Reverse anorexia/ Muscle dysmorphia/ Bigorexia/ Megarexia/ is a sub-type of body dysmorphic disorders, eating disorders and obsessive-compulsive disorders with the delusional belief of one’s body to be too small, weak, inmuscular, skinny, lean and becoming excessively obsessed with trying to correct the perceived flaws or attempting to pursue an ultimately unobtainable size while using dangerous methods.

DIAGNOSIS

DSM-5, the diagnostic and statistical manual of mental disorders mentioned it’s criteria for muscle dysmorphia: the individual is preoccupied with the idea that his/her body build is too small or insufficiently muscular. If the individual is preoccupied with other body areas which is often the case.

The symptoms usually begin in the late teens or early childhood.

MANIFESTATIONS

It is difficult to recognise muscle dysmorphia because not many people are aware of it and most people experiencing it usually look healthy. To spot the signs in someone you’ve got to know first what the signs are and I’m here to let you know that:

• Excessive and rigorous fitness routines
• Shame and embarrassment
• Anxiety
• Wearing heavy outfits or clothes in the heat or summer to appear larger
• Repeatedly counting calories
• Excessively checking/ avoiding mirrors
• Depression
• Preoccupying thoughts
• Often plagued by doubt
• Perceived body defects
• Misuse of steroids and muscle-building drugs
• Training through injury
• Extreme anxiety if such individual misses a workout

The manifestations do not mean that all body builders have muscle dysmorphia because those with muscle dysmorphia continue to work out or misuse steroids and muscle-building drugs even when they know that is hazardous to their health and well-being and some even opt for plastic surgery to correct perceived flaws. Individuals with severe muscle dysmorphia do not have insight into their problems before they don’t recognise that they need help and even sacrifice relationships, other interests, financial stability and careers to attain an unattainable size.

RISK FACTORS

While men are the most affected it affects the females of different ages too and the following predisposes people to muscle dysmorphia:

TRAUMA FROM BULLYING: people who have been ridiculed for their poor athleticism, being too small, too weak might I have to deal with this for the rest of their life and even battle with low self-esteem. SAY NO TO BULLYING!!!

Sexually assaulting/ domestic abuse on a victim has devastating consequences is inferiority complex and low or zero self-esteem same goes with verbal or emotional abuse.

CULTURAL IDENTIFICATION/APPROPRIATION: Many cultures have specific ways they are men expected to look like which is likely referred to as “manly”. This factor might predispose some to muscle dysmorphia.

COMPLICATIONS

Severe health complications could result from muscle dysmorphia because of the kind of lifestyle it entails. These complications are:

• Muscle failure
• Osteoporosis ( weak bones)
• Heart failure
• Kidney failure
• Substance misuse
• Anxiety disorders
• Eating disorders
• Suicidal behavior
• Obsessive-Compulsive Disorder

TREATMENT

• Education about what ideal healthy body is, proper nutrition and the dangers of over exercising.
• Cognitive behaviour therapy (CBT): this therapy is done to address derogradtory self-talk, unhelpful thinking patterns, repetitive compulsive behaviours. Help increase healthy behaviours.
• Selective serotonin reuptake inhibitors (SSRIs): These are antidepressants which are usually prescribed by the physician.