Exploring the Association between Food Insecurity and Muscle Dysmorphia Symptomatology in Adolescents and Young Adults


Muscle dysmorphia, also known as “bigorexia” or reverse anorexia, is a relatively obscure yet profound psychological disorder that revolves around body image concerns, particularly within the realm of muscularity. While society often emphasizes the dangers of anorexia and bulimia, muscle dysmorphia remains a lesser-known but equally impactful condition that affects individuals, predominantly men, who become consumed by the relentless pursuit of an idealized, hyper-muscular physique. This article seeks to delve into the multifaceted layers of muscle dysmorphia, examining its origins, diagnostic criteria, prevalence, societal influences, psychological underpinnings, and potential treatment approaches.

Origins and Definition:

Muscle dysmorphia was first introduced to the scientific community in the late 1990s as a subtype of body dysmorphic disorder (BDD). The condition involves a distorted perception of one’s own body, with a specific focus on muscularity. Individuals with muscle dysmorphia harbor an obsessive desire to attain a level of muscularity they perceive as ideal, often despite having a well-developed physique. This fixation can lead to detrimental consequences, including excessive exercise, steroid abuse, unhealthy dietary habits, and social withdrawal.

Diagnostic Criteria:

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not explicitly recognize muscle dysmorphia as a separate disorder. However, it is often considered a variant of BDD, which is characterized by obsessive thoughts about perceived flaws and defects in physical appearance. Common diagnostic criteria for muscle dysmorphia include preoccupation with muscle size, appearance-related rituals, repetitive checking of one’s body in mirrors, and significant distress or impairment in social and occupational functioning.

Prevalence and Demographics:

While prevalence rates for muscle dysmorphia are challenging to determine due to underreporting and misdiagnosis, studies suggest that the disorder is more prevalent in men, especially those involved in competitive bodybuilding or fitness activities. The condition tends to manifest in late adolescence or early adulthood, coinciding with the period when societal expectations regarding body image and attractiveness peak.

Societal Influences:

The societal landscape plays a pivotal role in shaping the manifestation of muscle dysmorphia. The pervasive influence of media, which often glorifies hyper-muscular male bodies, contributes to the development and perpetuation of distorted body ideals. Social media platforms, fitness magazines, and advertising further fuel unrealistic expectations, fostering a culture where the pursuit of an unattainable muscular ideal becomes a norm.

Psychological Underpinnings:

The psychological roots of muscle dysmorphia are intricate and often intertwined with factors such as low self-esteem, perfectionism, and a heightened sensitivity to societal expectations. Individuals with muscle dysmorphia may develop a distorted body image as a means of compensating for perceived shortcomings in other areas of their lives. The disorder may also be linked to anxiety disorders, obsessive-compulsive tendencies, and a deep-seated fear of social rejection.

Consequences and Health Risks:

Muscle dysmorphia can have severe consequences on both physical and mental health. Excessive training and steroid abuse, common behaviors associated with the disorder, can lead to cardiovascular issues, liver damage, and hormonal imbalances. Psychologically, individuals with muscle dysmorphia may experience depression, anxiety, and social isolation, as their relentless pursuit of an idealized body consumes their thoughts and actions.

Treatment Approaches:

Addressing muscle dysmorphia requires a multidimensional approach that encompasses psychological, medical, and social interventions. Cognitive-behavioral therapy (CBT) has shown promise in helping individuals challenge and modify distorted thought patterns associated with body image. Support groups, nutritional counseling, and, in severe cases, psychiatric medications may also play crucial roles in the treatment process. Moreover, raising awareness and fostering a more inclusive and realistic portrayal of body image in the media can contribute to preventing the development of muscle dysmorphia.

Food insecurity

Food insecurity, characterized by inadequate access to food due to financial constraints, is a critical issue affecting a substantial proportion of Canadian households (Coleman-Jensen et al., 2022; Tarasuk & Mitchell, 2020). Approximately 10% to 17% of households in Canada experience food insecurity, with a notable impact on adolescents and young adults (Idzerda et al., 2022; Polsky and Garriguet, 2022; Tarasuk and Mitchell, 2020). Beyond its immediate implications, food insecurity has been identified as a social determinant of health, contributing to adverse physical and mental health outcomes (Gundersen & Ziliak, 2015).

Associations with Mental Health

Research highlights the association between food insecurity and various mental health challenges, including stress, depression (Pourmotabbed et al., 2020), poor mental health, poor sleep quality (Mazloomi et al., 2022; Nagata et al., 2019), alcohol use (Nagata et al., 2021), anemia (Moradi et al., 2018), type-2 diabetes (Abdurahman et al., 2019), and hypertension (Weaver & Fasel, 2018). Additionally, a significant connection exists between food insecurity and eating disorder psychopathology (Hazzard et al., 2020).

Eating Disorders and Food Insecurity

The relationship between food insecurity and eating disorders encompasses binge eating, bulimia-spectrum disorders (Lydecker and Grilo, 2019; Nagata et al., 2023; Rasmusson et al., 2019), dietary restraint, laxative/diuretic use (Becker et al., 2017; Becker et al., 2019; Hooper et al., 2020), and body dissatisfaction (Altman et al., 2019). This association remains consistent across genders (Hallward et al., 2023). Both food insecurity and eating disorders share roots in the “feast or famine” cycles related to periodic food availability (Hazzard et al., 2020).

Muscle Dysmorphia and its Characteristics

Muscle dysmorphia, categorized by a pathological pursuit of muscularity, presents individuals with significant body dissatisfaction regarding their muscularity (Pope et al., 1997). This condition involves disordered eating behaviors, muscularity-oriented disordered eating behaviors, and the use of appearance- and performance-enhancing drugs (Ganson et al., 2022b; Murray et al., 2017; Ganson et al., 2023). Although currently classified as a specifier of body dysmorphic disorder, ongoing debate questions whether muscle dysmorphia should be reclassified as an eating disorder (Grunewald and Blashill, 2021; Murray et al., 2010).

Study Objective and Hypothesis

This study aimed to investigate the association between food insecurity and muscle dysmorphia symptomatology, focusing specifically on adolescents and young adults. This age group is disproportionately affected by food insecurity (Polsky & Garriguet, 2022) and represents a critical developmental phase where proper nutrition is essential for growth and development (Norris et al., 2022).

Hypotheses posited positive associations between food insecurity and muscle dysmorphia symptomatology. The “feast or famine” cycle in food insecurity could lead to weight fluctuations, deviating from the idealized muscular body that individuals with muscle dysmorphia strive for. Additionally, lower diet quality and inadequate access to essential nutrients may hinder achieving the desired muscular body, potentially leading to muscle dissatisfaction and compensatory behaviors.

Factors Contributing to the Association

Several factors may contribute to the hypothesized association between food insecurity and muscle dysmorphia symptomatology. Firstly, the “feast or famine” cycle may lead to cycles of weight gain and loss, impacting the idealized muscular body. Second, food insecure individuals may have a lower quality diet, lacking essential nutrients for muscle growth. Lastly, the financial constraints may force a choice between purchasing food or investing in pursuits of muscularity, highlighting the complex interplay between appearance concerns, eating disorders, and socioeconomic status.


Understanding the intricate relationship between food insecurity and muscle dysmorphia symptomatology is crucial for developing targeted interventions, especially among vulnerable populations such as adolescents and young adults. This study contributes valuable insights into the broader landscape of health disparities and emphasizes the need for comprehensive approaches to address both nutritional and mental health challenges.

reference link : https://www.sciencedirect.com/science/article/abs/pii/S1740144523001377


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