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Bigorexia

 
, medical expert
Last reviewed: 04.07.2025
 
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Quite a large number of people who are actively involved in bodybuilding suffer from such a pathology as bigorexia. Although few of them even guess about the existence of such a disease. Indeed, this term is not familiar to many: bigorexia means a certain mental disorder, when a person is dissatisfied with his body, constantly discovers some shortcomings in it. This can be insufficient relief and volume of muscles, insufficiently beautiful and pumped up limbs, etc. To "correct" the situation, people suffering from bigorexia practically "live" in the gym, bringing their body to imaginary perfection.

Epidemiology

Bigorexia is more common in teenagers and young people aged 18-24, and predominantly in men. Among people who are involved in bodybuilding, bigorexics are found in approximately 8-12% of cases.

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Causes bigorexia

Most experts agree that bigorexia is a mental disorder that has biological roots. When examining patients with bigorexia, a significant deficiency of serotonin, a mediator of nerve cells, as well as dopamine and γ-aminobutyric acid, the so-called pleasure hormones, was discovered. It can be assumed that their insufficient synthesis causes a predisposition to the development of bigorexia.

In addition, a mental disorder - dissatisfaction with one's body - is often diagnosed in people suffering from obsessive-compulsive disorders, which are manifested by obsessive actions and rituals. Experts suspect that patients with bigorexia have failures in the perception and evaluation of information received from the visual organs.

However, experts cannot yet formulate the exact pathogenesis of this disorder. Bigorexia is considered a psychological problem that is determined by a person's distorted self-esteem, when in his or her mind one's own body is far from ideal. And, although bigorexic patients, as a rule, have fairly pumped up muscles, their quality and relief do not satisfy the owner - bigorexics see a lot of shortcomings in their body, and constantly strive for external improvement.

Bigorexia sufferers, in the vast majority of cases, deny that they have a mental pathology. Some of them admit their imperfections, comparing their muscles and the state of muscle mass in other athletes and bodybuilders.

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Risk factors

It is quite possible that bigorexia is laid down in childhood – for example, if a child experiences ridicule from others. At the time when a child’s personal self-esteem is being laid down, ridicule can play a decisive negative role, which, one way or another, will affect his or her future adult life.

Bigorexia is a mental disorder that is often diagnosed in people who lack self-confidence, have hypersensitivity, have impaired self-criticism, and are prone to self-digging. Bigorexics sincerely consider their bodies to be unattractive: they are sure that their imaginary external flaws are too noticeable to others.

In addition to general ridicule, the distortion of the perception of one's appearance is also influenced by the excess attention of relatives - primarily parents - to the aesthetic side of the beauty of the human body. The child's close people can unconsciously focus attention on some of his external shortcomings, indirectly developing an inferiority complex in the child. Television and glossy magazines, which promote the cult of the "ideal body", also play an important role.

Less often, bigorexia can be one of the symptoms of another, underlying mental disorder – for example, schizophrenia, eating disorders, etc.

Symptoms bigorexia

Of course, if a person regularly attends bodybuilding classes, this does not mean that he should immediately be classified as a bigorexia patient. According to statistics, only about 10% of bodybuilders have clear symptoms of this pathology. To distinguish such people from healthy athletes, it is necessary to pay attention to the main signs of the disease:

  • mirror sign - the patient looks in the mirror too often, examining himself and identifying the “next” flaw;
  • photograph sign (not everyone has it) – the patient does not like to be photographed;
  • a sign of external observation - the patient often asks close people about his appearance;
  • having problems with friendly and personal relationships;
  • low self-esteem, lack of self-respect.

First signs

What are the signs that indicate a person suffering from bigorexia?

  • A bigorexic is always unhappy with his body. He even tries to dress accordingly - not emphasizing his figure, but on the contrary, hiding it.
  • For a bigorexic, working out in the gym is sacred. He may not go to work, miss a date, but training is always in the foreground. Moreover, most of the bigorexic's conversations and thoughts are connected with training.
  • A person suffering from bigorexia carefully monitors their diet, takes dietary supplements to build muscle mass, and does not neglect steroids and stimulants.
  • The fear of losing muscle mass with bigorexia is greater than other fears. The larger the muscle size of a bigorexic, the better.
  • A person with bigorexia has no free time - he spends it in the gym, even if he has a sore throat or a headache.
  • If a bigorexic does miss a class, he will then be tormented for a long time by a feeling of guilt for his own imperfection – irritability and even aggression are observed.

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Stages

The course of bigorexia can be conditionally divided into three stages:

  1. A single manifestation of a disease that lasts for several weeks, months, or years.
  2. The appearance of a recurrent course, with periods of complete relief of symptoms.
  3. A continuous syndrome, with periodic increase and worsening of symptoms of bigorexia.

