Recognition and treatment of muscle dysmorphia and related body image disorders.

OBJECTIVE To present the reader with various psychobehavioral characteristics of muscle dysmorphia, discuss recognition of the disorder, and describe treatment and referral options. DATA SOURCES We conducted a comprehensive review of the relevant literature in CINAHL, MEDLINE, SPORT Discus, EBSCO, PsycINFO, and PubMed. All years from 1985 to the present were searched for the terms muscle dysmorphia, bigorexia, and reverse anorexia. DATA SYNTHESIS The incidence of muscle dysmorphia is increasing, both in the United States and in other regions of the world, perhaps because awareness and recognition of the condition have increased. Although treatment options are limited, therapy and medication do work. The primary issue is identifying the disorder, because it does not present like other psychobehavioral conditions such as anorexia or bulimia nervosa. Not only do patients see themselves as healthy, most look very healthy from an outward perspective. The causes of muscle dysmorphia are not well understood, which reinforces the need for continued investigation. CONCLUSIONS Muscle dysmorphia is an emerging phenomenon in society. Pressure on males to appear more muscular and lean has prompted a trend in the area of psychobehavioral disorders often likened to anorexia and bulimia nervosa. Athletes are particularly susceptible to developing body image disorders because of the pressures surrounding sport performance and societal trends promoting muscularity and leanness. Health care professionals need to become more familiar with the common signs and symptoms of muscle dysmorphia, as well as the treatment and referral options, in order to assist in providing appropriate care. In the future, authors should continue to properly measure and document the incidence of muscle dysmorphia in athletic populations, both during and after participation.