In recent years, muscle dysmorphia, a subtype of body dysmorphic disorder (BDD), has emerged as a significant mental health issue affecting men, particularly young boys. Fueled by the pressures of social media and cultural expectations surrounding masculinity, an increasing number of men are developing a compulsive obsession with their muscle mass, leading to unhealthy exercise and dieting habits — and in some cases, steroid abuse.
Sam, a 25-year-old from the U.S., has struggled with body image issues since he was five years old, when his parents repeatedly told him he was “too skinny” and needed to gain weight to become a “real man.” As he navigated his identity in college, Sam found himself caught in the culture of body image obsession within the LGBTQ+ community, where muscular bodies are often revered as the standard of masculinity. This internalized pressure worsened his mental health, which became increasingly tied to his physical appearance. “When I start worrying about my body, then my routine and overall health start to deteriorate,” he explained.
This troubling trend is not unique to Sam. Research indicates that body dysmorphic disorder, which involves obsessive thoughts about perceived flaws, is on the rise, with muscle dysmorphia becoming particularly prevalent among men. Experts attribute this spike to an amplification of unrealistic body standards through social media, where fitness influencers, such as bodybuilder Sam Sulek, with nearly 10 million followers on platforms like YouTube and Instagram, regularly post workout routines and diet advice. These posts often depict an idealized, muscular physique, reinforcing the notion that a larger, leaner body equates to success and masculinity.
As ideals about masculinity shift toward more extreme body types, experts like Becca Boswell, clinical psychologist and director of the Penn Medicine Princeton Center for Eating Disorders, highlight the growing mental health risks. “Men face a lot of direct pressures around bodies and fitness in modern society that they wouldn’t have seen 20 years ago in the same way,” Boswell said. This shift is particularly harmful to young people, who feel compelled to meet these increasingly unrealistic expectations.
Understanding Muscle Dysmorphia
Muscle dysmorphia, a disorder first identified in the 1990s, is characterized by an obsessive preoccupation with muscle mass and body shape. While it shares some similarities with anorexia, it differs in that individuals with muscle dysmorphia are fixated on gaining muscle rather than losing weight. This condition often leads to compulsive exercise routines, extreme dieting, and the use of anabolic steroids in the absence of medical guidance.
Like other forms of BDD, muscle dysmorphia is frequently accompanied by anxiety, depression, and obsessive-compulsive behaviors. Those affected by the disorder often struggle with social isolation, strained relationships, and a sense of failure that can sometimes lead to suicidal thoughts. Mair Underwood, an anthropologist who studies muscle dysmorphia, emphasizes the severity of the disorder, noting that it is often trivialized by society. “People don’t understand the level of suffering that comes with these illnesses,” she said.
Despite its growing prevalence, muscle dysmorphia remains underdiagnosed, particularly because it primarily affects men, a group less likely to seek mental health support. This gender disparity is compounded by cultural norms that discourage men from seeking help for emotional or psychological struggles. William Grunewald, a Ph.D. candidate studying male disordered eating at Auburn University, attributes this to harmful ideals of masculinity that equate vulnerability with weakness.
The Role of Social Media
Social media has emerged as a key player in the spread of muscle dysmorphia, especially among younger generations. Platforms like TikTok and YouTube offer a constant stream of fitness content, normalizing extreme workout regimens and protein-heavy diets. A simple search for “muscle growth” or “bodybuilding” on these platforms yields millions of posts and videos offering advice, many of which promote steroid usage as a quick route to muscularity.
These platforms have democratized bodybuilding culture, making it accessible to a wider audience. However, this has come at a cost, with many young people becoming increasingly fixated on their appearance. As Sam Sulek’s recent Instagram post of a shirtless photo garnered 1.6 million likes, it highlights how social media fuels the relentless pursuit of the “perfect body.” This pressure has led to a rise in steroid usage, with a 6.4% global usage rate among men in countries where steroids are accessible.
The Challenges of Treatment
Despite the increasing awareness of muscle dysmorphia, many affected individuals struggle to acknowledge they have a problem. The distinction between healthy exercise habits and disordered behavior is often blurry, especially in an environment where extreme fitness regimens are normalized. Experts like Becca Boswell caution that the pressure to adhere to strict fitness standards can have detrimental effects on individuals’ mental and physical well-being.
One of the greatest challenges in treating muscle dysmorphia is the difficulty in identifying the disorder early. For many individuals, it is only after experiencing significant life changes — such as a breakup or injury — that they begin to question their obsessive behaviors. In some cases, it takes a major wake-up call before they seek help. This delay in treatment is further exacerbated by the insular nature of bodybuilding communities, where unhealthy behaviors are often normalized and even celebrated.
Recovery and Cultural Shifts
Recovery from muscle dysmorphia is a multifaceted process, involving not only physical health restoration but also psychological therapy aimed at addressing the root causes of compulsive behaviors. Becca Boswell, who works at the Princeton Center for Eating Disorders, explains that therapy focuses on helping individuals understand the underlying motivations for their behaviors and teaching them healthier ways to engage with exercise and body image. The goal is moderation, not abstinence — individuals with muscle dysmorphia are not encouraged to abandon fitness entirely, but to find a balanced approach that supports overall well-being.
Despite the progress in treatment, experts agree that a cultural shift is essential to truly addressing muscle dysmorphia on a societal level. Reducing the pressure on men to conform to rigid body standards will require a broad rethinking of how we view health and masculinity. The growing visibility of diverse body types on social media, as well as discussions about the mental health risks of bodybuilding, offer hope for future change.
As the conversation around body image continues to evolve, experts stress that the recovery process for muscle dysmorphia is not just about individual treatment but also about dismantling the harmful societal norms that perpetuate unrealistic expectations of masculinity. As Becca Boswell put it, “If we want to make a meaningful impact, society needs to help men recognize this as a real problem.”
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