Bigorexia: Addicted to a Delusion

By Cameron Turner 07/28/14

Bodybuilders are especially susceptible to dysmorphia, no matter their gender. But there are practical specific steps to a solution and a healthy body self-image.


Dylan Hafertepen used to hate mirrors.  The sight of his scrawny physique made him sick. The fact that he was carrying well over 200 pounds of massive muscle didn’t matter.  The fact that he had three gym memberships and trained with weights every day didn’t matter.  The fact that he spent up to half of his paycheck on muscle building supplements and special food didn’t matter.  No matter how much muscle he packed on, Dylan was convinced that he was still too skinny. And one glimpse of his body could cause an emotional meltdown.

"I spend mornings avoiding my reflection because I wake up feeling 'smaller,'” Dylan confessed in a soul-baring blog two summers ago. “The sight of my deflated figure can ruin the rest of my day, sending me into a depressive spiral obsessing over my many defects.”

Dylan’s been fighting against this unrealistic, flaw-focused image of himself since 2010 when he was diagnosed with Muscle Dysmorphic Disorder (MDD) a condition that causes people (mostly men) to believe that they aren’t muscular enough.  Nicknamed “bigorexia,” MDD is a subcategory of Body Dysmorphic Disorder (BDD), a form of anxiety which can lead to addictive behaviors among people who agonize over their perceived physical imperfections. 

Writing for the Association for Applied Sport Psychology, University of Northern Iowa psychologist Jennifer J. Waldron explained that “muscle dysmorphia typically occurs in boys and men who have a well-defined muscular build…(but) spend a great deal of time thinking that their muscular build is undersized and underdeveloped and desire bigger muscles.” 

While the vast majority of those coping with MDD are males, this hunger for hugeness also impacts a small percentage of women. Within the insular world of bodybuilding, muscle dysmorphia is said to be common among both genders. 2011 British bodybuilding champion Rene Campbell startled readers of the UK's Mirror newspaper by saying "I look at guys in the gym who are 20 stone (280 pounds) and I think I want to be that big. I'm jealous of their size." With 17 inch biceps, 28 inch thighs and a competition weight of 180 pounds, Campbell is a bona fide hulk. But she told the Mirror, "I won't stop until I'm bigger and better—I'm totally obsessive about it."

Colette Nelson, one of bodybuilding's most popular and accomplished athletes (she captured five heavyweight titles in 2004 in the fabled "Year of Colette"), explained during a recent phone interview how the quest for a thickly muscled physique can become all-consuming. "It becomes dysmorphic because the muscle becomes a self-fulfilling prophecy that we create in our heads that the more muscle we have the more successful you are, the better you are," Nelson said. Then she added a cautionary note: "It becomes a complete and utter obsession and it comes at all costs. A lot of the female bodybuilders will do whatever it takes."

For both men and women bodybuilders, doing whatever it takes often means relying on chemistry to speed up muscle growth. Nelson doesn't take sides in the steroid debate, but she warns women to be realistic about what they're getting into if they choose to juice. "I never judge anybody else because, you know what, it's your body. But you do have to recognize, as a woman, you're messing with your femininity (because) you're taking male hormones," Nelson says.

But many women bodybuilders are willing to take that risk because, as Nelson explains, "The muscle becomes so much more attractive than your own femininity does. You don't even care about your face anymore. All you see are the muscles and that becomes our sense of beauty and everything else goes by the wayside."

(Note: When she returned to competition early this summer after a four year hiatus, Nelson chose the physique division which doesn't require as much muscularity as bodybuilding. "The bodybuilders are just so big that I just couldn't keep up with them these days," says Nelson. "I would die to be able to have that much muscle. But the sacrifice sometimes is so great... I've always tried to maintain femininity.") 

Bodybuilding advocates often downplay the concerns about muscle dysmorphic disorder that are expressed by mental health and addiction professionals. Embracing slogans like "obsession is a word that the lazy use to describe the dedicated," bodybuilders state that extreme workouts and a regimented lifestyle (including a stringently controlled diet) are essential for success in their sport. That attitude is summed up in an online manifesto posted to in 2003, when the MDD debate was first heating up. In that much-quoted piece, personal trainer Derek Charlebois proclaims, "...It is clear that muscle dysmorphia is an actual disease. Depending on one's condition, I would not classify this as a bad disease... this 'disease' is what keeps most of us motivated. I for one openly admit to having 'bodybuilding bigorexia.' By positively harnessing this 'disease,' I have pushed myself to new levels."

Experts counter that muscle dysmorphia is completely different from the motivation to achieve new levels. Bigorexics cannot appreciate the success they have achieved because they zero in on small or imagined deficiencies. According to the Anxiety and Depression Association of of America (ADAA), "A perceived deficit may only be a slight imperfection or nonexistent. But for someone with body dysmorphic disorder, the flaw is significant and prominent, often causing severe emotional distress and difficulties in daily functioning... this can lead to low self-esteem, avoidance of social situations, and problems at work or school."

It can also lead to what the ADAA calls “compulsive or repetitive behavior to try to hide or improve (the) flaw” such as excessive working out, reliance on steroids and/or supplements, and refusing to look into mirrors. Such behaviors indicate that muscle dysmorphic disorder functions like an addiction, according to some mental health professionals. In a study published in January of this year, British researchers Andrew Foster, Gillian Shorter and Mark Griffiths recommend that muscle dysmorphia be reclassified as Addiction to Body Image. The report, which appeared in the Journal of Behavioral Addictions, argues that “the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids)...”  Foster, Shorter and Griffiths conclude that, "Based on empirical evidence to date, it is proposed that MD could be re-classified as an addiction due to the individual continuing to engage in maintenance behaviors that may cause long-term harm.”

Colette Nelson agrees that some bodybuilders take things to the extreme, disrupting their quality of life outside of the sport. But she says that isn't always the case. "When I think of an addictive disorder that takes you away from living other aspects of your life then we can maybe say 'let's look deeper into that,'" Nelson reasons. "But I am able to function fully in my life. I work a full time job, I make six figures a year, I run a business. So, if my (bodybuilding) rituals are what make me feel happy and feel safe and at peace with my identity then who is to say that what I'm doing is wrong, right or indifferent?"

Recognizing the harmful effects of his body dysmorphic disorder helped Dylan Hafertepen to take control of his life.  A daily self portrait project and other work with his therapist have boosted Hafertepen’s confidence about his body. “I've made considerable progress in the past couple years through therapy and reinforcing positive self-image,” Hafertepen blogged. “Nevertheless, my coping mechanisms aren't a cure, and occasionally I'll have a BDD attack and break down in depression.”  

But he doesn’t mind mirrors so much anymore. 

Cameron Turner is a writer based in Los Angeles. He last wrote about sobriety and hip hop and how our veterans are being destroyed by painkiller prescriptions.

Please read our comment policy. - The Fix
cam turner.jpg

Cameron Turner was a Los Angeles-based Journalist, editorial writer, broadcaster, and public speaker. He worked across a wide media spectrum, including network radio, television, online media, newspapers and magazines.