Men, is your gym grind masking a deeper body image issue?

Skinny, skinny, just so skinny.

Dubai-based mum of two, Krattika Bhavsar had to stop her 15-year-old son training for hours in the gym after school. For years, he had been coming home rather sullen and quiet, mentioning that his classmates were teasing him for being ‘too skinny’ and ‘too short’. He was the last to be picked in basketball. Bhavsar narrates how one child purposely tackled him to see him, giggling at how ‘light’ he was.

They changed schools, but the scars remained. “He grew obsessive about checking his muscles everyday, and watching his protein intake. It was a nightmare,” says Bhavsar, adding that she didn’t wish to go into more details of those teen years. “Long story short, it took him a long time to visit therapists and reframe his entire idea of a body image. And even now, if someone says that he’s thin, I can see him get a little anxious. He’s just 22.”

It’s not an uncommon scenario for men. Other mothers who don’t wish to be named explain that their sons too, keep asking about supplements, looking for the ‘right’ protein intakes and flex their muscles every chance they get.

Hiten Lalwani, a 56-year-old professional, recalls how his son just kept trying to drink protein shakes, till he put his foot down. “I used to wonder if it was my fault, because when he was a child, I used to keep saying eat healthy for muscles. We didn’t know better.” Recalling from experience he explains, “We always praise strong, muscular men. We grew up with that idea, and anyone who looks thin is considered weak. That needs to change.”

So what exactly is muscle dysmorphia, and how is it different from general body dissatisfaction?

Dr Victoria Mountford, Psychology Lead and Eating Disorder Service Lead at Sage Clinics explains what it is: It’s a reverse form of anorexia nervosa, instead of an obsession with thinness, the person believes they are too small and is preoccupied with muscularity and leanness.

Unlike general body dissatisfaction, which might involve occasional frustration with appearance, muscle dysmorphia is a persistent, obsessive concern that affects daily life. As a result, men with this disorder often spend excessive hours exercising, follow extreme diets, and may misuse supplements or steroids to gain muscle.

 It has been a growing issue for the past decade, as Dr Mountford says. Depending upon criteria used to define body image concerns and the methods used to measure it, research  suggests that  up to 40 to 50 percent of men report dissatisfaction with their bodies, especially around muscularity and tone.

Moreover, social media, influencer culture and fitness trends compound the pressure on men to maintain a sculpted physique. The body dissatisfaction increases. “It’s clear that the ideal for male bodies has become increasingly and unrealistically muscularised over recent decades – just look at the change in children’s action hero toys or leading men in movie franchises,” notes Dr Mountford.

As Dr Mountford and Dr Sreevidhya Srinivas Clinical Psychologist, Medcare Camali Clinic explain, it’s quite often those who are in their late teens, through early 30s. It’s a period that often coincides with heightened concern about self-image and social acceptance, explains Dr Mountford.

 And so, the excessive bodybuilding, weightlifting or sports, where appearance matters. “Cultural expectations, peer pressure, and personal history, such as experiences of bullying or trauma, can also increase susceptibility. In my clinic, I see teenage boys, as well as men, presenting with these signs, so it’s important parents are aware of muscle dysmorphia,” she says.

It consumes you—staring in the mirror every day, waiting for change. You track everything you eat, train as hard as you can, and still, the frustration never fades.

This muscle dysmorphia has wide-ranging effects, including anxiety, depression and disordered eating. The person starts prioritising gym routines, diets, supplement schedules over friendships. And so, daily functioning is fractured, with the boys skipping work, school or social activities to maintain exercise and dietary regimes, says Dr Mountford.

And worse, men are also less likely to seek help. It’s less manly to express vulnerability, they feel. Moreover, shame, fear of judgment or misunderstanding of the conditions stops them from reaching out. Excessive praise and compliments about their body, will just reinforce their behaviour as there isn’t much awareness about muscle dysmorphia.  They may feel that admitting they struggle with body image threatens their sense of masculinity, which can delay intervention and worsen outcomes,” she adds.

Dr Srinivas concurs: “Many clients who are males often delay therapy until distress is severe because acknowledging body image struggles feels ‘unmanly.’ This emphasises the need for more awareness campaigns directed towards the needs of men; these conversations help reduce shame around seeking support and associating it as a sign of weakness.”

Muscle dysmorphia often coexists with anxiety, depression, and eating disorders. It becomes a cycle: the more one tries to ‘fix’ their bodies, the worse the underlying psychological distress gets, which in turn can result in more activities related to maintaining appearance, Dr Srinivas explains.

The red flags that we tend to ignore are excessive exercise, distress if workouts are missed, frequent mirror checks,  weighing, strict control over diet, preoccupation with supplements, and avoidance of social situations. The family should watch for skipped social events, obsessive talk about calories, frequent weighing, or steroid use. “Gentle conversations with compassion and empathy, not confrontation, are more effective in encouraging help-seeking,” advises Dr Srinivas.

Treatment involves psychological therapy and nutritional guidance. While Cognitive behavioral therapy (CBT) is particularly effective in addressing distorted beliefs about body image, encouraging balance, valuing achievements beyond appearance, promoting self-compassion, and challenging unrealistic fitness ideals can help men develop a healthier, more sustainable relationship with their bodies. And, they would need the support of their family and friends.

Dr Srinivas adds, “Evidence-based therapy, especially CBT, is proven to be beneficial for muscle dysmorphia. Alongside professional support, promoting body neutrality and focusing on what the body can do, not just how it looks, helps reduce fixation on appearance. Encouraging men to redefine the notion of strength as not just physical but in combination with emotional resilience can also be transformative.”