Muscle dysmorphia psychopathology linked to binge eating behaviors among both women and men

New research provides evidence that binge eating may play a role in the clinical presentation of muscle dysmorphia in both men and women. The findings have been published in the Journal of Eating Disorders.

Muscle dysmorphia is a condition that causes people to have an excessive preoccupation or distress with their body shape and size. Often referred to as “Bigorexia” — especially among men — it is characterized by the belief that one is not sufficiently muscular, despite having a healthy weight and normal muscle mass for their body type.

Millions of individuals suffer from this condition all over the world, and often go to great lengths in order to alter how they look, including extreme diets. But little is known about the relationship between muscle dysmorphia and binge eating — a gap that the authors of the new study sought to fill.

For their study, the researchers recruited a sample of 422 men and 5,483 women who followed popular German-speaking fitness influencers on Instagram. The participants ranged in age from 18 to 72 years, and their body-mass index ranged from 13.3 to 66.4 kg/m2.

The participants completed validated assessments of binge eating (the Eating Disorder Examination-Questionnaire) and muscle dysmorphia (the Muscle Dysmorphic Disorder Inventory), along with questionnaires regarding their demographic information, their drive for thinness, and their drive for leanness.

Approximately 28% of male participants and 9% of female participants met the criteria for being at-risk of muscle dysmorphia. The researchers found that both men and women who scored higher on the muscle dysmorphia measure were more likely to have had binge eating episodes on at least four of the previous 28 days. This association was related to a facet of muscle dysmorphia known as appearance intolerance, which describes a feeling of hatred or embarrassment towards one’s body.

But what about other facets of muscle dysmorphia?

People seeking to build muscle often engage in a practice known as “bulking” – a periodic overconsumption of calories to gain size. While this practice may seem to put one at risk for disordered eating, that does not appear to be the case. The facet of muscle dysmorphia known as the drive for size was unrelated to binge eating.

Functional impairment, a facet of muscle dysmorphia that describes disruptions to everyday life, was also unrelated to binge eating.

“It is not merely the desire for a muscular body that is associated with binge eating, but rather the strong negative evaluation of one’s body with the body-related feelings of shame and disgust,” the researchers said.

There was also a significant relationship between the drive for thinness and binge eating. However, the drive for leanness was unrelated to binge eating.

“Drive for leanness refers to the control over a low body fat percentage and muscle visibility, whereas drive for thinness describes the control over low body weight,” the researchers said. The findings are in line with previous research, which has “suggested that the drive for leanness is less maladaptive than the drive for thinness concerning the development of disordered eating.”

In addition, the researchers found that participants who tracked their daily calorie consumption were less likely to engage in binge eating.

Together, the findings indicate that “both [muscle dysmorphia] psychopathology and drive for thinness should be considered when assessing disordered eating related to the muscular ideal,” the researchers concluded. “The assessment of bulimic features, particularly binge eating episodes, should form part of the assessment of [muscle dysmorphia].”

The study, “Association between muscle dysmorphia psychopathology and binge eating in a large at‑risk cohort of men and women”, was authored by Robin Halioua, Andrea Wyssen, Samuel Iff, Yannis Karrer, Erich Seifritz, Boris B. Quednow, and Malte Christian Claussen.

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