From Obesity to Bigorexia: A Clinical Case Report
DOI:
https://doi.org/10.20344/amp.24473Keywords:
Adolescent, Body Dysmorphic Disorders, Body Image, Feeding Behavior, Feeding and Eating Disorders, Muscles, Obesity/complicationsAbstract
Body image is a multidimensional construct about one’s appearance. Social and media factors contribute to dissatisfaction and are associated with mental health disorders. In adolescence, obesity emerges as a significant factor, with a four-fold increased risk of body dissatisfaction. Muscle dysmorphia is characterized by an obsessive pursuit of muscularity and distorted body image. A 16-year-old male with a history of obesity and depression, medically accompanied since age 10, developed obsessive behaviors around diet and exercise after weight loss and remission of depression. He adopted a “bulking and cutting” regimen and used creatine, protein, and caffeine supplements. He displayed rigid behavior, with poor insight. Given the pervasive functional impairment, he was referred to child and adolescent psychiatry. Muscle dysmorphia, classified as a body dysmorphic disorder, is underdiagnosed. Adolescent obesity may be a predisposing factor. Early recognition, particularly in adolescents with obesity and body image concerns is crucial for healthy development.
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Latorre-Román PÁ, Garrido-Ruiz A, García-Pinillos F. Versión española del cuestionario del complejo de Adonis; un cuestionario para el análisis del dimorfismo muscular o vigorexia. Nutr Hosp. 2015;31:1326-32.
Badenes-Ribera L, Rubio-Aparicio M, Sánchez-Meca J, Fabris MA, Longobardi C. The association between muscle dysmorphia and eating disorder symptomatology: A systematic review and meta-analysis. J Behav Addict. 2019;8:701-19. DOI: https://doi.org/10.1556/2006.8.2019.44
Lusich R, Grunewald W, Smith A. Longitudinal relationships between negative attitudes towards obesity and muscle dysmorphia symptoms. Eat Behav. 2025;56:101948. DOI: https://doi.org/10.1016/j.eatbeh.2025.101948
Nagata JM, Hur JO, Murakami K, Ganson KT, He J, Murray SB, et al. Muscle dysmorphia in adolescents and young adults. Lancet Child Adolesc Health. 2026;10(2):122-34. DOI: https://doi.org/10.1016/S2352-4642(25)00283-4
Orrit G, Pablos A, Guzmán FJ. Muscle dysmorphia: predictive and protective factors in adolescents. Cuad Psicol Deporte. 2019;19:1-11. DOI: https://doi.org/10.6018/cpd.347981
Alencar AS, Nascimento LB, Soares CF, Bressera MG, Brito NL. Vigorexy: a danger in the search of the ideal body. Int J Soc Psychiatry. 2020;66:726-27.
Mitchison D, Mond J, Griffiths S, Hay P, Nagata JM, Bussey K, et al. Prevalence of muscle dysmorphia in adolescents: findings from the EveryBODY study. Psychol Med. 2021;51:2199-206.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596
Ganson KT, Cunningham ML, Pila E, Rodgers RF, Murray SB, Nagata JM. “Bulking and cutting” among a national sample of Canadian adolescents and young adults. Eat Weight Disord. 2022;27:3759-65. DOI: https://doi.org/10.1007/s40519-022-01470-y
Murray SB, Griffiths S. Adolescent muscle dysmorphia and family-based treatment: a case report. Clin Child Psychol Psychiatry. 2015;20:324-30. DOI: https://doi.org/10.1177/1359104514521639
Oliveira A, Araújo J, Severo M, Correia D, Ramos E, Torres D, et al. Prevalence of general and abdominal obesity in Portugal: comprehensive results from the National Food, Nutrition and Physical Activity Survey 2015–2016. BMC Public Health. 2018;11:614. DOI: https://doi.org/10.1186/s12889-018-5480-z
Montani JP, Schutz Y, Dulloo AG. Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk? Obes Rev. 2015;16:S7-18. DOI: https://doi.org/10.1111/obr.12251
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