Forms

Medicine knows three types of obsession with one's own body. All three types are mental disorders:

  • Bigorexia (muscle dysmorphia) is characterized by excessive training in gyms and sports halls.
  • Anorexia nervosa is a conscious refusal to eat in order to lose weight.
  • Bulimia nervosa is characterized by regular consumption of large amounts of food followed by getting rid of the food by inducing vomiting or taking laxatives and diuretics.

Complications and consequences

Special nutrition and exhausting workouts on exercise machines sooner or later lead to visible mental disorders. A bigorexic becomes a slave who serves the cult of his body. A logical consequence of bigorexia is growing self-doubt, lack of self-fulfillment, depressive states, conflict, and gradual withdrawal from social life.

Regular use of steroids and other similar drugs can have a negative impact on health - some people develop impotence, cancer appears. As a result of constant stress and steroid use, the cardiovascular system suffers.

There are known cases where young people committed suicide due to dissatisfaction with their appearance.

Diagnostics bigorexia

The diagnosis of bigorexia is made by a psychiatrist or psychotherapist, based on information received from the patient himself, from his environment, and also on the clinical signs of the disease.

Tests are usually not required. However, in some cases, when there is a suspicion of a hormonal imbalance in the patient's body, the doctor may prescribe the following laboratory tests:

  • assessment of progestogenic activity – tests for prolactin and progesterone;
  • assessment of the aromatization process in the body - blood test for estrogen;
  • assessment of androgenic activity – blood test for dihydrotestosterone;
  • tests for LH and FSH levels.

Instrumental diagnostics for bigorexia are usually uninformative.

Differential diagnosis

Differential diagnosis of bigorexia is carried out with other obsessive-compulsive disorders (neuroses, personality disorders), as well as with schizophrenia.

Who to contact?

Treatment bigorexia

Treatment of the disease is always carried out in a complex. These are mandatory sessions of psychotherapy, with auxiliary drug treatment.

Psychotherapy for bigorexia is usually long-term – the course lasts at least six months. The main treatment methods are considered to be the following psychotherapeutic techniques:

  • exposure with reaction prevention;
  • cognitive restructuring to establish control over thoughts;
  • imaginary representations with listening to audio recordings with stories of other patients.

Bigorexics are given the opportunity to experience the impact of individual situations. This approach helps to significantly reduce the breadth and number of obsessive ideas.

Another successful technique is to set patients up to react to their own inadequate thoughts. The fact is that the main degree of stress is provoked not directly by sensations or convictions, but by unsuccessful attempts to overcome them.

With the help of the listed methods, patients establish control over personal imaginary problems that are associated with their own body, while simultaneously getting rid of obsessive states, self-flagellation and low self-esteem.

At the consolidation stage of treatment, the doctor may resort to hypnosis. During the session, the patient is immersed in a peculiar state, in which his consciousness narrows, with the introduction of the necessary "correct" settings. In addition, the patient is taught a lesson in self-hypnosis, auto-training: thus, the patient can independently consolidate the results that were obtained during the course of treatment.

Medicines

In severe cases of bigorexia, therapy with psychotropic drugs – antidepressants – is prescribed. The drug Clomipramine, an antidepressant with psychostimulating, sedative and thymoleptic properties, is particularly effective in this category.

Proven effectiveness in bigorexia is also demonstrated by agents representing a series of selective serotonin reuptake inhibitors. Such drugs include Fluoxetine, Sertraline, Escitalopram. No less successfully used is Mirtazapine, an antidepressant belonging to a series of serotonergic drugs.

Method of administration and dosage

Side effects

Precautionary measures

Clomipramine

Take orally 25-50 mg 2-3 times a day.

Dizziness, fatigue, hand tremors, taste changes, headaches.

Clomipramine should not be taken concomitantly with steroids.

Fluoxetine

Taken in individual dosages, starting from 20 mg/day.

Irritability, sleep disturbances, headaches, diarrhea.

During treatment, alcohol consumption should be avoided.

Escitalopram

The standard dosage is 10 mg of the drug once a day, with a possible increase in dosage.

Drowsiness, headache, nausea, sweating, changes in accommodation, rhinitis.

You cannot stop taking the drug abruptly; you should do it gradually under the supervision of a doctor.

Mirtazapine

The standard dose is 15-30 mg daily before bedtime.

Increased appetite, drowsiness, dizziness, swelling.

Mirtazapine is incompatible with alcohol.

Vitamins

To prevent the destructive effect of bigorexia on the nervous system, sometimes it is not enough to take pills. It is important to eat a complete and varied diet, as well as take certain vitamin complexes that will strengthen the body and increase resistance to the disease.

