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I always believed I was never good enough. If I had to be judged on how I looked, everything had to be perfect. And I believed I did not have the kind of rippling muscles that some of my good friends have.’ These are the words of Rakesh (name changed), a 30-something Indian who is working as a mid-level manager in a reputed company, and they perfectly sum up the thoughts of a person who is obsessively concerned with their muscularity and looks.

Experts have a term for this: muscle dysmorphia.

People affected with muscle dysmorphia usually believe that their bodies are small and weak — even though many of these people are in very good shape with reasonably well-developed muscles.

Sherry Singh Panchal

As defined by the International OCD Foundation, Muscle Dysmorphia is a form of Body Dysmorphic Disorder (BDD) characterized by an obsession of not being muscular or of being thin. People suffering from BDD are preoccupied with worries that one’s body is “too small” or “not muscular enough” despite having a normal build, or in many cases, an extremely “buff” physique.

If not tackled early, it could lead to sufferers experiencing shame, guilt, and embarrassment with some even ending up abusing their body. Some experts believe such feelings stem from experiences when they were bullied or teased as kids for being too scrawny or too fat. It could also result from being a perfectionist with a lifelong and pervasive sense of low self-esteem. An earnest desire to look and feel better could in certain cases result in men and boys becoming obsessed with their bodies.

Subin Babu

Rakesh ticked almost all of these boxes. ‘I rememberbeing taunted and bullied as a child for being scrawny,’ he says. ‘I was determined to put on some muscle and would hit the gym seriously sometimes all days of the week, keen to develop a good body.’

According to experts, individuals with muscle dysmorphia spend approximately five and a half hours a day thinking about their muscles and body size. They turn down important social occasions so that they don’t have to skip their dieting or training. They undergo frequent, long and painful bouts of social isolation and their relationships with friends, partners and family usually spiral downwards.

Dr. Muhammad Tahir

‘Being teased or bullied while growing up, cultural and media influences that create unrealistic models of bodily perfection as both attainable and necessary, play a role as well,’ says Sherry Singh Panchal, a registered accredited member of the British Association of Counselling and Psychotherapy (BACP).

‘With this comes low self-esteem and feelings of social isolation and loneliness. It usually is the sense of self and self-worth that a person experiences. This is an impressionable age for the young generation and external influences have a deep impact. More than just worrying about their body, there are underlying issues; most of the time with a lower sense of self-worth on how they feel about themselves.’

According to Sherry, it could also be because of the messages these children were surrounded with as they grew up. ‘That’s when they need to talk to someone about it – counsellors, therapists, psychotherapists or experts.’

Hala Tajrine

Being obsessed over body shape and size could have negative repercussions. A diagnosis of muscle dysmorphia is not a light-hearted matter. It entails long lasting muscle impairment not to mention affecting performance at school/work and physical health.

‘When the mind is constantly preoccupied with negative thoughts that one’s body is ‘too small’ or ‘not sufficiently muscular’ despite having a normal and healthy build, is an early warning sign of muscle dysmorphia,’ says Dr. Muhammad Tahir, Chairman, American Wellness Centre, which provides both mental health and medical services. ‘Constant negative thoughts lead to distractibility and make it difficult to focus attention on other important areas of life. Furthermore, the belief that others are also negatively judging their appearance creates constant chaos in the mind, sometimes to the point of seeming delusional.’

Dr. Mohsin Azam

Dr. Mohsin Azam, Specialist Orthopedic Surgeon, HealthHub, would agree. ‘Education is important in creating awareness to those individuals who suffer with muscle dysmorphia. While importance to body image has always been an area of focus, nowadays there are several cosmetic procedures to make a person look more presentable. To an extent it is okay as long as healthy approaches are taken in moderation. However, if the person chooses unnatural means such as steroids, growth hormones and other substances with chemicals in them, the after-effect can prove dangerous to an extent where cardiac related issues could develop.

‘Excessive protein intake may also cause heart disease, kidney damage, calcium loss and many other health complications, so it is best to have a healthy balanced diet and fitness regime,’ says Dr Mohsin.

