Surviving ‘bigorexia’ as a teen by Vice News

Dr Amit D. Mistry, a consultant psychiatrist specialising in sports psychiatry and eating disorders, features in a recent investigation by Vice News.

The special programme explores ‘bigorexia’, a body dysmorphic disorder that triggers a preoccupation with the idea that your body is small or not muscular enough. This often leads to obsessive behaviours, such as over-exercising, extreme diet regimes and the use of steroids, causing physical and mental health effects.

Bigorexia may also be referred to as muscle dysmorphia or ‘reverse anorexia’.

According to Dr Mistry, ‘bigorexia’ it is a form of body dysmorphia we commonly see in males, however, the condition is not gender-specific.

“Often what we see in bigorexia are males who are obsessed with muscle development, and they are convinced that they are small, or ‘scrawny’, despite objective evidence that they are not,” he said.

Dr Mistry explains that some people who develop eating disorders or bigorexia will present with a common “narrative”, such as being bullied in childhood for being overweight or having low self-esteem.

He explains that developing a relationship with exercise can be “healthy” and positive for the “majority of people”, however, “sometimes, that can turn into something else.”

This relationship starts to become hazardous “if we become solely dependent on exercise, and if our identity becomes very focused as well,” says Dr Mistry.

“Now, what can happen is people can have a problematic relationship with exercise so that they exercise excessively and start picking up injuries. If we keep going along this spectrum, and things become more severe, these problems turn internally. We’re talking about the thinning of the bones, disruption to our hormones… and it’s very similar to substance addiction.”

According to Dr Mistry, the condition is often linked to substance misuse, typically with regard to “androgenic and anabolic steroids” which can lead to “reduced testicles, reduced sex drive, depression and suicidal thoughts.”

How do we ensure better body positivity for men?

“One per cent of research on eating disorders is being focused on men. If we’re saying that potentially up to 25% of outpatient caseloads are males with eating disorders, surely our funding should match that,” said Dr Mistry.

However, Dr Mistry said it’s important to not just talk about men, but all genders.

“If we’re going to get better at this, we have to recognise certain groups within males struggle with eating disorders. We know that those who are LGTBQ+, non-cis-genders and also ethnic minorities; we’re not very good at recognising their distress,” he said.

He also placed an emphasis on greater accountability on social media platforms and the use of ultra-filtered images, which are “unrealistic and unsustainable”.

Additionally, Dr Mistry explains that some people can find themselves in dangerous situations trying to imitate the aesthetic of certain athletes.

“A lot of patients that I see in clinic, they’ll idolise themselves on elite athletes. So they want to follow a certain diet or a certain exercise regime. This is risky business if you’re engaging in over-exercising, or having an obsession with muscle development,” he said.

What is body dysmorphic disorder (BDD)?

Body dysmorphic disorder (BDD) is an anxiety disorder linked to body image.  Sufferers of BDD will spend an obsessional amount of time worrying about one or more perceived flaws in their physical appearance. Often, these ‘flaws’ can be minor and not usually recognised by others.

When someone has body dysmorphic disorder, they will intensely focus on appearance and body image. This can lead to constantly checking themselves in the mirror, seeking reassurance from others or grooming themselves.

These obsessional behaviours can often occupy many hours each day in the lives of sufferers.  As a result, BDD can cause severe emotional distress and impact someone’s ability to carry out day-to-day responsibilities.

BDD typically develops in the early teenage years in both males and females,  however, it can occur at any age.

If untreated, BDD can lead to other mental health problems, including social anxiety, isolation, depression and anxietymood disordersalcohol or drug misuse, eating disordersself-harm and suicidal thoughts.

It can vary in severity from person to person; however with treatment, one can make a recovery from BDD.


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  • Dr Amit D. Mistry

    Dr Amit D. Mistry

    Consultant Psychiatrist (Eating Disorders, General Adult & Old Age)

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“When you have a problem and you drink, take drugs or gamble, the problem won’t go away. Stay and tackle the problem”