In my 20s, my eating disorder morphed to include muscle dysmorphic behavior. I began compulsively lifting, never being satisfied with what I saw, and constantly dealing with injuries. That drive to be lean and the drive to be muscular and big are all part of the same experience of not knowing how to measure my real value or what "health" was really all about.
This diagnosis is one of the most misunderstood mental health diagnoses out there. Predominantly seen in males but growing in all gender groups, muscle dysmorphia involves the perception that one can't get lean enough and muscular enough to make themselves happy. Being in the gym or working out can feel like the most important part of life. The anxiety that comes with missing out on exercise can feel overwhelming, so they will choose the workout over social events and even work and academic expectations. Another sign is working out while injured or sick due to a severe discomfort with the thought of losing out on the gains they have worked so hard to get. The drive for a lean body and large developed muscles is often accompanied by rigid dietary practices and use and abuse of legal and illegal appearance and performance enhancing drugs and products. The exercise is not just about obtaining the idealized body, but it also becomes the main tool for managing anxiety and mood issues that may also exist. Anxiety understandably increases significantly when exercise and food rituals are interrupted. It's a bit like an addict suddenly losing access to their drug. Health requires a balance of the physical, emotional and social aspects of life. Recovery requires a comprehensive and knowledgeable team including mental health providers and medical professionals.
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