From Obesity to Bigorexia: A Clinical Case Report

Authors

  • Inês Eiras Serviço Pediatria. Unidade Local Saúde Alto Minho. Viana do Castelo. & Serviço Pediatria. Unidade Local Saúde Médio Ave. Vila Nova Famalicão. https://orcid.org/0009-0003-0881-7816
  • Maria Inês Sousa Serviço Pediatria. Unidade Local Saúde Médio Ave. Vila Nova Famalicão. & Serviço Pediatria da Unidade Autónoma de Gestão da Mulher e da Criança. Unidade Local Saúde de São João. Porto. https://orcid.org/0000-0001-8560-8792
  • Ana Bandeira Santos Serviço Pediatria. Unidade Local Saúde Médio Ave. Vila Nova Famalicão. https://orcid.org/0009-0007-1457-6659
  • Filipe Oliveira Serviço Pediatria. Unidade Local Saúde Médio Ave. Vila Nova Famalicão. https://orcid.org/0009-0005-1805-508X
  • Paula Fonseca Serviço Pediatria. Unidade Local Saúde Médio Ave. Vila Nova Famalicão. https://orcid.org/0000-0001-7792-6870

DOI:

https://doi.org/10.20344/amp.24473

Keywords:

Adolescent, Body Dysmorphic Disorders, Body Image, Feeding Behavior, Feeding and Eating Disorders, Muscles, Obesity/complications

Abstract

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.

Downloads

Download data is not yet available.

References

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

Downloads

Published

2026-07-24

How to Cite

1.
Eiras I, Sousa MI, Bandeira Santos A, Oliveira F, Fonseca P. From Obesity to Bigorexia: A Clinical Case Report. Acta Med Port [Internet]. 2026 Jul. 24 [cited 2026 Jul. 28];. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/24473

Issue

Section

Case Report