Body Dysmorphia in My 50s

A 35-Year Struggle with Bigorexia

Marilynne had noticed her teenage son, James, swallowing a couple of capsules containing arginine pyroglutamate. This was the latest muscle-building aid he’d read about, this time in a magazine he’d been sent by Allsports, the company that produced the supplement. James had only been training a few months and he was desperate to turn his skinny adolescent body into a ripped, muscular physique. The arginine pyroglutamate capsules were one of several supplements he’d introduced into his daily routine along with a number of other tonics in his quest for “more size”. Marilynne was a little concerned about all these supplements that James was taking, and he seemed to be obsessed with bodybuilding. But at least he was getting plenty of exercise and was making healthy food choices, and the weight training seemed to be building his confidence.

This took place sometime around 1988, and, if you haven’t guessed already, “James” is my 16-year-old former self. The bodybuilding world back then was steeped in numerous fads about the latest muscle-enhancing supplements. Incidentally, while a quick Google reveals that arginine pyroglutamate continues to be available, it’s scarcely heard of now. Over the last 30 years, little has changed, except for manipulative marketing becoming even more creative, and our cyber shelves are stacked high with the latest “get-ripped” tonics. Maybe I shouldn’t be too dismissive: if I hadn’t blown my hard-earned pocket money on the latest ineffective muscle-growth supplement, it’s unlikely that I would have developed an interest in nutrition and subsequently pursued a successful career in the field. I certainly wouldn’t have written these articles you’re (hopefully) enjoying! And my get-big-muscles-fast strategies did, after all, promote intake of nutrient-rich foods.

A Kid Lacking Confidence

As a kid, I was skinny, shy and lacking in confidence. I was bullied for much of my school days, which, although seldom physical, meant frequent exclusions and continual verbal put-downs in respect of my scrawny appearance. Much of this was jovial banter and it didn’t always bother me, but some abuse was vicious. Maybe this sort of ridicule shouldn’t have affected me much, but it did. Like many kids who experienced bullying growing up, I sought ways to push back. Around my sixteenth birthday, I found solace in the gym and instantly caught the weight-training bug. It wasn’t long before my physique improved and, along with it, my confidence. I left school at 17 and haven’t been bullied since. 

Despite always being a hard-gaining bodybuilder, I did, slowly but surely, sprout something resembling a reasonable physique. However, during the growth process, starting in my late teens and continuing well into my thirties, not a single day went by where I didn’t review the calories in my food and supplements in the pursuit of packing on bulk.  And when I wasn’t “bulking” – trying to build hard-to-come-by muscle – I was restricting my calories in the hope of stripping the fat to be “ripped”. My physique-obsessed brain refused to allow me to chill out. Even during those occasions when I was sick and scarcely able to eat, it urged me to tot up the calories of what little food I was forcing down, in a vain attempt to avert feelings of panic about the muscle my body was doubtlessly being stripped of. Paradoxically, this mindset only served to enhance my insecurities.

I was dead set on growing bigger and becoming more muscular, and, in my quest to motivate myself, I hand-wrote posters with phrases like “Think Big” and “I Must Get Big” and stuck them around my bedroom, including one on my ceiling directly above my pillow so it would be the last thing I’d see as I went to sleep and the first as I woke up in the morning.

If you think that’s odd behaviour, listen to this. I’d partially cook a huge portion of rice and then scoop it into a large mixing basin with a small amount of tuna and sweetcorn. I’d then proceed to spoon it into my mouth, washing down mouthfuls with gulps from a piping hot mug of tea. The rationale was that the hot drink would be absorbed by the rice, making it swell further, expanding my stomach so that I’d be able to eat more food in the future. More food means bigger muscles, right? I’d sit watching TV for distraction from the discomfort of chomping my way through the bland meal. Yeah, yeah, I hear you … a nutrition student, who clearly should have known better, doing this! But that’s the thing: sensible goes out of the window and is replaced by some weird “logic”.

The most troublesome issue, however, was how I’d react to others’ comments about my size. I find it odd that people feel the need to make unprompted remarks about people’s appearance, but I guess it’s part of life. People would casually make a comment that I was “slim” or that I’d “lost weight”. These remarks would upset me to the extent that for hours the comment would play on my mind. My mood would be extremely low, preoccupied with the judgment, and I’d feel like a failure. On occasion, these negative emotions would show up simply if someone failed to comment that I was “looking big” when I felt that they should have.

And on those occasions when I did receive a comment about looking bigger or more muscular, I’d be rewarded with a short burst of internal elation. To garner these compliments, during periods where I was more content with my physique, I’d wear a tight top that accentuated my physique, in search of flattery. Conversely, on days when I was feeling less happy about myself, I’d go out wearing three, four or even five layers, in order to appear big; I’d even do this in hot night clubs. I had a self-designed thick cut-off top: a garment with the sole purpose of being worn underneath a sweatshirt to make me look broader.

From my late teens until well into my forties, there were periods when I struggled with depression. Don’t get me wrong; I’ve had many great times and lots of laughs and I certainly enjoyed the gym. However, these body image struggles clearly exacerbated my mood issues. Although I was never diagnosed, looking back, I exhibited traits in line with body dysmorphic disorder.

What Is Body Dysmorphic Disorder?

