College counseling centers and health services have reported increasing numbers of cases of college men with eating disorders and a sharp rise in the percentage of men who are dissatisfied with their bodies (Morgan, 2002). Evidence shows that more men are presenting to college counseling centers with low self-esteem, appearance concerns, and abnormal eating and exercising behaviors (Morgan, 2002); and research indicates that 95% of college men report dissatisfaction with some aspect of their bodies (Labre, 2002). Moreover, men increasingly are presenting to college counseling centers with manifestations of muscle dysmorphia: low self-esteem, shame, decreased social functioning, and anxiety regarding their appearance. This development, in association with the risk of creatine use and other adverse health behaviors, is creating a growing need for college counselors to better understand the issues facing college men with regard to their body dissatisfaction. - from here---------------------------------------------------------------------------------------------------------------------------------
Body image is often measured by asking the subject to rate their current and ideal body shape using a series of depictions. The difference between these two values is the amount of body dissatisfaction. Monteath and McCabe found that 44% of women express negative feelings about both individual body parts and their bodies as a whole. Psychology Today found that 56% of the women and about 40% of the men who responded to their survey in 1997 were dissatisfied with their overall appearance.
The desire to lose weight is highly correlated with poor body image, and more women than men desire to lose weight. Kashubeck-West et al. reported that when considering only men and women who desire to lose weight, sex differences in body image disappear.
Men's body image is a topic of increasing interest in both academic articles and in the popular press. Current research indicates many men wish to become more muscular than they currently perceive themselves to be, often desiring up to 26 pounds of additional muscle mass.
The desire for additional muscle has been linked to many men's concepts about masculinity. A variety of research has indicated a relationship between men's endorsement of traditionally masculine ideas and characteristics, and his desire for additional muscle. Some research has suggested this relationship between muscle and masculinity may begin early in life, as boys' action figures are often depicted as super-muscular, often beyond the actual limits of human physiology.  - from here
Men are no more immune to the compelling forces of the media than women have been. Men and boys feel pressured to conform to the lean and chiseled body image stereotypes of Hollywood and Madison Ave; where women and girls strive to achieve thinness, men and boys look for well-developed muscles, sleek abs, sculptured pectorals. Since the 1970's, three times as many men have become dissatisfied with their overall appearance. One study shows that close to half of men between the ages of 50 and 59 were dissatisfied with their overall appearance, as compared with 41 and 48 percent for younger age groups. Related body image conditions include:I took a closer look at
* BDD, body dysmorphic disorder (a severe preoccupation with an imagined or slight defect in appearance that can impair daily function and cause severe depression,)
* Steroid use
* And muscle dysmorphia in which men and boys believe their muscles aren't large enough; these individuals spend inordinate amounts of time in the weight room.
The onset of disease in males is typically triggered by a concern with bodybuilding and sport training, an indicator that schools and coaches can have a great deal of influence in determining how a child thinks about himself, his body and his priorities. They also play a significant role in prevention. In fact, one of the chief differences between male and female eating disorders is that disordered men are more likely than women to be involved in sports like biking, wrestling, of diving that require weight control. Other differences include that facts that the average age of onset for men (15-16) is slightly later than that for women. (14-15) In addition, men may purge through self-induced vomiting and exercise more readily than do women because dieting, as a device to manage weight, is not as socially acceptable for men.
Muscle dysmorphia can cause people to:
* Constantly examine themselves in a mirror
* Frequently compare themselves with others
* Hate their reflections
* Become distressed if they miss a workout session or one of their many meals a day
* Become distressed if they do not receive enough protein per day in their diet
* Take potentially dangerous anabolic steroids
* Neglect jobs, relationships, or family because of excessive exercising
* Have delusions of being underweight or below average in musculature.
* In extreme cases, inject appendages with fluid (e.g. synthol) - from here
Muscle dysmorphic disorder, unofficially known as "bigorexia," is a disorder that normally affects men rather than women. It is recognized as a subtype of body dysmorphic disorder (BDD), which involves preoccupation with the appearance of body parts. Common among bodybuilders, muscle dysmorphic disorder (MDD) is marked by a never-ending drive to get bigger.
