#NEDAwareness Week: Reverse Anorexia

“What is Reverse Anorexia?” (By: Megan Dottermusch)

Disclaimer: “Reverse anorexia” is not a medical, diagnosable, DSM-V term, but rather vernacular to describe an obsessive mindset.

Reverse anorexia is a type of body dysmorphic disorder in men and women that can lead to severe physical and emotional consequences. National Eating Disorders Awareness Week is Feb. 22-28, but the entire month provides an opportunity to inform people that eating disorders affect both genders. I once thought body image issues were something that only women struggled with, but I’ve since discovered that men also wrestle with these demons.

Leigh Cohn, President of N.A.M.E.D. (National Association of Males with Eating Disorders), was instrumental in helping me understand the struggles men have with eating disorders. I discussed this problem with him to find out how we can educate the public and work to end the stigma surrounding body dysmorphia.

What is Body Dysmorphic Disorder?

Body dysmorphic disorder (BDD) is an image disorder that causes the affected individual to have an altered sense of their appearance. According to Cohn, BDD is often generalized and referred to as “reverse anorexia.” Of course, almost all of us have some body part that we would change if we could, but we don’t become obsessed over it. Someone with BDD is so consumed with fixing an imperfect body part — or the part that they perceive is imperfect — that this obsession negatively affects their ability to live a normal life. They consider their imperfections, which in reality may be so slight that they’re not noticeable, to be so obvious to others that they withdraw from friends, family, and school, and may even go so far as to seek plastic surgery.

We typically see BDD develop in adolescence, affecting men and women at roughly the same rate, although Cohn says it is likely higher in men. While experts can’t pinpoint the exact source of this disorder, some people have a genetic predisposition to developing BDD. One explanation is that their brain may be unable to adequately process serotonin, the neurotransmitter that determines a person’s mood or disposition. Other risk factors include damaging experiences, such as bullying, emotional trauma or a negative family environment. It is not unusual for individuals with BDD to also have obsessive-compulsive disorder, social anxiety disorder, additional eating disorders, and depression.

Reverse Anorexia

Anorexia nervosa can best be described as an obsessive fear of gaining weight. In people with this condition, regardless of how thin they become, their mind insists they are overweight. Although it is thought that men have lower rates of this condition, this may be the result of misdiagnosing the condition in them. As awareness increases, anorexia nervosa may be recognized more in men, and therefore treated in greater numbers.

However, reverse anorexia is a type of BDD, primarily affecting men, in which men want to be bigger or more muscular. Reverse anorexia is sometimes referred to as bigorexia, or muscle dysmorphia.

Cohn explains, “Whereas someone with anorexia would look at a little flab under their arms and think, ‘I’ve got to lose weight,’ someone with reverse anorexia would look at their muscles and think, ‘Those need to be larger … those aren’t big enough … my abs aren’t defined enough.’ ”

What are the signs and symptoms?

It’s important to know the symptoms of reverse anorexia so you don’t assume everyone lifting weights at the gym has this body image issue. According to Cohn, “Males with reverse anorexia obsess about taking supplements and steroids, and steroid use is a really big problem among people with BDD.”

In addition to anabolic steroid use, symptoms include an obsession with working out, building muscle and decreasing body fat. In fact, these individuals place such a high priority on working out to the exclusion of other activities, such as school, work or hanging out with friends, and are agitated when they have to miss a workout session. They also adhere to an overly strict diet that focuses on eating protein (to build muscle), and excludes carbohydrates. Other warning signs include weighing themselves more than once in the course of a day, and spending a considerable amount of time in front of a mirror examining their muscles. However, sometimes this condition may also cause men to avoid looking at themselves in the mirror at all or they may wear baggy clothes in public because they feel that their bodies are inadequate.

Seeking Treatment

Left untreated, BDD can be an emotionally debilitating and paralyzing condition that can also have serious physical consequences. Research has shown that steroid use can adversely affect the body, and limiting one’s diet to the exclusion of other foods that provide nutrients can lead to malnutrition. Combined with the emotional and mental turmoil that those with reverse anorexia suffer, along with their social isolation, it becomes apparent that these individuals cannot lead a normal life without intervention.

While the public is pretty knowledgeable of the dangers of anorexia among women, we need to raise public awareness that body dysmorphic issues, which predominately affect men, are just as dangerous. It’s important to understand that women are not the only people who struggle with eating disorders, and equal attention should be given to men so we can identify and treat these problems across the board.

Disclaimer:

If you suspect that you have an eating disorder, or think that you know someone who does, please seek professional help for a proper diagnosis and clinical counseling. Mental health assistance in the form of treatment and counseling has proven to be effective in combating eating disorders in both women and men. For more information on help and support, visit the websites of N.A.M.E.D., the Eating Disorders Coalition of Tennessee, and the National Eating Disorders Association.

About the Author

Megan Dottermusch is the community manager for Counseling at Northwestern, the masters in counseling program offered by The Family Institute at Northwestern online. She earned her B.S. in Business Marketing from the University of Maryland and was an active member in Kappa Delta Sorority. While serving as Risk Manager on her chapter’s Executive Board, Megan was a confidant and resource for its members seeking help for personal and emotional issues. As a result, she has become passionate about combatting mental health stigmas, promoting wellness through proper nutrition, fitness, and everyday mindfulness.