BODY DYSMORPHIAS IMPACT ON THE FITNESS INDUSTRY
It is natural to worry about our appearance or be unhappy with some part of the way we look, but these concerns do not usually affect our daily lives. For others, it gravely impacts how they function.
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Body dysmorphic disorder (BDD), or body image disorder, is defined as a mental disorder characterized by negative, persistent thoughts about one’s own body that are hard to control and impact a person’s ability to live normally.
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“It’s [when] your subjective evaluation of your body is very different from the objective assessment of your body,” said Dr. Gabrielle Fundaro, an ACE-certified health coach. “A person with anorexia nervosa could look in the mirror and think ‘I’m fat,’ and in part it’s because they have misapplied emotional states to a physical characteristic.”
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Body dysmorphia affects one in 50 people. Within the United States, it is estimated that five to 10 million people have this condition, according to the Cleveland Clinic. Research conducted by the American Psychological Association (APA) indicates that BDD often develops in adolescents and teens, occurring in about 2.5% in males and 2.2% of females.
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A subtype of body dysmorphia is known as muscle dysmorphia (MD), a condition that causes a person to obsess over their body or a part of the body as being “too small” or “not muscular enough” despite having a normal build, or in many cases, an objectively extremely “buff” physique.
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Muscle dysmorphia mainly affects males, according to the International OCD Foundation. One study showed that about 22% of men with BDD also met the criteria for muscle dysmorphia.
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MD is sometimes referred to as “bigorexia” or “reverse anorexia.” It may have some overlap with eating disorders but is not an eating disorder. While individuals with MD often follow very precise, time-consuming, picky diets, their eating habits focus on improving the mass and leanness of their muscles, as opposed to concentrating on weight or body fat percentage, as seen in individuals with eating disorders.
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People with MD “exercise excessively, spending many hours at the gym, often risking injuries, or making them worse by refusing to stop, even when in significant pain,” according to the International OCD Foundation.
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It is normal for a weightlifter, bodybuilder or powerlifter to not be satisfied with their physique. This is not an indication of body dysmorphia rather the personality trait of perfectionism, which can have a positive or negative impact.
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However, body dysmorphia plays a major role in the fitness industry. “Body image concerns and disordered eating, and actually full-blown diagnosable eating disorders, occur at far higher rates in weight class restricted athletes … and then [at] even higher rates in competitive physique athletes,” said Eric Helms, a research fellow for Auckland University of Technology at the Sports Performance Research Institute in New Zealand, a natural (without the use of performance-enhancing drugs) bodybuilder and chief science officer and coach for 3D Muscle Journey, drug-free bodybuilding and powerlifting coaching program.
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Fundaro started her own telehealth coaching business, Vitamin PhD Nutrition, and works with all types of people. She has noticed how different sports impact body dysmorphia. “Looking at women’s rugby or hockey, those athletes … have had just anecdotally less body image disturbance and less focus on the appearance of their body,” she said. “They don’t have an emotional attachment to [their body]; whereas folks who have been physique competitors or those that are in a weight-class sport or even gen pop people who have been heavily influenced by that bodybuilding mindset, they’ve internalized specific ideas about what they’re supposed to look like.”
Types of weightlifting:
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Bodybuilding is the practice of progressively building muscle for aesthetic and strength purposes. The primary goal of bodybuilding is to use resistance training to develop, shape and sculpt the various muscles of the body over getting stronger. Bodybuilding competitions require competitors to lean out to only the essential fat levels needed to survive, and then are judged based on their physique.
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Powerlifting tests the competitor’s strength in three main barbell lifts: the bench press, squat and deadlift. Powerlifting is all about increasing a lifter’s one-rep max with the training geared toward developing maximal muscular strength.
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Olympic weightlifting, or competitive weightlifting, focuses on two dynamic barbell lifts: the snatch and the clean and jerk. The snatch involves flinging weight from the ground all the way overhead in one fluid motion. The clean and jerk is performed by lifting the barbell from the floor to the shoulders (clean), and then from the shoulder to overhead (jerk).
Body Dysmorphic Disorder affects 1.7% to 2.4% of the general population – about 1 in 50 people
But what comes first: the chicken or the egg? Does body dysmorphia exist beforehand or exist as a result of weightlifting?
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“It’s probably not that people with no predisposition or prior history of these issues get into the sport and then [experience body dysmorphia or disordered eating],” said Helms. “They tend to have certain personality characteristics that predispose them toward that [including]: obsessive nature, willingness to be analytical and neurotic, push themselves past their comfort limits, willingness to ignore body signals.”
Eric Helms // Photo courtesy of 3D Muscle Journey
Gabrielle Fundaro // Photo courtesy of Vitamin PhD Nutrition
If people perpetuate negative thoughts about themselves and are interacting with fitness content, “you will not struggle to find content that is going to validate those negative things you think about yourself,” Nuckols said. “There are some people wo start [feeling] pretty good about themselves – they have a pretty neutral to positive body image – and then, the algorithm slowly destroys that for them.”