According to the NHS, body dysmorphic disorder (BDD), or, as it’s more commonly known, body dysmorphia, “is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. These flaws are often unnoticeable to others” [1]. Those with BDD needn’t be vain or self-obsessed, but it can cause significant upset and adversely impact the individual’s life. Although it’s most common in teenagers and young adults, people of any age and sex can have BDD.

The DSM-5* outlines the criteria for BDD. It notes that individuals often perform repetitive behaviours, such as mirror checking, excessive grooming and reassurance seeking, or mental acts in response to appearance concerns, like comparing his/her appearance to that of others. And the “preoccupation causes distress or impairment in social, occupational or other areas of functioning”. The manual also states that the “appearance preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder”. And, specifically in reference to muscle dysmorphia, the “individual is preoccupied with the idea that his or her body build is too small or insufficiently muscular” [2]. It’s this – muscle dysmorphia, or, as it’s commonly known, “bigorexia” – that describes my own behaviours.

How prevalent is BDD? It’s estimated that as much as two percent of people globally are affected by BDD** [3], but there’s a lack of data regarding its prevalence in older adults. With the increase in people having plastic surgery for cosmetic reasons, one can guess that it’s likely a growing issue. But what about muscle dysmorphia, more specifically? Again, one can speculate: more middle- and old-aged people seem to be hitting the gym both for health and longevity reasons as well as vanity.

A Dysmorphic 51-Year-Old?

Now in my early 50s, my behaviours relating to BDD have, thankfully, massively diminished. No longer do I agonise for hours after an offhand comment about me looking like I’ve lost weight. No longer do I Blu-Tack-faux motivational posters to my ceiling. No longer do I sweat my bollocks off from wearing multiple thick tops. And no longer, you’ll be relieved to know, do I force-feed myself cauldrons of semi-boiled rice and wash it down with scalding-hot tea^♰. Crucially, negative thoughts about my appearance certainly don’t adversely affect my wellbeing anywhere near the extent that they used to.

Why is muscle dysphoria less of an issue for me now? It might be down to me having had other life aspirations that demand greater cognitive bandwidth, such as helping to grow a successful business and pushing my career as a nutrition communicator. Moreover, exercise-wise, I have different goals: these days I train to support my physical fitness, mental wellbeing and longevity as much as I do to promote muscularity. But I also think I’m more self-aware now and realise that over-caring about what others think demonstrates elements of narcissism. People are more concerned about what’s going on in their own lives than giving a second thought about how I look.

However, this same ability to self-reflect has made me look inwardly and notice that I still exhibit traits of muscle dysmorphia. For instance, I continue to feel more than a pang of discomfort when someone asks, “Have you lost weight?” even though, no doubt, their intention is to merely suggest that they think I’m in good shape. And while I put more of a focus on exercising for fitness and longevity than younger James did, I’d be lying if I said training for appearance wasn’t a primary motivator. And when I “feel” I’m not in particularly good shape, I wear baggier clothes to hide my physique. I live with a constantly annoying internal battle: years of yearning to be “big” have left me continually feeling dissatisfied, especially as I’m certainly nowhere near the size I was ten years ago. Equally, as I wish to stay relatively lean, when I’m bulkier, I’m similarly unhappy. What this means is that I eat large amounts to support muscle growth while watching how much I consume to prevent excessive fat gain. The result? Failing at both: I neither gain muscle nor stay as lean as I’d like.

Or maybe I’m being unnecessarily critical. Stepping back, I guess many people would look at my physique and consider me to be in “reasonable shape”*^♰, and not just for a 51-year-old, but compared to most adult males. And being completely honest with myself, I don’t follow anything like the strict dietary regimes required for maximal muscle gain or for fat loss. I simply follow my own message and make nutritious food choices.

Do I still have BDD now that I’m in my early 50s? Well, it’s certainly not so much a disorder, as I don’t struggle with anywhere near the amount of mental anguish that I used to. So, no, not BDD. But I definitely still have an unhealthy preoccupation with how I look, with those negative feelings showing up when someone passes a comment like “Have you lost weight?” reminding me that there’s a relic of bigorexia lurking within. Those neuronal pathways that caused twenty-year-old James such anguish still fire now and again.

Now that I’m putting out social media videos^♰♰, it’s been suggested that some should feature me shirtless to demonstrate that I’m in good shape and follow a good diet. That’s not going to happen: it’s neither the kind of message I’m trying to push nor something I’m comfortable with. So, if you ever do see me topless – like, say, relaxing beside a pool on holiday – know that I’m probably not actually that relaxed.

* The Fifth Edition of The Diagnostic and Statistical Manual of Mental Disorders; the standard classification of psychiatric diagnoses and mental health disorders.
** It’s unclear if this is in industrialised nations or also includes less developed regions.
♰ Maybe my tactic worked: I no longer have any trouble eating huge amounts of food!
♰♰ You can read my musings on this in Being an Online Nutrition Communicator.
*♰ The fact that I felt the need to say this indicates that I still have issues with muscle dysmorphia.

References:
1. NHS (2023) Body dysmorphic disorder (BDD). Available at: https://www.nhs.uk/mental-health/conditions/body-dysmorphia/ (Accessed: 14 April 2024).
2. National Library of Medicine: National Center for Biotechnology Information (2016) DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t19/ (Accessed: 14 April 2024).
3. Hardardottir, H. et al. (2019) ‘Body dysmorphic disorder: Symptoms, prevalence, assessment and treatment’, Laeknabladid, 105(3), 125-131.