workout, avoided social events because you did not like how you looked, or spent more than five minutes scrutinizing your body in a mirror and feeling worse afterward, you know what I am talking about. Maybe it does not rise to the level of a clinical disorder. But it is still worth examining.

The social media pipeline

Social media did not create body dysmorphia. It existed before Instagram. But social media has massively amplified it, and I think it is creating a pipeline that funnels young men toward disordered thinking about their bodies.

Here is how the pipeline works:

Step 1: A teenager or young man feels insecure about his body. Normal developmental experience.

Step 2: He starts following fitness accounts on Instagram, TikTok, or YouTube. He sees physiques that look attainable because the creators claim to be "natural."

Step 3: He starts training, which is genuinely positive. He sees some results. He feels good.

Step 4: The algorithm starts feeding him more extreme content. Guys who are bigger, leaner, more vascular. The comparison bar keeps rising.

Step 5: His results do not match what he sees online. He starts thinking something is wrong with him. His genetics, his training, his diet. He starts following more accounts looking for the "secret."

Step 6: He discovers that many of the physiques he has been comparing himself to are achieved with performance-enhancing drugs, but the creators deny using them. His perception of what is naturally achievable is permanently skewed.

Step 7: He either accepts an unrealistic standard as his goal and becomes chronically dissatisfied with his body, or he starts using substances to try to close the gap.

Fardouly et al. (2018) found a direct correlation between time spent on appearance-focused social media and body dissatisfaction in young men. The more time on these platforms, the worse they felt about themselves. This is not speculation. It is measured data.

The fitness influencer industry runs on making you feel inadequate. That is the business model. Make you feel like you are not good enough, then sell you the solution. The solution never works because the goal was never achievable naturally, so you keep buying. Programs, supplements, coaching, gear. It is a machine that converts insecurity into revenue.

Signs you might be dealing with this

This is the section I want you to read honestly. Not defensively. Just honestly.

You cannot miss a workout without significant anxiety or guilt. Not mild disappointment. Genuine distress. If missing one session because of illness or a family obligation ruins your entire day, that is a red flag.

You have avoided social situations because of how you look. Skipped a pool party because you did not feel lean enough. Declined a date because you were in a "fluffy" phase. Canceled plans because your gym session ran long and you could not do both.

You check your body in mirrors, windows, and phone cameras constantly. Not a quick glance. Extended checking. Lifting your shirt in public restrooms. Flexing in car windows. Comparing your reflection now to your reflection an hour ago.

You compare your body to others compulsively. Not occasionally. Constantly. Every man you see is evaluated relative to you. Are his arms bigger? Is he leaner? You cannot be in a gym, a beach, or even a grocery store without sizing up every male around you.

Your mood depends on how you think you look. Good body day? Good mood. Bad body day (bloated, flat muscles, post-cheat-meal guilt)? Everything feels wrong. Your emotional state is hostage to your perceived appearance.

You continue training through injuries or illness because stopping is unacceptable. Training with a minor tweak is one thing. Training with a diagnosed injury because you are terrified of losing size is another.

Your diet rules your life. You cannot eat at a restaurant because you do not know the macros. You bring tupperware to social events. You have turned down meals cooked by people you love because it did not fit your plan. Food has become a source of anxiety rather than nourishment and pleasure.

If you read that list and thought "well, yeah, but that is just being dedicated," I would gently push back. Dedication is flexible. It adapts to life. It does not cause distress when disrupted. What I described above is rigidity born from fear. There is a difference, and it is worth sitting with that distinction.

The supplement and steroid connection

Muscle dysmorphia is one of the strongest predictors of anabolic steroid use. Kanayama et al. (2006) found that men with muscle dysmorphia symptoms were significantly more likely to use anabolic steroids than those without.

This makes intuitive sense. If you genuinely believe your body is too small no matter how much you train, and the natural ceiling of muscle growth is lower than what you see on social media every day, steroids become a logical "solution." They let you build more muscle. They let you stay leaner. They close the gap between where you are and where you think you should be.

Except they do not actually fix the dysmorphia. A 2006 study by Pope et al. found that steroid users with muscle dysmorphia did not report greater body satisfaction than non-users with dysmorphia. The goalpost just moved. Now they needed to be even bigger, even leaner. The fundamental distortion in perception persists regardless of how much muscle you carry.

I have known guys who went on gear, gained 30 pounds of muscle, and still felt small. The problem was never their body. It was their perception of their body. And you cannot fix a perception problem with a syringe.

How the fitness industry profits from your insecurity

I work in this industry and I am going to be blunt about this because I think it needs to be said.

The fitness industry is worth over 30 billion dollars in the US alone. A significant portion of that revenue is generated by making people feel inadequate about their bodies and then selling them products to address that inadequacy.

Before and after photos are the most powerful selling tool in fitness. But consider what they actually communicate: "You are the before. You should be the after. Buy this to get there." That is a message rooted in dissatisfaction with your current self.

