Vigorexia: Definition, Causes, Diagnosis, Symptoms, Substance Abuse, Treatment and Prevention

Also known as muscle dysmorphia, it is a pathological concern with muscle and thinness, which mainly affects male bodybuilders.

It has long been recognized that many women suffer from anxieties related to body image, ranging from simple unhappiness with shape and weight to a serious eating disorder such as anorexia nervosa .

Men also show these concerns, pursue an idealized muscular body image as the main goal of their training as an athlete or in the gym.

Therefore it can be said that it is the opposite of Anorexia .


  • Vigorexia implies a specific dissatisfaction with the musculature rather than the body as a whole, with a discrepancy between the imagined one and the real one.
  • By focusing openly on the body image, some athletes are induced to desire an unattainable figure.
  • Obsession for being inadequately muscular. Compulsions include spending hours in the gym, wasting excessive amounts of money on ineffective sports supplements, abnormal eating patterns or even substance abuse.

Who does Vigorexia affect?

  • Vigorexia can affect anyone, but it is more prevalent in men than in women.
  • Although the figures are difficult to estimate, up to 100,000 people or more throughout the world meet the formal diagnostic criteria in the general population.
  • The prevalence among athletes has not yet been determined through formal clinical studies, and much of the information has been extrapolated from the general population.
  • As social influences change and promote a more muscular physique, children at younger and younger ages are at greater risk of developing body image disorders such as muscle dysmorphia.

In one study, 3 types of body bodies were presented to 3 teenagers on a laptop. Each was asked to select a body type based on 3 questions:

  1. How would you like your body to look?
  2. How do you think the ideal male body should be?
  3. What do you think others think your body is?

Subjects were presented with various body types and asked to select the one that most closely resembled their own.

In the first two questions, the children selected body types that weighed 30 to 40 pounds more than the reference image, while the answers to the third question revealed that they perceived that their bodies were much thinner and weaker than they were. they really were.

Some guys even asked if they could enlarge the larger image.

This phenomenon is not isolated from the United States; Similar results were obtained in Europe and South Africa.

With a body image so closely related to self-esteem and self-confidence, society may be setting the stage for a generation of boys and girls who are not satisfied with their bodies, not because they are not attractive, but because society tells them they should look better

The data describing the effect of vigorexia on women are also very limited. However, researchers acknowledge that women may be affected, although the muscle impulse is less than that observed in men.


Attributing vigorexia to a single causal factor is difficult. Some attribute this disorder to the effect of the media and popular culture, while others are inclined to individual psychological predisposing factors.

Whatever the causes, vigorexia is a growing concern, particularly in terms of identifying the people who are most susceptible to its development.

Clinical case studies suggest that vigorexia is found most often in people who are not satisfied with their bodies and are heavily involved in weight lifting and other muscle development activities.

Because the term “weightlifter” can be applied to most people, a clear definition of how vigorexia relates to the general concept of “fitness” remains vague.

To assess the presence of vigorexia, certain questions can be asked. There is no particular number of questions used to diagnose that disease, nor is there a specific time to ask them; the questions simply serve as a guide for the clinician to connect the pieces of the MDM puzzle.

The athletic trainer must determine the scope of the situation and select the corresponding questions.

Vigorexia can have a profound effect on all aspects of life, often interfering with normal daily function.

For example, a man with this disease, detailed how he lost the birth of his first child because he had to finish his 6-hour training.

Another testified that he lost his prestigious position in a well-known law firm because he had to comply with a strict diet and diet regimen.

Muscle dysmorphia and substance abuse

Many people who can not achieve personal goals or handle the pressures of coaches with regard to an unrealistic ideal body image can turn to anabolic steroids or other dangerous substances to fulfill their aspirations.

Certainly not all those who are at risk of developing vigorexia will resort to the use of anabolic steroids. but all those people are at risk of suffering devastating damage to their self-esteem and their physical and emotional well-being.

Many people with vigorexia or similar symptoms resort to the prolific use of sports and nutritional supplements.

Companies that produce these products take advantage of the insecurities of men and women over their bodies.