A lot of fitness marketing, especially for men, preys on people’s drive for validation, according to Greg Nuckols, a powerlifter, head of content for Stronger by Science and co-owner of Monthly Applications in Strength Sport (MASS).
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“If you can identify people’s pain points and poke those pain points, that’s a good way to move product,” Nuckols said. Training programs validate how people feel about themselves negatively but offer a solution.
Greg Nuckols // Photo courtesy of Gymtalk
There is no data to show causation on whether bodybuilding independently causes disordered eating patterns or body image concerns. However, Helms noted one characteristic that is consistently present among bodybuilders and weightlifters: control freak.
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“In bodybuilding, there is always an element of control; [bodybuilders] like the fact that they can manipulate training [and] nutrition and just put forth a lot of effort [to] drastically change the way they look and achieve some incredibly high standards,” he said.
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On the other hand, someone who has a history of disordered eating or body dysmorphia and starts to compete in the sport can be putting themselves at risk of having a relapse.
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“Many of the biological aspects of dieting down to basically essential body fat levels – three to five percent for men [and] eight to twelve percent for women – creates symptoms that are associated with anorexia,” Helms said.
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In the case of an existing body image issue or an eating disorder caused by body dysmorphia, bodybuilding is “turning up the volume on what might already be there,” Helms said.
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When all those things are mixed, it can “enhance the likelihood of” developing body dysmorphia or disordered eating, according to Helms. “But I wouldn’t state confidently that it is just the sport itself – no matter how it’s done, no matter who comes to it – that causes eating disorders.”
When it comes to competing in powerlifting, there are designated weight classes for men and women. For men, the weight classes go all the way up to 120 kilos of 264 pounds. If you’re over 264 pounds, you are considered a super heavyweight. For women, the top weight capped classes are 84 kilos or 187 pounds. However, the average American woman 20 years old and up weighs on average 170.6 pounds, according to the Centers for Disease Control and Prevention. If a woman is above that, they are considered a super heavyweight.
Photo courtesy of Annemarie LePard
Nuckols is against the terminology used to define the weight classes. “I don’t think we should be calling anyone super heavyweights,” he said. “I largely suspect that a lot of slightly larger than average women really don’t like being called a super heavyweight if they’re like 185-190 pounds.”
Amanda Rizo // Photo courtesy of Psychology Today
Amanda Rizo said weightlifting is a great sport. “It has awesome potential for creating a very positive and uplifting community,” she said. “Although, on the other extreme, … it reinforces some negative behaviors. Some people can [fall] into the cycle of just chasing the trophy and chasing these accolades that they get, and then they start associating, ‘If I do this then I’m good, and then I’m accepted by people. My body seems worth and good and attractive.’”
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Eric Helms uses a strategy when he coaches people prepping for a bodybuilding competition: “Separation between their normal body image from their competitive body image, and also both of those from their self-worth. They need to have more than just, ‘I am me and I’m a bodybuilder,’ but rather, ‘I have value and I love bodybuilding.’”
PERSONAL TESTIMONIAL
Fitness trainer, former athlete and coach Lindsey Greeley was diagnosed with body dysmorphia in the midst of her bodybuilding career. “I would say like 23 [or] 24-years-old is probably when I was really at my worst with body dysmorphia.” At this time, Greeley was “crazy” and “obsessed” with the fitness industry.
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Greeley started bodybuilding back in 2010 at 16-years-old. She performed in her first show at the age of 17. “It’s really different when you’re getting critiqued on your body … I put my body through all these things thinking I look so great and then just get torn down,” she said.
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Greeley’s involvement in the bodybuilding community took a toll on her mental health. “I struggled my whole life with body image, body positivity, loving my body. I had a severe eating disorder also,” she said. “It’s crazy what these things [can] do because you think going to the gym is a healthy thing, getting involved in weightlifting is good for me, but it can turn into something that’s really bad for your mental health.”
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Greeley recalled her struggles with body image.
Greeley got into bodybuilding due to school bullying, but ultimately was forced to end her career in 2017-18.
While Greeley was laying on her deathbed, she said she felt “so broken” because she did not know who she was without bodybuilding. “My whole life, everyone has known me and associated Lindsey Marie Fit and bodybuilding,” she said.
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It took Greeley a long time to develop a healthy lifestyle when it comes to fitness.
BODY DYSMORPHIA HISTORY
Robustness was celebrated before the 1900s. It was a sign of wealth and prosperity – an indicator that you were not going to starve during times of famine and not doing a lot of hard labor. “It was attractive to have a soft, round body,” said Fundaro. Now, it’s stigmatized.
