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Eating Disorders, Addictions and Substance Use Disorders pp 439–457Cite as

Muscle Dysmorphia: Where Body Image Obsession, Compulsive Exercise, Disordered Eating, and Substance Abuse Intersect in Susceptible Males

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Abstract

A growing number of adolescent and adult males are dissatisfied, preoccupied - even impaired by concerns about their physical appearance. Feelings of discontent and insecurity can lead to disordered eating and substance abuse when males compare themselves against popularized cultural standards of attractiveness and see themselves falling short. When body image dissatisfaction, compulsive exercise, and food intake dysregulation combine and intensify, risk increases for a psychiatric condition identified within the past 20 years known as muscle dysmorphia, a disturbance of self-perception in which individuals are obsessively preoccupied with the belief they are insufficiently large or muscular. Muscle dysmorphia shares characteristics with eating disorders (such as persistent attention to intake and compensatory behaviors focused on control of weight/shape), obsessive–compulsive disorder (excessive body monitoring and physical activity), and body dysmorphic disorder (including extreme attention to outward appearance). The condition is frequently associated with anabolic androgenic steroid abuse, which may exacerbate an observed exercise dependence or compulsive drive for muscularity. Therapeutic approaches are guided by the individual symptom picture with respect to issues such as obsessional thoughts/compulsive behaviors, mood dysregulation, and anxiety, and have principally been derived from clinical studies examining body dysmorphic disorder, for which both psychotropic medications and cognitive behavioral therapy are considered first-line treatment. Nutrition education and support is also warranted. More research is needed to increase understanding regarding the unique pressures and profound subjective distress males can experience with respect to accepting their bodies, as well as to develop better approaches to assessment and treatment of this complex condition.

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Authors and Affiliations

  1. Adult Eating Disorders Program, Resnick Neuropsychiatric Hospital, University of California, 300 UCLA Medical Place, 4248C, Los Angeles, CA, 90095, USA

    S. E. Specter

  2. Pyschiatry-Nutrition Science, 450 N. Robertson Blvd., Suite 200, W. Hollywood, CA, 90048, USA

    S. E. Specter

  3. Nutrition In Recovery, Behavioral Health Nutrition Dietetic Practice Group (Academy of Nutrition and Dietetics), 11150 W. Olympic Blvd. Suite 760, Los Angeles, CA, 90064, USA

    David A. Wiss

Authors
  1. S. E. Specter
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  2. David A. Wiss
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Correspondence to S. E. Specter .

Editor information

Editors and Affiliations

  1. Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA

    Timothy D. Brewerton

  2. Psychiatry and Behavioral Neurosciences, University of South Florida, Bloomfield Hills, Michigan, USA

    Amy Baker Dennis

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© 2014 Springer-Verlag Berlin Heidelberg

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Specter, S.E., Wiss, D.A. (2014). Muscle Dysmorphia: Where Body Image Obsession, Compulsive Exercise, Disordered Eating, and Substance Abuse Intersect in Susceptible Males. In: Brewerton, T., Baker Dennis, A. (eds) Eating Disorders, Addictions and Substance Use Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45378-6_20

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  • DOI: https://doi.org/10.1007/978-3-642-45378-6_20

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  • Online ISBN: 978-3-642-45378-6

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