Many people take higher doses of these products than recommended, which may predispose them to a variety of health problems, such as kidney failure .

Athletics can only provide enough motivation for a person to start using dangerous doses of supplements, anabolic steroids, or both. Athletes with a poor sense of self and dissatisfaction with body image can be prey to substance abuse and in fact they are very easily.


In general, athletes are very concerned about their health and well-being. In some sports, proper weight and physique are qualities that can improve some aspects of athletic performance.

The idea of ​​becoming bigger to obtain an “advantage” over competition permeates athletes today.

Athletes involved in sports that emphasize muscularity, thinness and aesthetics may be predisposed to develop vigorexia.

For male and female athletes, body weight is another concern. Dissatisfaction with body weight can cause a body dysmorphic disorder.

In general, athletes are more critical with their bodies and body weights than recreational athletes or those who do not practice exercise.

Failure to meet performance standards or expectations can lead to a negative view of the body, resulting in a greater emphasis on achieving a certain appearance or ideal body.

This combination of sports performance, body image and body weight can cause a disturbance of the body image .

The best-informed athletic trainers recognize body image disorders such as disordered eating patterns, body dysmorphic disorder and muscle dysmorphia, and can offer better treatment options.

The evaluation and reference protocols must be individualized to the institution where they will be applied. Accusations should be put on the back burner, and the athlete should be approached with the utmost respect, understanding and empathy for an intervention to work.

Other approaches include being sensitive to the condition, without prejudice and empathic, but also realistic and frank.

To understand treatment options for vigorexia, it is important to first address common barriers.

Many do not seek treatment; therefore, the health professional has the responsibility to identify and intervene at the appropriate time.

The biggest obstacle is convincing the person with vigorexia that he needs help.

Many approaches can help the person to recognize the condition, such as openly discussing the body image, encouraging group or team discussion, and requesting help from the support and support staff to address the issue.

The devastating psychological and social consequences often go unnoticed and, therefore, are not addressed.

Currently, no specific programs have been developed to help people with vigorexia, although several general approaches have advanced.

As with many conditions and injuries related to athletics, athletic trainers are at the forefront and need to be well versed in recognizing the signs and symptoms of vigorexia, with prevention as the ultimate goal.

Athletic trainers can recognize lesser forms of vigorexia simply by being familiar with the dispositions of their athletes, as well as with common signs and symptoms.


As indicated above, people with vigorexia often do not seek treatment, so one of the biggest obstacles is convincing the patient to accept help.

Vigorexia responds well to the same treatments that help other eating disorders.

The treatment should initially focus on normalizing eating and exercise patterns and also on addressing obsessive thoughts.

If it is about steroid abuse, you must take special care and caution

Those who have responded better have been treated with antidepressant medications such as fluoxetine (Prozac, Eli Lilly and Co, IN), alone or in combination with cognitive behavioral therapy .

Many people who have milder forms of vigorexia are not the best candidates for the aforementioned therapies, because they can seek intervention only when they have a related injury or illness.

To adequately address this disease, society has to undergo a paradigm shift in the way we approach our bodies and body images.

Traditionally, men are not supposed to worry about appearance or vanity. Men, particularly children, do not want to be seen as feminine or weak.

When helping people with vigorexia, several steps should be considered. The individual has a distortion of his own reality.

Nothing is good enough, even though the person may believe that one more cycle of steroids or one more cosmetic procedure is all that will be needed to look good.

This process feeds itself, perpetuating the psychological need for more. Encouraging talking about inner feelings and dissipating feelings of isolation are good first steps.


Athletic trainers can use various resources to address the issue of vigorexia. However, resources are only beneficial when those who use them are properly educated.

The impulse of this review is to serve the purpose of increasing the awareness and knowledge of the health professional with respect to the subject. Many schools have policies on the management and discussion of eating disorders.

When considering programming to address vigorexia and other body image disorders, athletic trainers do not need to reinvent the wheel.

The development of informational pamphlets and the offering of group discussions, team meetings, and, occasionally, in-service educational programs can increase the awareness of athletes and coaches about the disorder.

Programming can be as creative or as basic as it suits the needs of the school and its athletes.