When Bigger is Never Big Enough

Body Image Among Boys and Men

By Dr. Lindsey Landgrebe, EDCare

For Men’s Health Month, we’ve invited Dr. Lindsey Landgrebe from EDCare for a special blog post on muscle dysmorphia in men and boys. In this post, Dr. Landgrebe discusses the impacts of fitness culture on body image while providing a list of things to lookout for when it comes to muscle-oriented disordered eating. 

Muscularity & Masculinity

From Instagram posts displaying workout routines and gym progress selfies, to TikTok influencers promoting clean eating and performance enhancing supplements, to dating apps that reinforce appearance driven value and worth, adolescent boys and emerging adult men are increasingly exposed to messages that reinforce an ideal muscular, yet lean body where bigger is better. The associations between muscularity and masculinity are clear – whereby masculinity is often defined by muscularity. 

The internalization of these messages can create body dissatisfaction and a desire to change one’s body composition, shape, and size. For some, this pursuit of a muscular, lean body ideal can result from experiences of bullying or body shaming. For others, this pursuit can be a means of gaining acceptance or a sense of belonging and prove one’s masculinity. While these behaviors are often reinforced or praised by friends, family, and on social media, it is important to create space for discussions around body image for boys and men given the potential consequences of pursuing this body ideal.

Muscle dysmorphia is becoming increasingly prevalent among boys and men across racial and ethnic groups (Hong & Ennis, 2014; Jung et al., 2010). A preoccupation of one’s body composition and developing a muscular physique can be unrelenting and cause psychological distress. Someone struggling with muscle dysmorphia may have a distorted perception of their body, perceiving themself as smaller than they truly are. This can lead to a desire to hide their body in an effort to not be perceived as small by others or avoidance of social interactions. 

The drive to be bigger and leaner can often lead to muscle-oriented disordered eating (Griffiths et al., 2013). Excessive and rigid workout routines and clean eating rituals that emphasize an over-consumption of high protein based foods or supplements can develop and interfere with school, work, and other social activities (Murray et al., 2016). These behaviors can also result in medical complications and increase anxiety and mood symptoms. 

Warning Signs of Muscle-Oriented Disordered Eating

  • Preoccupation of body composition and perceived inadequacies of being too small that illicit significant distress and impair functioning
  • Compulsive exercise and rigidity around workout schedule
  • Avoidance of social gatherings where one’s body would be exposed or wearing oversized, baggy clothing to hide one’s body
  • Clean eating that consists of a meal plan high in protein 
  • Use of anabolic steroids, protein supplements, and other performance enhancing substances
  • Continuing to engage in dieting, use of performance enhancement substances, or working out despite understanding of consequences to one’s health and well-being
Help is available if you recognize these warning signs in yourself or others you care about. Speaking with a mental health professional could help identify the underlying function of this drive to be bigger and could create space to explore one’s sense of self beyond body shape, size, and appearance. Additionally, due to the physical consequences of muscle-oriented disordered eating, it would be important to speak with your primary care physician if you notice any changes to physical health. 


Griffiths, S., Murray, S. B., & Touyz, S. (2013). Disordered eating and the muscular ideal. Journal of Eating Disorders. Advance online publica- tion. http://dx.doi.org/10.1186/2050-2974-1-15

Hong, D., & Ennis, C. (2014). The role of ethnicity in male students’ drive for muscularity. Research Quarterly for Exercise and Sport, 85, A99– A100. http://dx.doi.org/10.1080/02701367.2014.930647

Jung, J., Forbes, G. B., & Chan, P. (2010). Global body satisfaction among college men in the United States and Hong Kong-China. Sex Roles, 63, 104–117. http://dx.doi.org/10.1007/s11199-010-9760-z 

Murray, S. B., Griffiths, S., & Mond, J. M. (2016). Evolving eating disorder psychopathology: Conceptualising muscularity-oriented disor- dered eating. The British Journal of Psychiatry, 208, 414–415. http:// dx.doi.org/10.1192/bjp.bp.115.168427 

Dr. Lindsey Landgrebe

Primary Therapist | EDCare