Like many boys within the 90s, Jonathon Freelove played with motion figures. He-Man, Ninja Turtles and ThunderCats were his favourites. While the characters were imaginary, he knew one a part of them resembled the human world: their torsos. Swollen biceps and defined abdominal muscles on the plastic figurines were his first introduction to what masculinity and the male physique could seem like. 

By adolescence, the seemingly flawless, God-like Arnold Schwarzenegger and Rocky Balboa were his idols. He would pick up his father’s copies of Men’s Health across the house and flick through. It was 2001, and headlines included: “Fat to Flat”, “Sex. Money. Muscle.”, and “Look Great Naked”. 

Determined to resemble the jacked-up bodies he’d aspired to since childhood, Freelove began lifting weights, and replaced “bad” food with “clean” alternatives. Although his recent hobby was praised by those around him, “it was only a type of self-harm, because I hated the best way I looked,” he says. As his body goals became increasingly unattainable, the habit became an obsession; the more he burned, the further his confidence fell. Inside a 12 months of lifting weights, Freelove was admitted to The Priory Hospital in Birmingham for a nine-month-stay, for an eating disorder.

“My ankle was swollen up because I had severe fluid retention, and I used to be having irregular heartbeats,” he says, a consequence of abusing caffeinated pre-workout powders. But in treatment, one thing baffled him – he was attempting to get larger, not smaller. “I used to be obsessive about muscularity,” he says. He then received a further diagnosis: muscle dysmorphia (MD).

“The day you begin lifting is the day you turn out to be ceaselessly small,” is a standard phrase within the bodybuilding community. While for a lot of bodybuilders this mantra speaks to their drive for ever-bigger muscles that characterises the game, for a smaller section of the population, it encapsulates the losing battle that’s MD.

WHAT IS MUSCLE DYSMORPHIA DISORDER?

MD is a subtype of body dysmorphic disorder (BDD) which affects two percent of the population. Seen mostly in men, it’s defined as a preoccupation with one’s perceived lack of muscularity, despite having a mean construct, or in lots of cases, an especially muscular body. This ends in repeated behaviours to attempt to fix the perceived flaw: abusing pre-workout supplements, steroids, excessive exercise, restrictive eating and body checking.

The condition shouldn’t be classified as an eating disorder, nonetheless, symptoms often occur concurrently. It entered the psychiatric lexicon in 1997, and in 2002, The Adonis Complex: How you can Discover, Treat and Prevent Body Obsession in Men and Boys was published, which introduced the novel concept that a gym obsession could turn out to be pathological, many years before the fitness industry would find its most profitable frontier on social media.

However it’s necessary to tell apart between avid gym-goers with insecurities and clinical dysmorphia. A key sign is when the fixation begins to interfere with one’s day by day activities, says Viren Swami, professor of social psychology at Anglia Ruskin University. As an illustration, when George Mycock, 27, from Stoke-on-Trent, spent a day or two off his weight-reduction plan, or out of the gym, he’d be consumed by paranoia that everybody would know. So, he’d avoid leaving the home, he says, and at all-time low, he locked himself away for 3 weeks. He’d planned to take his own life, but was narrowly saved by a friend.

WHY CASES OF MUSCLE DYSMORPHIA ARE RISING

While the primary recorded cases were over 20 years ago, body image concerns have gotten increasingly prevalent amongst young males. “It has appeared to explode over recent years,” says Dr Gabriela Vargas, director of the Young Men’s Health website at Boston Children’s Hospital. Love Island torsos, algorithm-fueled protein shakes and YouTube videos with titles corresponding to “The Secret of How Andrew Tate Got HUGE While in Prison,” are pressuring boys and men to bulk up. “I’ve struggled with it due to how normalised [the gym] has been,” Freelove says. “When really, for me, it’s the place I shouldn’t be going.”

Over half of British men show signs of body dysmorphia, a recent report found. Inside the community of avid male gym-goers, a study published last year within the US found that all participants who immersed themselves in bodybuilding practices described themselves as having some extent of muscle dysmorphia. 

Men, nonetheless, are less more likely to seek treatment than women – despite one in three eating disorders occurring in men, in response to the National Eating Disorder Association, just one in 20 people in treatment are male, Vargas says. Meanwhile, in 2016, it was reported that lower than one percent of all of the body image and eating disorder research was conducted exclusively on males, leading some researchers to state that it is a “silent crisis” in men’s mental health.