Supplement companies use images of enhanced athletes to sell products that will never produce those results. Fitness influencers create content designed to make you feel like you are behind. Training programs promise transformations that are unrealistic for most natural lifters.

This is not a conspiracy theory. It is just marketing. And it works because insecurity is a reliable motivator. People who are content with their bodies do not buy transformation programs.

I am not saying the entire industry is evil. There are honest coaches, ethical companies, and genuinely helpful products and services. But the ecosystem as a whole incentivizes and exploits body dissatisfaction. Being aware of that dynamic is the first step to protecting yourself from it.

When training becomes compulsive

There is a line between disciplined training and compulsive training. It is not always obvious, especially from the inside.

Disciplined training: You follow a program, you are consistent, you push yourself, and you can also take rest days without anxiety, eat a meal that is not "optimal" without guilt, and miss a session for a legitimate reason without spiraling.

Compulsive training: You train even when injured. You train even when your body is begging for rest. You cannot take a day off without feeling like you are losing everything you built. Your training schedule is non-negotiable regardless of what else is happening in your life.

The distinction is control. In disciplined training, you are in control. You choose to train. In compulsive training, the training controls you. You feel like you have to train or something bad will happen (muscle loss, fat gain, emotional distress).

If your partner, family, or friends have expressed concern about your exercise habits, that is worth listening to. People close to you can often see patterns that are invisible from the inside.

Getting help without giving up fitness

This is the part that scares most guys away from addressing body image issues. They think getting help means giving up training. It does not. And any therapist who tells you to stop lifting entirely (barring a specific medical reason) does not understand the role exercise plays in your life.

The goal is not to stop training. The goal is to change your relationship with training and your body so that it is healthy instead of compulsive.

Cognitive Behavioral Therapy (CBT) is the most evidence-based treatment for body dysmorphic disorder. Wilhelm et al. (2014) showed that CBT specifically adapted for BDD produced significant reductions in symptoms, and the improvements lasted after treatment ended.

What CBT for body dysmorphia typically involves:

• •Identifying and challenging distorted thoughts about your body ("I look small" when you objectively do not)
• •Reducing compulsive behaviors (mirror checking, body comparison, excessive exercise)
• •Gradual exposure to anxiety-provoking situations (wearing a t-shirt instead of a hoodie, going to the beach)
• •Building a more realistic self-image based on evidence rather than distorted perception

Finding a therapist who understands both BDD and fitness culture is ideal. Not all therapists do. Ask specifically about their experience with body dysmorphia and exercise-related issues.

For guys who are not ready for therapy (and I get it, the stigma is real even though it should not be), there are some things you can do on your own:

• •Limit social media exposure to fitness content. Seriously. Unfollow accounts that make you feel bad about yourself. I do not care how "motivating" they claim to be. If the net effect is making you feel inadequate, they are not serving you.
• •Stop comparing your physique to others. I know this is like saying "stop breathing." But practice noticing when you do it and consciously redirecting your attention.
• •Take photos every few months and compare yourself to yourself. Not to anyone else. Your only relevant comparison is who you were six months ago.
• •Talk to someone. A friend, a partner, a fellow lifter. Just saying "sometimes I hate how I look even though people tell me I look good" out loud takes away some of its power.

What recovery actually looks like

Recovery from disordered body image is not a straight line. It is not like rehabbing a torn ACL where you follow a protocol and you are good in nine months. It is more like gradually loosening the grip that your appearance has on your emotional state.

Some days you will look in the mirror and feel genuinely okay with what you see. Other days the old thoughts will come back hard. The goal is not to never have a negative thought about your body. The goal is to have those thoughts without them controlling your behavior.

Recovery might mean:

• •Training four days a week instead of six because you recognized the extra sessions were compulsive, not productive
• •Eating at a restaurant without knowing the exact macros and being okay with it
• •Taking a full rest week when your body needs it without feeling like you are falling behind
• •Wearing a tank top to the gym without spending ten minutes in the locker room deciding if your arms look good enough for it
• •Seeing a guy with a better physique and thinking "good for him" instead of "what am I doing wrong"

None of this means you stop caring about your body or your training. It means you care about it in a way that adds to your life instead of consuming it.

A note to the guys who recognize themselves in this article

If you read this and something resonated, you are not weak, broken, or less of a man. You are dealing with something that affects a huge number of men and that our culture is terrible at acknowledging or addressing.

The gym should be a place that makes your life better. Training should be something that gives you confidence, health, strength, and stress relief. If instead it has become a source of anxiety, compulsion, and self-hatred, something has gone sideways. That is not your fault. But it is your responsibility to address.

You do not have to figure this out alone. And you do not have to give up the thing you love to get better. You just have to be willing to look honestly at your relationship with it and make some changes.

I still train. I still love it. But I also took a hard look at some of my behaviors and got help adjusting the ones that were not serving me. My body does not look any different than it did before. But my experience of living in it is completely different. That matters more than any measurement or mirror ever will.