Muscle dysmorphic disorder is perhaps easiest to describe in terms of its similarity to anorexia nervosa. Thought patterns, risk-taking behaviors, and avoidance of treatment are areas that look the same to friends and family for both disorders.
Thought Patterns in Muscle Dysmorphic Disorder
In anorexia: "No matter how much I restrict food, exercise, or purge, I can't get thin enough."
In muscle dysmorphic disorder: "No matter how much I work out, how many supplements, steroids, or human growth hormone I take, I can't build enough muscle mass."
To the observer, of course, someone with muscle dysmorphic disorder usually seems to be quite large enough. But that won't stop the workouts; in fact, this person will avoid other enjoyable activities if they would make him miss opportunities to work out.
Risk-Taking in Muscle Dysmorphic Disorder
The person with anorexia will often be aware of many of the risks it creates--osteoporosis, muscle loss, injury (from compulsive exercise), heart arrhythmias, and fatigue, among others, possibly leading to death. Getting thinner and/or staying thin is more important.
Similarly, the individual with muscle dysmorphic disorder may continue to work toward greater muscle mass despite being injured. He will generally not concern himself with the risks of steroid or human growth hormone use.
Avoidance of Treatment in Muscle Dysmorphic Disorder
While those with bulimia receive treatment less often, those with anorexia are perhaps more likely to believe that they do not need treatment. Most live under the illusion that their chosen way of life is the best way out there. They believe that others say it's dangerous because they are envious. The material on this web site might be dismissed by someone with anorexia for this reason.
Muscle dysmorphic disorder produces the same effect. The overriding belief is that even if there are problems with working endlessly to develop muscle, those problems are not as bad as the problems that would come if the person gave it up.
Severity and Risks
A study on the relationship between muscle dysmorphic disorder and other forms of body dysmorphic disorder suggests that among those with BDD symptoms, persons with MDD had poorer quality of life and a higher rate of substance abuse. They were also more likely to attempt suicide.
Muscle dysmorphic disorder's similarity with anorexia nervosa would seem to make it a prime candidate for similar treatment. Given that muscle dysmorphic disorder is more likely to affect men, however, raises an issue: Currently, here are few facilities that specialize in treatment of males. This may make men less likely to receive the treatment they need.- from here
This article takes a closer look at the media
I ran across a fascinating statistic in an article about male body image. If the original G.I. Joe were made life-size, his biceps would have been 12.2 inches in circumference. But 30 years later, Joe has been transformed: His biceps would now measure 26.8 inches in circumference. To put that in perspective, no bodybuilder has ever achieved biceps of that size. Not one.
But why the shift? Why does G.I. Joe's body need to change to be interesting to young boys? It seems that our criteria for appreciating the male body have moved from function to form.
Changes in Male Body Image
It's common for boys (and men, certainly) to compete with each other physically to see who can do more -- jump higher, run faster, lift more, throw farther and more accurately. You'll even see it on work crews where men are doing physically taxing work. There's a tendency for many men to prove that they can outwork or outlast others.
But this appears to be changing. As men's health and fitness magazines focus on how the body looks, rather than what it does, readers change their priorities as well. The questions men now ask are, "What supplement can I take to help me increase my muscularity?" or "How should I work out to make my biceps bigger?"
Effects of Advertisements on Male Body Image
A study examined advertisements depicting male bodies in a major sports magazine over the course of 30 years, beginning in the mid-1970s. The goal was to examine whether models have increasingly been shown in ways that emphasize the body's appearance over its ability.
While some measures the researchers used showed no clear trends, other variables were more telling. For example, models in today's advertisements are less likely to be shown using the advertised product. Also, body parts that can be considered sexualized (e.g., biceps, chest, back, and the abdominal and pelvic regions) are much more likely to be exposed in the 2000s than they were in the 1970s. Plus, it has generally become harder to determine where a model is looking in advertisements (the researchers hold that models whose eyes are hidden are easier to be seen as objects). These criteria would suggest decreasing focus on the body's ability and greater focus on appearance.
