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Understanding Bigorexia: When Fitness Goes too Far

By Russ Klettke

There are two kinds of bodybuilding contests out there. One is a sanctioned competition held in on stages with men in teeny tiny posing trunks. The other is wherever gay men who are into fitness gather. In both, the syndrome known as “bigorexia” (muscle dysmorphia) will sometimes surface. The condition is an inability to be satisfied with one’s own muscle size and is characterized by a no-holds-barred approach to getting as big as possible.

So who wins? “Bodybuilding is a very strange sport,” says Maik Wiedenbach, a New York-based trainer and author of “105 Training Myths and Tips” (set to be published in 2011). “There is no finish line as in other sports. Bodybuilding is based on very subjective goals.” In a true bodybuilding competition, athletes are judged on mass, definition, proportion, symmetry and stage presence. You could say the same thing happens when you show up shirtless at a pride parade, dance party or beach—except in the gay context, almost everyone is a competitor and everyone is a judge.

“The gay world in New York City is very competitive,” says Wiedenbach, who trains both gay and straight clients. “And it gets really rough when you’re over 40. When you walk by an Abercrombie & Fitch advertisement, you see these beautiful young people with perfect bodies. There’s a very strong emphasis on looking pretty.” Wiedenbach says he sees the phenomenon of bigorexia a fair amount and thinks it needs to be discussed more.

Driven by an ever-elusive ideal
Just as is the case with female anorexia and stick-thin runway models, the A+F root of muscle dysmorphia is part of a broader phenomenon. The GI Joe action figure—don’t call them dolls for boys—was found to have the equivalent of an 12-inch bicep in the 1960s, but today by scale would measure 26 inches.

There is at least one live human with arms that size. Actually, an inch bigger. It’s Greg Valentino, “the man whose arms exploded.” He is 5’5” tall, has a 27-inch waist and once had 27-inch arms. He freely acknowledges past use of synthetic testosterone, Enanthate and Equipoise, involving about 15 hypodermic injections per week. He was eventually arrested, convicted and incarcerated on charges related to drug dealing. What motivated him? “I've got small man complex, Napoleon complex,” he told a bodybuilding supplement website. “If I can't grow taller, then I'm going to be the biggest freak I can be.”

That's an honest admission from someone whose bigorexia led to a spectacular downfall. Another trainer, Brian Quirk, a certified fitness trainer and owner of BQ Fitness in Wappingers Falls, NY, observes that, “The life of a true bigorexic can be tormented by intense feelings of inadequacy and failure,” he says. “The health of a bigorexic suffers in every regard.”

Another trainer I spoke with, Josef Brandenburg, owner of The Body You Want training in Washington, DC, concurs. “The unhealthy guy believes that he is his muscles,” he says. “He isn't worthy until he is perfect. And since humans can't be perfect, he never feels worthy.”

So is everyone who strives to maximize his potential bigorexic? No. “I don't think you can distinguish between the two based on behavior, size or even drug usage,” says Brandenburg. “I think it comes down to attitude.”

Quirk expands on that, placing “fitness” into a broader context. “Fitness is a component of health, not the essence of health,” he says. “If one’s overall health is suffering in order to benefit fitness, there could be a problem. A healthy fitness enthusiast, on the other hand, sees fitness as part of the bigger picture. It enhances and contributes to other aspects of life.”

What are the warning signs? Like the alcoholic or drug or sex addict, much of it boils down to what is sacrificed. For example, when the individual will forgo social events and relationships for exercise. The serious bodybuilder oftentimes needs to skip developing a career—which presents a dilemma if he is using anabolic steroids to achieve his goal. The costs for growth hormones can be as high as $10,000 per month, says Wiedenbach, imposing a financial burden that he says is supported by means that “you don’t want to know”—alluding to various forms of sex work. Perhaps most serious is when the abuse of chemicals or injury from weight training are causing serious physical or psychological damage to the individual.

Distinguishing between healthy bodybuilding, bigorexia and male anorexia
Researchers have been looking into muscle dysmorphia for at least ten years. A paper published in the American Journal of Psychiatry in August 2000 (Olivardia, Pope, Hudson) reported on a study involving men with the condition and weightlifters who were not bigorexic, with a companion study of men of the same age who did and did not have eating disorders (bulimia or anorexia). They found:

  1. Men with muscle dysmorphia scored noticeably higher in terms of anxiety, moodiness, and unusual eating behaviors.
  2. Those individuals had those characteristics before they found bodybuilding as an outlet (Wiedenbach confirms this, noting that guys he’s seen with bigorexia begin bodybuilding with insecurities).
  3. Bigorexia may fall into a broad spectrum of conditions that are part of obsessive compulsive behaviors, and it may warrant its own distinct diagnosis (i.e., it might one day be officially classified as a disease).
Another study published in the Canadian Journal of Psychiatry in March 2006 (Goldfield, Blouin, Woodside, Blake) identified additional features of bigorexia:
  1. Thirty percent of competitive male bodybuilders at one time were bulimics, a rate much higher than the general male population. The study authors believe that food deprivation related to achieving bodybuilding ideals leads to obsessions with forbidden foods, the consumption of which then contributes to negative self-images and purging.
  2. Non-bodybuilder bulimics and bodybuilders both say their body shape is equally important as friendships and work.
  3. About 25 percent of recreational (i.e., non-competitive) bodybuilders report steroid use, indicating such use is about self-image, not competitiveness.
  4. Both bulimics and bodybuilders are driven by perfectionism, however the bulimics “are more likely to have more emotional problems than bodybuilders.”
Perhaps this research confirms the obvious to many whose lives are tangential to or wholly immersed in gym culture, gay or straight. Weidenbach—who, like the other trainers interviewed for this article, is straight but works with many gay clients—says that he thinks bigorexia is fed “when you surround yourself with similar people.”

That’s not to say just hanging out with other guys who are into bodybuilding lead you to this condition. It’s more about how you define yourself: a guy who is all about being muscular, or a guy whose many characteristics include being muscular. It’s an important distinction.

About Russ Klettke: Russ Klettke is an ACE (American Council on Exercise) certified fitness trainer and also the author of “A Guy’s Gotta Eat, the regular guy’s guide to eating smart” (Marlowe & Co., 2004, with Deanna Conte, MS RD LD), available where books are sold and in more than 70 public library systems in the U.S., Canada and Europe. For more information, see