Body Dysmorphia Among Males
Written by ‘Ai Pono Hawaii Staff Writer
Body Dysmorphic Disorder (BDD) is defined by Mayo Clinic as “a mental health disorder in which you can’t stop thinking about one or more perceived defects or flaws in your appearance.” In short, it’s a disease of “imagined ugliness” where the sufferer fixates and obsesses on so-called “flaws” in their appearance that don’t exist or are so small no one else even notices them. Persons with BDD may feel ashamed and embarrassed by their appearance and may even avoid social interactions because of their embarrassment. Although the media tends to focus on women when it comes to body dysmorphia, men statistically suffer from body dysmorphia as much as women do. It’s been estimated that the prevalence rate for BDD in US adult males is 2.2% (for US adult females it’s 2.5%).
This means that in the US, a little over two men in every 100 adult males suffer from body dysmorphia.
Unfortunately, men are statistically less likely to seek treatment or come forward about their mental health struggles, so awareness surrounding body dysmorphia among males is still relatively low.
What Does Body Dysmorphia Look Like Among Males?
As we mentioned earlier, Body Dysmorphic Disorder is a mental health disorder in which the sufferer is obsessed with perceived “flaws” or “defects” in their body. Often for males with BDD, this looks like an obsession with their body’s height (usually the belief they are too short), weight, shape, genital size, and muscle mass. Other focus points for males with body dysmorphia include obsessions over baldness and fear about having too much bodily hair.
Males suffering from body dysmorphia will often spend excessive amounts of time trying to reverse or “fix” their perceived flaws, even going to extreme and dangerous lengths to achieve their ideal body. Some may even have surgeries done to fix their so-called “flaws.” These surgeries usually do little to make them feel better about their appearance, and after the surgeries, they may even experience anxiety and fear that the “flaw” or “defect” will come back.
Common symptoms of body dysmorphia in males include:
Body camouflaging (wearing certain clothes, body positioning, always wearing a hat, etc.) to hide their “defects”
Seeking cosmetic surgery like muscle implants, liposuction, and hair plugs
Engaging in restrictive or eating disorder behaviors
Mood swings
Obsessively working out
Compulsive mirror checking or mirror avoidance
Constantly needing reassurance from others about their appearance
Muscle Dysmorphia Among Men
One of the most common manifestations of body dysmorphia among men is muscle dysmorphia (or bigorexia). In fact, recent studies have found that 1 in 10 men at the gym suffers from muscle dysmorphia. Muscle dysmorphia is a singular obsession with gaining muscle. Men with the disorder, despite believing they are small and don’t have enough muscle mass, are often very muscular (although this is not a qualification for muscle dysmorphia). Men suffering from bigorexia or muscle dysmorphia believe they are either too lean and skinny or think that they have too much fat and not enough muscle.
These obsessive beliefs can lead to the following behaviors:
Spending hours at the gym
Overexertion during weightlifting
Working out even when injured
Negatively comparing themselves to more muscular men
Experiencing distress and panic when a workout is missed
Using steroids or weight loss drugs
Putting workouts and eating schedules before social engagements and other activities
Body camouflaging
Eating disorders & bulimic behaviors
Substance abuse
While body dysmorphia among males often looks like an obsession over body size and muscle mass, it’s important to note that not all men experience body dysmorphia in the same way. The disorder is unique to each person’s history, cultural background, and sense of identity. So no matter how the disorder presents itself, the main thing to keep in mind is body dysmorphia is an obsession and fixation over one’s perceived flaws or defects.
What Causes Body Dysmorphia Among Males?
While the causes of body dysmorphia are still unclear, most likely a mixture of environmental (things like bullying, trauma, and social pressure), and biological factors contribute to the disorder in males. Medical researchers believe these environmental and biological components affect the brain’s chemistry causing a wide range of mental health issues, including BDD. Typically, Body Dysmorphic Disorder develops during the adolescent years when things like hormonal changes and growth spurts coupled with components like social pressure and teasing often cause anxiety and other mental health issues. This may then lead to a fixation on appearance.
Another possible contributor to body dysmorphia in males is a concern over appearing more masculine and fitting within an ideological male image. This issue may be more prevalent in homosexual men, but little research has been done in this area. Kayti Protos, a licensed clinical social worker at the Bucks LGBTQ Center in Bucks County, Pennsylvania, states, “the body dysmorphia [in many trans-masculine clients] is impacted significantly by their gender dysphoria.” She goes on to say that the center sees a lot of clients engaging in unhealthy, restrictive behaviors in an attempt to present their bodies in a more masculine, androgynous appearance.
The Body Dysmorphic Disorder Foundation lends to this idea, saying the obsession over body image among males suffering with BDD may be “related to the degree to which it is (a) visible (b) controllable and (c) a symbol of masculinity.” In other words, males suffering from BDD may be (for a number of reasons) trying to conform to the cultural symbol or idea of masculinity.
Body Dysmorphia Among Males & Substance Abuse
Men with body dysmorphia are much more likely to abuse substances than people in the average population. Although women with BDD have a higher probability of abusing substances than the average population as well, men with BDD are two times more likely to develop substance abuse problems than females with BDD. Studies have found that 43 percent of males with BDD abused alcohol, 30 percent abused cannabis, 9 percent abused cocaine, and 6 percent abused opiates like oxycodone. Other substances abused by males with body dysmorphia were stimulants, steroids, and hypnotics or sedatives. Interestingly enough, over half of the men in the report suffered from body image problems a year or more before developing substance abuse problems. This indicates that in most cases, the abuse of drugs and alcohol by males with BDD is a way to self-soothe and self-medicate anxiety and other mental health issues. Males with BDD also use certain drugs and stimulants as a way to control their weight and body size.
Treating Body Dysmorphia in Males
Despite the fact that BDD is highly treatable, many males with BDD do not seek help. Some of the reasons include a cultural tendency for men to hide weaknesses, a fear of being vulnerable and showing emotional sensitivity, an unwillingness to give up compulsive behaviors, and anxiety over losing muscle mass or gaining body fat. When men with BDD do seek help, the treatment that typically works best is a two-pronged approach using Cognitive Behavioral Therapy and medication. Cognitive Behavioral Therapy focuses on teaching patients to identify and replace their negative, BDD thoughts with healthy, positive ones, while also helping them address and replace their harmful behaviors. Medications like antidepressants (specifically SSRIs) are also used with great success to help relieve the patient’s obsessive thoughts and behaviors during BDD recovery.
If you or a loved one may be suffering from Body Dysmorphic Disorder, please seek professional help today. At ‘Ai Pono Hawaii, we offer intensive outpatient programs for both men and women suffering from body dysmorphia. We’ve helped countless people find life and happiness in recovery, and we want the same for you.
Take the next step today and talk to someone about recovery or simply learn more about the recovery programs we offer.