“We’re still learning quite a bit about it, because partially, it just hasn’t been prioritised in research,” Vargas says, of MD. “There’s this huge shift that should occur by way of acknowledging that it is a significant concern for men,” she says.

A PERVASIVE CULTURE OF STEROIDS

Freelove overcame his eating disorder in hospital, but he continues to struggle with dysmorphia. At his lowest, he would visit the gym multiple times day by day and abuse SARMs, illegal muscle-enhancing drugs that mimic the results of testosterone and anabolic steroids, which have been found to be sold in UK shops. He learnt about them via YouTube influencers, who trivialised the strawberry and watermelon drinks as gym bag must-haves. But upon a visit to the doctor for depression – that he would later learn was no less than partially SARMs-inflicted – he was told he had the testosterone levels of a 90-year-old man. He still takes hormone alternative medication to reverse the damage.

There are still multiple million, predominantly male, steroid users within the UK, in response to the UK Anti-Doping agency. Research from marketing firm Mintel found almost 1 / 4 of men aged 16-24 within the UK take supplements for exercise. “We all know that teens which might be using protein supplements are moving on to the anabolic steroids,” says Vargas, because immersing into the gym community can increase the danger.

On the more extreme end, bodybuilders have even died in recent times from suspected steroid-related causes, including celebrity bodybuilder Wealthy Piana on the age of 46. Piana freely admitted having taken steroids since he was a teen, nonetheless, the explanation for his death thus far stays unclear.

“If you would like to win your class and take a look at to be an expert bodybuilder, you’ve gotten to take steroids,” says bodybuilder Grant Lloyd, 25, from North Carolina, who uses the drugs. He began collaborating in competitions at age 14, and suffers from MD, but thinks that the game’s endemic steroid culture makes it unavoidable.

UNREALISTIC BODY IDEALS ON SOCIAL MEDIA

On account of the competitive and aesthetic nature of bodybuilding, social media is a natural home for the culture. Oscar*, 27, an internet trainer and non-competitive bodybuilder from Liverpool who asked to stay anonymous, began sharing content on Instagram. “I’d get one negative comment like, ‘oh, why are you giving advice on muscle growth? You’re so small,’” he says, leading him to experience dysmorphic thoughts. Now, to acknowledge his growth, he must compare side-by-side past and present pictures of himself. Otherwise, in his reflection, he simply feels too small, he says.

And following bodybuilders only worsened this. “Social media shows you the one per cent of people that look the perfect of the perfect, whose content performs the perfect –  it creates this echo chamber,” he says, especially attributable to the prevalence of steroid usage.

Greater social media usage amongst adolescent and young adults has been related to symptoms of muscle dysmorphia, in response to a study published this year. It described social media algorithms as “rabbit holes,” that “ultimately perpetuate the unrealistic body ideals, that are commonly posted on social media and precipitate attempts to vary one’s body.”

TOXIC MASCULINITY

However the rise in MD runs deeper than algorithms. Mycock believes that for some, the appeal of constructing muscle is being “able, capable to fight, intimidating, dominant – these patriarchal ideas of what a person ought to be.” And Freelove admits he partially got into weightlifting to look attractive to women: “If I seem like this, I’ll find a way to get in a relationship”.

Swami sees this intertwining of muscularity and masculinity as a comparatively recent cultural change, starting within the early 90s, when fashion and wonder industries realised the market power of targeting men, he says. Men began to be sold the concept that their bodies are non-biological commodities to be invested in, he says. And with the backdrop of evolving gender roles, Swami thinks muscle-building offers immediate agency over one’s virility: “It’s the one type of masculinity that seems like it’s malleable.” 

 But for Oscar*, as a transgender man, this malleability was a lifeline: while on a two-year wait list for hormone therapy, he began weightlifting to attach together with his masculinity.“I assumed, well, if I construct more muscle, I do know I can look closer to how I feel in my head,” he says. 

But living inside a culture that valorises the muscular physique can delay recovery, MD victims say. “Lots of your physical symptoms to the outward world are great,” says Mycock. In consequence, self-destructive behaviours could be hidden in plain sight. “It’s hard to stomach the nuance of it because for thus long, we’ve been told it’s good – and regardless of what, it’s good,” he says. He adds: “Exercise ought to be treated more like medicine, within the sense, there’s all the time a listing of unintended effects.”

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