Bigorexia Is the Latest Eating Disorder Affecting Teens—Here’s What Parents Need to Know

Whether it’s social media influence, peer pressure, or the competitive nature of high school sports, it’s common for teens to develop body image issues. Some are determined to become dangerously thin, while others are the opposite, fixated on building excessive muscle. Those in the latter category might develop a condition called bigorexia, or muscle dysmorphia. 

For teens with bigorexia, the desire to get bigger and more muscular leads to compulsive workout schedules, strict diets, and, at times, consuming risky supplements or steroids. Here, we’ll cover everything you need to know about what bigorexia entails, potential risk factors, dangerous effects on the body and mind, and how to create a positive body image in a society plagued by unrealistic body and beauty standards.

What is Bigorexia?

Bigorexia is a type of body dysmorphic disorder (BDD), a mental health condition that causes someone to become obsessed with perceived flaws in their physical appearance that are often unnoticeable to others. 

More specifically, bigorexia falls into a subcategory of BDD called muscle dysmorphia—a debilitating fixation on muscle size and physical appearance. Research published in The International Journal of Clinical Practice states that those with bigorexia hold a strong desire to have less body fat and more muscle.

A person struggling with bigorexia might believe they are too small or not muscular enough, even if they’re actually in great shape. They may feel the need to keep working out and building muscle to get the exact look they want, even when other people see them as strong or well-built.

“(Their) concern causes such distress that they engage in a lot of compulsive checking behaviors and rituals to try to change how they look,” explains Nancy Zucker, PhD, Director of the Duke Center for Eating Disorders. “It’s to such a degree that it impairs their functioning. (It’s an) all-consuming fixation.”

Because many with bigorexia turn to supplements and restrictive diets, it can also be considered an eating disorder. While anyone can develop bigorexia, Dr. Zucker notes that it’s thought to be more common in men.

What Causes Bigorexia?

Both societal and psychological factors can play a significant role in developing bigorexia. Possible causes might be some combination of the following:

Underlying anxiety

Dr. Zucker explains that social anxiety, in particular, can be a precursor to body image issues and disorders like bigorexia because of the underlying insecurity and fear of rejection. 

“For many eating or anxiety disorders, social anxiety kind of comes first,” she explains. (There is) this fear of being negatively evaluated by other people and really wanting to be included.” 

This fear of being viewed negatively by others, or not being accepted by your peers, is a key vulnerability that can lead to disorders like bigorexia.

Social media influence

Today’s teens are constantly inundated with images that harm their body image as they scroll through the Instagram-perfect lives of other people. Not surprisingly, many of these images on social media present unrealistic beauty standards that are not achievable for the average kid. 

This can make it easy for them to feel like they don’t look good enough, or that they look different enough from other people their age that it might make them believe they’ll be rejected or ridiculed for their looks. 

“Teens and preteens in the past may have looked at models in single magazines that were published once a month, or on TV shows,” says Julie Stefanski MEd, RDN, a Registered Dietician Nutritionist and Spokesperson for the Academy of Nutrition & Dietetics. “Kids today are constantly inundated with images of people (who) don’t necessarily look like the typical person in society.”

Teens who are trying to mimic adult athletes or bodybuilders will gravitate toward products being sold on their favorite social media platforms.

“Products that are advertised to improve performance, stimulate muscle growth, and increase endurance or stamina can pique a teen’s curiosity and seem like a quick fix for their insecurities,” she says.

Competition and peer pressure

The teenage years are marked by their emotional turmoil—and most teens are especially keen to fit in,at any cost. If friends or classmates are focused on working out, bulking up, or achieving a certain body type, it can lead to an unhealthy sense of competition or comparison.

Along these lines, sports like football or wrestling can put a lot of pressure on teens to improve strength and muscle mass, which are often tied to performance. 

“Children internalize what they hear at home, at sports practice, and at school,” says Stefanski. “Whether you’re a parent, family member, teacher, or coach, it’s completely unnecessary to offer a commentary about body weight or muscular build.”

The same goes for any adults, parents and family members included, who constantly comment on how much and what types of food a child eats—this type of talk can easily lead to damaging body image issues.

What are the Signs a Teen May Be Struggling with Bigorexia?

Certain signs of bigorexia can be obvious, while others are more subtle. Here are some warning signs to look out for that a teen may be struggling with bigorexia:

• Working out interferes with life and relationships: They may prioritize workouts over school, hobbies, and even time with friends and family, often skipping social events to avoid missing a workout. “You should have the flexibility to say, ‘I was planning on doing this workout, but my best friend’s birthday party is tonight,’” says Dr. Zucker. 
• A change in eating patterns: Stefanski adds that teens may skip meals, avoid favorite foods, or repeat meals daily that don’t vary. They may also request protein powders or foods geared toward bodybuilders or dieters from the grocery store. 
• Frequently checking their appearance: They may constantly look at themselves in the mirror (known as “body checking”), measure their muscle size, or wear clothing that emphasizes muscle tone. In contrast, they may also wear extra baggy clothing to hide their perceived lack of muscles. 
• Mood swings: Muscle dysmorphia can cause obsessive behaviors and intrusive thoughts, leading to extreme insecurity, anxiety, depression, or irritability. You may notice they become overly defensive when talking about their body or angry if they have to miss a workout. Keep track of any sudden personality changes. 
• Exercise becomes a need, not a want: They no longer find joy in working out—instead, it’s a way to relieve anxiety or guilt.

