Muscle dysmorphia: The intense fear of being skinny

BALTIMORE (Map, News) - Almost every patient suffering from reverse anorexia nervosa is male.

The obsessive-compulsive disorder, also known as muscle dysmorphia, pushes patients to exercise relentlessly.

In public, patients with muscle dysmorphia believe others are staring at specific parts of their body associated with masculinity, such as their shoulders. Even if ripped or chiseled, they perceive their physique as small, and feel inadequate and weak.

“These are people who feel that they need to amplify their muscle mass even when they are exceedingly muscular,” said Dr. Harry Brandt, director of the Center for Eating Disorders at Sheppard Pratt.

Spending hours a day inside the gym, patients isolate themselves from their families and friends. The condition is most common in young adults, according to Brandt, but cases are increasing among adolescents.

In high school, 24-year-old Michael Feldman binged on boxes of cereal and gallons of ice cream at night when alone. His anorexic behaviors turned into muscle dysmorphia once he realized exercise would help him shed more weight than starving and binging.

Feldman, a New York resident, interviewed 30 men on bodybuilding and the ideal male body to write “Muscle Bound,” a play he recently performed in Baltimore. He plans to visit local universities on future tours.

Feldman believes a double standard exists in our society that deters men from recognizing their problems and seeking treatment.

“I never admitted to myself that I had a problem because I was a guy. People would tell girls at school with eating disorders that they should get help, but tell me I was disciplined and dedicated,” Feldman said.

Receiving positive comments from friends reinforced Feldman’s dangerous eating behaviors and rigorous gym schedule. The playwright was compelled to work out even when vomiting or in intense pain from a shoulder injury.

Muscle dysmorphia can be hard to diagnose because patients may appear healthy. Often the most noticeable symptom is a patient’s misguided priorities.

“When I was researching the play, it was comforting to finally find the name for my behavior, but at the same time it was disturbing that the term and the condition exist. It’s so prevalent but no one talks about it,” Feldman said.

“It rules your life to the point that you would even skip a job interview. You put the gym first, diet second and relationships third.”

jnovak@baltimoreexaminer.com

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