How Male Body Image Issues Can Get Out of Control
This focus on appearance is what makes men's pursuit of greater muscularity similar to the pursuit of thinness in women (anorexia nervosa). Both are pursuing visual ideals that are sometimes impossible to achieve. In some cases, the obsession with gaining muscle mass interferes with life away from the gym. This phenomenon, called muscle dysmorphic disorder (and commonly known as "bigorexia"), can lead men to risk their health by using potentially dangerous substances such as anabolic steroids and human growth hormone (HGH).
Even though visual ideals are generally unattainable, they represent concrete goals. This can be a relief to some men who aren't sure how to embrace their masculinity in other ways, or who believe they aren't successful enough in other areas. In short, adding muscle -- changing appearance, rather than improving ability -- literally helps some feel more "like a man." Unfortunately, many find that no amount of muscle is enough.- from here
And now let us end this wall of text, with another wall of text.
Although many women have body image issues and participate in weight-control behaviors, only a small percentage meet the full criteria for an eating disorder (Tylka, 2004). Likewise, many men who do not meet all of the diagnostic criteria for muscle dysmorphia may still engage in behaviors that are unhealthy and may be associated with significant distresses and impairments (Chung, 2001). Subclinical behaviors that can be associated with muscle dysmorphia can still lead to "strained relationships, impaired social activities, and occupational dysfunction" (Harvey & Robinson, 2003, p. 297) and can be problematic to manage in a college population. For example, a male student may experience strained social relationships because of his feelings of low self-esteem or inadequacies as a man, avoid social functions that interfere with a strict workout schedule or because his self-esteem and body image are so poor, or be distracted from academic work because of the time devoted to exercising or worrying about his appearance.Still 59 unpublished blogposts to...erm....post....sigh
Even though the behaviors associated with muscle dysmorphia have been identified, research about the possible causes of the disorder is still lacking. In a study of college men in Canada, T. G. Morrison, Morrison, and Hopkins (2003) found that male students attributed the desire for muscularity to social benefits, health benefits, sociocultural pressures, and masculinity. However, this study only examined the desire to be muscular, not the unhealthy drive for muscularity found in muscle dysmorphia. Olivardia, Pope, and Hudson (2000) stated that, "like eating disorders, muscle dysmorphia may be stimulated by sociocultural influences" (p. 1295).
It is possible that this emergence of muscle dysmorphia among college men is due, in part, to changing cultural trends. Specifically, the new ideal male physique is a muscular mesomorphic build, which is characterized by significant muscular definition in the upper body and a slim waist and lower body (T. G. Morrison et al., 2003). Furthermore, researchers are now suggesting that the ideal body portrayed by the mass media influences men's perceptions of what is attractive and lead them to view their bodies as objects or a constellation of different muscular parts (T. G. Morrison et al., 2003).
It is widely believed that the increase in eating disorders among women may have been linked to the images of women in the popular media. Several recent studies have examined how images of men in the media have changed. Pope, Olivardia, Gruber, and Borowiecki (1999) examined the waist, chest, and biceps of male action figures over the past 30 years and found that they have become more muscular and currently exceed the proportions of even the largest bodybuilders. Leit, Pope, and Gray (2001) examined Playgirl centerfolds from 1973 to 1997 and, based on perceived body mass index and fat free mass index, found that the models have become increasingly lean and muscular throughout the past decade and suggested that some men may see themselves as inadequate in comparison with these male models. A related study found that the number of advertisements appearing in women's magazines containing men who are undressed or advertising something unrelated to their bodies have increased dramatically over the past 40 years (Pope, Olivardia, Borowiecki, & Cohane, 2001), whereas Leit, Gray, and Pope (2002) found that college men were more dissatisfied with their own bodies after viewing advertisements that highlight muscular men as compared with a control group who viewed neutral advertisements. Also, Botta (2003) found that men who read sports magazines showed few signs of body dissatisfaction because they were typically reading for the sports information; however, men who read health magazines reported more body dissatisfaction because they were more likely to compare themselves with the men pictured in these magazines.