The Mental and Physical Effects of Bigorexia 

Bigorexia doesn’t just affect how teens see themselves—it can take a significant toll on both their body and mind, especially if extreme dieting or supplementation is included. These are some potential mental and physical effects of bigorexia in teens: 

• Nutritional deficiencies: Stefanski states that protein-packed meat, especially poultry, may be prioritized over other foods in an attempt to build muscle and reduce body fat. She explains that diets that center on meat do not provide a good balance of vitamins and may not provide adequate calcium for bone development. 
• Overtraining injuries: A compulsive exercise schedule without enough rest can lead to muscle strains, joint pain, stress fractures, and fatigue.
• Hormonal imbalances: According to Stefanski, “An imbalanced diet that prioritizes protein as the only goal decreases other important food groups like vegetables and fruits that contribute beneficial nutrients for the immune system and hormonal balance.” A nutritionist can help your child determine the healthiest diet for their body. 
• Anxiety and depression: The fixation on having the perfect body can cause significant stress, leading to obsessive thoughts and constant worry over working out and food intake. 
• Dangerously low body fat: Dr. Zucker explains that extremely low body fat can negatively impact hormone levels, brain organization, and overall health. If body fat seems particularly low, this should be an issue addressed with your child’s pediatrician. 
• Withdrawal and isolation: They may prioritize workout and diet routines over spending time with friends and family and avoid social events if they interfere.
• A lack of essential calories: Stefanski explains that no amount of protein intake will lead to muscle growth if total calorie needs aren’t met. “Rather than using protein for muscle synthesis, the protein will be converted to use as an energy source by the body.  No amount of protein powders or dietary supplements can make up for skipped meals and excessive restriction.”  

How Can Parents Support a Teen with Bigorexia?

If you’re noticing clear signs of bigorexia in your teen, professional intervention is likely the best option, says Dr. Zucker. She explains that treatments such as cognitive-behavioral therapy (CBT) and exposure therapy may be needed, as parents may not be able to address the issue on their own.

“You can’t reason someone out of it,” she says.

That said, there are still some ways parents can work in tandem with a mental health professional and a pediatrician to support healing, including:

• Have open conversations: Ask how they have been feeling about their body image and workouts, approaching the conversation with care and without judgment.
• Avoiding criticism: Instead of stating your concern for how much they’re working out, ask questions like, “I noticed you’ve been at the gym a lot—how are you feeling?”
• Encourage balance: Offer to help them find a healthy balance between working out, nutrition, social activities, and rest. 
• Limit social media: Breaks from social media can help them avoid unrealistic body comparisons.
• Validate how they feel: Ensure that it’s okay to feel insecure sometimes and that you understand the pressure of wanting to fit in with their peers. That said, you can also remind them that their body image is not tied to self-worth or value.

How to Create a Healthy Body Image at Home

As parents, you always want the best for your child—but as much as we’d like to, we can’t control every single factor that contributes to the development of body image concerns. You also can’t control everything your teen is exposed to—even if you use strong parental controls at home, you can’t always predict what they’ll encounter once they walk out the door.

Promote positive self-talk in the home 

That said, you can reduce the likelihood that your child will develop an eating disorder by being a positive, steady source of support. One of the best things you can do, says Stefanski, is think about how you’re commenting on your own body. 

“Some families have daily conversations about weight, dieting, and body shape. This type of discussion becomes ingrained in how children view themselves,” she says. “I’ve seen people feel negative about their body weight throughout their whole lifetime. Breaking the constant diet mentality cycle and determining self-worth based on the scale begins with ending conversations about dieting and negative body commentary in front of your children.”

Be careful how you describe certain foods

She recommends avoiding using words like “toxic” or “clean” when talking about foods, adding, “Children are concrete thinkers. If you call a delicious cake a toxic food, they are not going to understand why it’s ok to eat cake for a birthday. This mentality takes the joy out of occasionally enjoying tasty foods that also happen to be high in added sugar.” 

Limit screen time

When it comes to social media, Stefanski stresses the importance of recognizing harmful accounts—and you should also make sure that your kids have other interests besides spending time online.

“Teens need to be aware that social media influencers who are selling dietary supplements or products have an interest in you believing their information, even if it is misleading, so that you buy their products. You can teach kids to look for the hashtag #sponsored, (which means) the influencer is following FTC rules regarding sponsorship of their info.”

Keep Checking in With Your Kids

At the end of the day, all we can do as parents is focus on the things within our control —modeling healthy attitudes, maintaining open communication, and helping our kids build confidence and meaningful connections.

Dr. Zucker emphasizes the importance of connecting with your child as often as possible. Many times, families are so overscheduled they become like ships passing in the night, allowing obsessive behaviors to creep in under the radar. She adds that regular check-ins are important, along with honest conversations about setting healthy limits for certain behaviors—and that it’s possible to do too much of a good thing.

Along with open communication with your teen, fostering strong social connections and teaching them how to engage with others can serve as a powerful tool against disorders like bigorexia. 

“(It’s about) helping them so that they feel comfortable having meaningful conversations with people and helping them with the basics (of) connecting to others,” says Dr. Zucker. “I think that’s the best protection against these obsessive, physical appearance-focused disorders.”