Muscle Dysmorphia: A Growing Concern Among American Adolescents

Muscular dysmorphia, also known as vigorexia or the Adonis complex, is a disorder characterized by an excessive concern over muscle size and definition. Individuals suffering from this condition feel that their bodies are not muscular enough, leading them to increase their muscle mass and volume through extreme exercise and weight training.

According to the Mayo Clinic, this disorder occurs almost exclusively in men. It is part of the so-called body dysmorphic disorders, where people cannot stop thinking about one or more perceived defects in their appearance, even when these are minimal or invisible to others. They warn that individuals with this condition may feel so embarrassed, intimidated and anxious that [they] may avoid many social situations. This behavior can generate emotional distress that significantly impacts their ability to develop and function in daily life.

Research published in the journal Psychological Medicine indicates that this condition is increasingly frequent among male teenagers. Another study published in the Journal of Adolescent Health found that among 4,489 male participants between 16 and 25 years old, a quarter reported worrying about not having enough muscle, and 11 percent admitted to using products to develop muscles, such as creatine and anabolic steroids. This trend is alarming and highlights the growing pressure on young men to meet unrealistic body standards.

Another study published in the journal PLOS Mental Health revealed that the consumption of supplements to increase muscle mass can elevate the risk of muscle dysmorphia in adolescents. The study found a stronger relationship in those who used products to gain weight or volume. The authors noted that the use of six different dietary supplements intended to increase muscle mass was associated with greater symptoms of muscular dysmorphia, including obsessive time in the gym and concern with food intake, which became more pronounced as the amount of supplements consumed increased. This finding underscores the need for further research and intervention strategies to curtail the normalization of supplement use and address the symptoms of muscle dysmorphia.

Muscle dysmorphia, or Muscle Dysmorphic Disorder (TDM), is a subtype of Body Dysmorphic Disorder (TDC), marked by an obsessive concern that one is not muscular or thin enough, even when there is no real basis for it. A study published in January 2025 by the Journal of the American Academy of Child and Adolescent Psychiatry analyzed the prevalence and impact of body dysmorphic disorder in young people aged 5 to 19. The study found that 1% of young people suffer from TDC, with it being significantly more common among teenagers (1.9%) than children (0.1%). Additionally, the condition was more frequent in women (1.8%) than in men (0.3%).

The study from PLOS Mental Health is observational, making it difficult to determine whether the use of supplements increased symptoms of muscle dysmorphia or if those with more symptoms were prone to taking more supplements. However, the findings justify a greater research and the development of intervention strategies to address the increasing normalization of supplement use and the symptomatology of muscular dysmorphia.

The Impact on American Adolescents

In the United States, the pressure to conform to certain body ideals is clearly depicted in mainstream media, with countless magazines, television shows, and social media influencers promoting idealized body images. This relentless exposure often causes American adolescents to feel inadequate and may lead them to develop muscle dysmorphia as they engage in extreme behaviors to achieve an unrealistic physique.

Omaha native Jake, for example, was diagnosed with muscle dysmorphia at the age of 17. He visited the gym almost daily, consumed hundreds of calories worth of supplements, and constantly compared himself to professional bodybuilders. His parents finally sought help when his obsessions began to interfere with his schoolwork and social life. Treatment revealed, therapists said, that he had become hypnotized by the idea that he was not muscular or thin enough, when, objectively, he was in good health and shape.

Recent Developments in Treatment and Prevention

Recognition and treatment of muscle dysmorphia are still evolving. Experts emphasize the importance of early detection and intervention. Cognitive Behavioral Therapy (CBT) is often combined with medication to help individuals manage their thoughts and behaviors. Treatment plans may include strategies to challenge negative self-images and provide tools to handle impulses or rituals that exacerbate the condition.

Additional symptoms of muscle dysmorphia may include excessive time in the gym, over-exertion in weight lifting, constant comparison with others, and distress over body exposure. Often, individuals with this condition will experience significant anguish, mood swings, and other emotional disturbances. As stated by the Body Dysmorphic Disorder Foundation, concern for not being muscular or thin enough, often despite being in good shape, defines muscle dysmorphia,.

• Excessive time and over-exertion in weight lifting to increase muscle mass
• Worry and panic over missing workouts
• Insistence on training even when injured
• Eating disorders, use of special diets, or excessive protein supplements
• Steroid abuse and often of other substances
• Distress over body exposure, leading to camouflage the body
• Compulsive comparison and verification of the physical self
• Significant distress or mood swings

According to the Mayo Clinic, body dysmorphic disorder does not typically improve without treatment. It warns, it is possible that it could worsen over time, causing anxiety, extensive medical bills, severe depression, and even suicidal thoughts and behaviors. Early intervention, including cognitive-behavioral therapy and medication, is crucial for managing and potentially reversing the effects of muscle dysmorphia. Participation in healthy activities and contact with supportive environments are also encouraged. Despite the challenges, individuals with muscle dysmorphia can seek help, learn to manage their condition, and lead fulfilling lives.

In severe cases, psychiatric hospitalization may be necessary, especially when an individual cannot maintain their daily responsibilities or is at risk of self-harm. Moreover, specific drugs approved for body dysmorphic disorder are yet to be developed, though treatments used in other mental health conditions can be effective when supervised by professionals.