Richard Gomes, a Certified Fitness Trainer shares his experiences. ‘There are so many youngsters, especially University students who appear to be overly conscious of their body. They spend plenty of time engaged in identifying their ‘flaws’ or ‘defects’ and come to the gym only to make themselves feel better. They are often plagued by doubts, insecurities, shame and low self- esteem. They want to spend more time perfecting their muscles. In their desperation to achieve ever-larger and leaner, and more ‘perfect’ bodies, people with Muscle Dysmorphia exercise excessively, spending many hours at the gym. They constantly check the appearance of their muscles in mirrors, [and look for quick ways] to boost their image.’

Richard Gomes

According to Richard, good exercise, nutrition and good recovery are vital for those who are keen to look toned and fit. The attitude and mindset of some youth is ‘truly disturbing’ he says. ‘Some come just to show off their masculinity, lift heavy weights, throw dumb-bells on the floor after using, make grunting noises while running on the thread mill to show that they are the ‘big guys’. They want to be ‘most talked about’ and ‘popular’ in the gym and feel this is the best way for them to make it happen’.

As a personal trainer, he says he always advices clients to be healthy first and up their fitness level. ‘We recommend that they opt for a normal time to work out and they will definitely reach their goal and maintain their body in a healthy way. If they want to be fit, they need to take care of their health as well. Many people experience a shrinkage in their muscles after leaving the gym. Furthermore, this disrupts the hormonal balance and leaves them irritated. The body automatically fails to produce testosterone naturally, which would lead to irritability.’

Subin Babu, Co-Founder & Director of Restart Fitness, echoes some of Richard’s thoughts. ‘For the past few years, we have noticed so many young men coming to the gym and working out excessively, lifting weights through the day, repeatedly checking mirrors or overly avoiding them. Social media influence is also high and many youngsters get trapped into taking [quick fixes] for short term gains. We need to constantly make them aware that fitness is not short term, it’s a lifestyle. For this, we need to live and eat healthy’.

‘This is a main concern prevalent with teenagers nowadays. And social media does play a great influence. I don’t encourage teenagers to take protein powder. Now is the time for them to opt for natural food sources.’

He says for adults, a protein shake or whey powder may be permitted but only after they have consulted their trainer, nutritionist or a dietitian.

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It is a piece of advice other experts stress upon.

‘Artificial protein powders, steroids and other external growth supplements have dire consequences on health and are sure to affect wellbeing as well. Rather than these, try to inculcate healthy habits of exercise and nutrition for a healthy life’ advices Hala Tajrine, Clinical Nutritionist, American Wellness Centre.

‘If someone needs to build up muscle mass and it does not affect their personal life, then it is fine.

‘But if it affects their daily routine – forcing them to go to the gym drastically and exercise too much, then it is definitely harmful and they need to seek professional help, advises Sherry Singh.

What do we do about it?

Comments Researcher Dr Scott Griffiths, an Early Career Fellow investigating body image, eating disorders, muscle dysmorphia, anabolic steroid use, during a TEDx event: ‘Let’s stop creating an environment in which such eating disorders flourish. It’s time we criticise standards that teach our boys and girls that the importance of their self-worth is their physical appearance.

‘Let’s celebrate bodies for their function and not their form. Let’s dismantle the stigma that men don’t care about their appearance. It’s time to criticise traditional notions of masculinity and offer young men substantial and genuine options of masculinity that they can work with and that resonate with them. And on an individual level, for those who worry about their appearance –it’s time to seek help’.

Signs and Symptoms
1. Excessive or prolonged hours of weightlifting or vigorous exercises
2. Training even when injured
3. Abuse of steroids or other body building products
4. Excessive usage of food supplements
5. Excessive thoughts of how frail or small the muscle mass is
6. Excessive analysis of one’s physical appearance in the mirror
7. Panicky when one misses a workout session
8. Distress or mood swings
9. Disordered eating