  • Magnikum is a drug that combines the most important substances for a patient with bigorexia - magnesium and vitamin B 6. Magnikum ensures normal sleep, soothes and alleviates the symptoms of the disease.
  • Milgamma is a complex drug for intramuscular injection. The drug contains the entire necessary list of B vitamins.
  • Trigamma is a drug equivalent to the previous remedy.
  • Vitabalance Multivit is a special complex of vitamins and minerals for stabilizing nerve conduction, calming the nervous system, and restoring the body after exposure to stress.

Physiotherapy treatment

Physiotherapy is most often used to prevent bigorexia, but some methods can also be used to treat this problem. For example, the following procedures will definitely be beneficial:

  • Warm baths with water temperature from 35 to 37°C, lasting from 15 to 20 minutes, with simultaneous application of a cool compress to the forehead and temples.
  • Contrast shower up to three times a week, regular ventilation of the room, rubbing and dousing with cool water at a temperature of 23 to 30°C (preferably in the fresh air).
  • Swimming in open water (lake, river, sea), and in winter – in a pool.

Air and sun baths, active recreation in nature, walks in the fresh air, and relaxing massage sessions normalize the state of the nervous system in bigorexia.

Folk remedies

Traditional methods can really help prevent further progression of the initial stages of bigorexia. However, despite the fact that traditional methods exist and are quite effective, you should not postpone visiting a competent psychotherapist.

  • Consume 150 g of fresh carrots or 200 ml of carrot juice daily.
  • Pour 3 tbsp. of fine straw with 500 ml of boiling water, leave to infuse until cool. Drink the resulting volume of medicine during the day.
  • Keep 100 ml of beet juice in the refrigerator for three hours, add 50 g of honey. Take three times a day, half an hour before meals.
  • Drink viburnum jelly 100 ml up to six times a day, every day.

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Herbal treatment

  • An alcohol tincture is prepared from the roots of the zamaniha (one part of the roots to 10 parts of alcohol). Take 35 drops up to 3 times a day, before meals.
  • Prepare tea from mint leaves and drink 100-150 ml in the morning and before bed.
  • Prepare an infusion of 1 tbsp. of aster flowers and 200 ml of boiling water. Take 1 tbsp. up to 4 times a day.
  • Prepare an infusion based on ginseng (1 part plant to 10 parts boiling water). Take 1 teaspoon daily, in the first half of the day.
  • Take freshly prepared motherwort juice, 35 drops up to 4 times a day, half an hour before meals.
  • Take peony tincture from a pharmacy, 35 drops three times a day, for a month.

Homeopathy

While traditional medicine uses psychotherapy, antidepressants and sedatives for bigorexia, homeopathy offers the use of unique medications that do not cause addiction and side effects. Homeopathic remedies for bigorexia do not suppress, but normalize functional processes in the brain. Such drugs can really be effective, provided that the dosage is individually selected, which may depend on the severity of symptoms and the constitutional characteristics of the patient.

For bigorexia, the following homeopathic remedies are most often used, in a dilution of 6-30:

  • Moskus;
  • Ignatia;
  • Pulsatilla;
  • Argentum nitricum;
  • Nux Vomica;
  • Nux Moscata;
  • Platinum;
  • Cocculus;
  • Anacardium Orientale.

Taking homeopathic medicines can be successfully combined with other treatment methods. Such a comprehensive approach is always more effective and helps to cope with such a problem as bigorexia faster and better.

Surgical treatment

Bigorexia should be treated at the first symptoms. At the initial stages of development, methods such as psychotherapy, breathing exercises, and autogenic training are considered effective. The use of surgical treatment (plastic surgery) is not recommended, since mental disorders cannot be cured by this method, but it is possible to develop a habit of making surgical adjustments to one's own body. The patient will still remain dissatisfied with himself.

It is impossible to cure bigorexia on your own: it is necessary to consult a psychologist. Sometimes inpatient therapy is prescribed – for example, if the patient is prone to suicide or during severe depression.

Prevention

Unfortunately, a large number of athletes are close to developing disorders of their body perception. Therefore, at the first suspicion of such problems, it is necessary to immediately contact a psychotherapist.

Taking care of your body's beauty is, of course, very good. However, there is a fine line that can easily be crossed, leading to fanatical self-improvement.

Photos of fitness models and handsome men from magazine covers really motivate many people to succeed. However, one should not think that all people should fit artificially created standards.

  • Don't belittle yourself, be proud of your achievements, and adequately perceive the presence or absence of progress in the training process.
  • Remember that training should help improve your health and put you in a positive frame of mind: improve your body for this, but not to achieve some imaginary ideal.
  • Do not neglect the opinions of friends and experts - they can evaluate your efforts from the outside and make an adequate assessment of your efforts.

Forecast

If the treatment was carried out in a timely and competent manner, the prognosis can be considered favorable for most patients. Some patients may experience repeated episodes of the disease, since bigorexia often becomes chronic. If no treatment is carried out at all, the clinical signs of the problem persist.

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