There is evidence that college men are at a developmental stage that could put them at risk for having an unhealthy obsession with body image issues. Spitzer, Henderson, and Zivian (1999) reported that an inclination toward a lean and muscular body begins at 6 or 7 years of age, continues throughout adolescence, and reaches a pinnacle in the emerging adulthood time period. Furthermore, Olivardia et al. (2000) found that the average age for the onset of muscle dysmorphia was 19.4 years.
Because the identification of muscle dysmorphia is relatively new, few studies about this disorder have been published. Some of the first studies involved male weight lifters because they seemed the most at-risk group for the disorder. Olivardia et al. (2000) conducted a case-control study of weight lifters and then conducted a comparison study of college students. The two populations were found to have similar incidences of body dissatisfaction, eating disorder behaviors, and drive to become more muscular. A study by Pope, Gruber, et al. (2000) compared the perceptions college men in Austria, France, and the United States have about their own body, the ideal male body image, and the male body that they believed women prefer. The men from all three countries similarly perceived their bodies as less than ideal and misidentified what women prefer by grossly overestimating the kilograms of muscle women desire in an ideal male body. Olivardia, Pope, Borowiecki, and Cohane (2004) replicated this study with college students in the United States and arrived at the same conclusion with regard to how college men perceive their own bodies and the body shape that women are believed to desire.
Several efforts have been made to develop instruments to measure muscle dysmorphia. Some studies have used the Somatomorphic Matrix to have men view computerized male body images and add or subtract muscle and fat in order to identify their current images, the ideal image, and the image that women want (Olivardia ct al., 2000; Olivardia et al., 2004; Pope, Gruber, et al., 2000). These studies and others have validated the Somatomorphic Matrix as an effective tool to measure muscle dysmorphia. Mayville, Williamson, White, Netemeyer, and Drab (2002) created the Muscle Appearance Satisfaction Scale as a self-report measure for the cognitive, affective, and behavior dimensions of muscle dysmorphia. This instrument was found to be a valid measure of muscle dysmorphia in men but not women. McCreary, Sasse, Saucier, and Dorsch (2004) determined that the Drive for Muscularity Scale (DMS; McCreary & Sasse, 2000) creates a valid overall score for both men and women; however, the DMS Attitude and Behavior subscales are valid only for men. Cafri and Thompson (2004) reviewed the available assessment instruments and concluded that the DMS, the Somatomorphic Matrix, and a modified version of the Somatomorphic Matrix were the most effective methods for measuring the psychological and behavioral factors of muscle dysmorphia.
Creatine Use: An Added Complication for College Men
In the case of eating disorders among college women, a defining feature is the drive to be thinner. Correspondingly, women with these concerns engage in problematic compensatory and weight management behavior, such as inappropriate purging through vomiting and laxative use. Likewise, a defining feature of the muscle dysmorphia syndrome is the drive for increased muscle mass. Correspondingly, men may engage in problematic behaviors that involve the use of muscle-enhancing substances, such as creatine. Ricciardelli and McCabe (2004) reported that extreme methods to build muscle mass include the use of anabolic steroids and that less extreme methods include the use of food supplements, protein powders, and particular forms of exercise. Although the risks of using anabolic steroids are well known, the use of the legal substance creatine is a new concern because it may lead to steroid use if the desired results are not achieved (Kanayama, Gruber, Pope, Borowiecki, & Hudson, 2001; Metzl, Small, Levine, & Gershel, 2001). Morgan (2002) reported that "a subculture of drug abuse and risky self-medication" (p. A53) is growing on college campuses because drugs like ephedrine and creatine are readily available. Given this environment, college counselors should become informed about the potential dangers of such a subculture and the possibility that it will lead students to the use of illegal substances.
Creatine is a substance found in food that has been shown to increase weight without increasing fat, but no studies on its long-term effects have been reported (Pope, Phillips, & Olivardia, 2000). L. J. Morrison, Gizis, and Shorter (2004) found that 41% of the 113 participants in their study, ages 18 to 30 years and attending a commercial gym, had taken creatine. Furthermore, creatine is currently the most popular supplement used by male high school and college athletes (McGuine, Sullivan, & Bernhardt, 2001). Of further concern is the fact that creatine is not a regulated substance, and persons of any age can purchase it (Congeni & Miller, 2002). - from here