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In the early 1900s, Ancel Keys, an American physiologist who studied the influence of diet on health, developed the Mediterranean diet – a diet inspired by the eating habits of people who live near the Mediterranean Sea– and helped produce MREs (Meals Ready-to-Eat) for the military. Keys is characterized with bringing the concept of calories and macronutrients to the public. “The fact that food had calories and contained macronutrients that had protein, carbs and fat, and that the food we took in [contributed] directly to body size became public knowledge for the first time,” Fundaro said.
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Fast forward to World War I and the notion of food conservation which was centered around convincing Americans to change their eating habits in order to have enough food to feed military personnel and starving civilians in Europe – it was part of an American’s civil duty to ration food, consume foods that were not eaten regularly and, overall, eat less.
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The introduction of calories and macronutrients and the reduction to food consumption “started to A) make people look at bodies in a different way, and B) attach morality to food and food consumption because … if you had a large body, you were hoarding food in the shape of fat … [which made you] not a good civilian,” Fundaro said.
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Despite the Great Depression being a worldwide economic crisis, there was still an upper-middle class and above group that was not affected by the depression. In prior years, during times of famine, robustness was celebrated, however, Americans remained thin. “Now it was a way for them to still represent their morals,” said Fundaro. “Everyone’s eating a little bit less and some people are legitimately starving, [but] people in the upper-middle class and above, they were like, ‘Oh, I can still maintain my girlfish figure … the depression has done wonders for my waistline.’”
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By the time World War II comes around, if you were thin, you were “moral [and] Caucasian” because immigrants were usually considered to be “heavier set,” according to Fundaro. “The times were still very focused on this thin ideal.”
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It has been over 100 years and this “thin ideal” and focus on macronutrients have progressed forward. “We’ve attached morality to food and morality to body size,” Fundaro said. “You’re supposed to have a very rational, unemotional attachment to food – you need to just eat to fuel yourself and [not] enjoy it … because that’s too emotional.”
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This carriage of people’s beliefs over the years has been adapted to fit different media such as Instagram. “We get these messages and it’s sort of normalized this way of eating and has reduced the importance of enjoying your food or the cultural or traditional aspects of it,” Fundaro said.
SOCIAL MEDIA IMPACT
“Social media dysmorphia” is not a psychiatric disorder like BDD but replicates its tendencies such as constantly taking and posting selfies only to scrutinize and criticize them.
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Social medias relationship with body dysmorphia and disordered eating is another situation of what comes first. Are people who are consuming fitness content more predisposed to developing these conditions? Do they already have these conditions at the baseline and then are more likely to consume fitness content? Does fitness content initiate body image issues and disordered eating?
Gif courtesy of Annemarie LePard
But data suggests that social media heightens body dysmorphia.
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Helms was part of a study that exposed men and women to “thin, ideal” images. The results indicated there was a significantly greater effect on women. “It had a negative effect on their psyche,” said Helms. “They devalued themselves from constantly seeing what was interpreted as this is what you’re supposed to look like.”
“Social media can connect people inn really beautiful ways, but it can also create echo chambers where everyone is stuck in this sort of groupthink,” said Fundaro. “A lot of what drives our decisions is fear. We have a fear of not being accepted or being left out – we want to belong; we want to be in this group.”
This fear is what encourages people to follow the ways of fitness influencers. “If we see that all the fitness [content] on Instagram is people having green juices and doing intermittent fasting, we want to do that too,” said Fundaro. “If can really drive people to follow influencers regardless of the quality or accuracy of the information.”
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There is also the case of fitness influencers, particularly women, getting plastic surgery and then claiming they got their body from fitness. “No, you didn’t. Now what you’re doing is you are selling these fitness programs that girls, especially young girls, are buying,” said Greeley. “You’re selling a broken dream.”
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As a result, people develop body dysmorphia. “They’re comparing themselves to an unrealistic body that they could never have,” said Greeley. “You’re creating this poor body image for millions of girls that follow you on Instagram [who] now compare themselves every day when they’re really comparing apples to oranges.”
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“It’s this completely unrealistic expectation that you’re regularly exposed to,” Helms said.
Photo courtesy of "The Lexington Line"
Powerlifting emphasizes strength over physique. However, it can turn to a point of weight obsessed. “[A powerlifter] posts a PR (personal record) [on social media], it gets some traction, some likes, some comments, [but] they post a physique update, and if they’re conventionally attractive, that gets a lot more interaction,” said Nuckols, “which is kind of weird because if people are following them because they’re a very good powerlifter, it shouldn’t matter what they look like.”
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People who fall into this “trap” start to develop a different relationship with their body as it relates to powerlifting. “It becomes less about solely what can my body do and put up on the platform and more about what can my body do but also how does it look, and am I going to get likes for this,” Nuckols said.
BODY ACCEPTANCE
When people look at a person in a large body, they make several assumptions. They have assumed that a large body means the person is unhealthy, the person has developed their body size by way of a series of choices that were the wrong choice, that this person’s body size is representing their poor morals. Basically, this person is existing this this big body which means that they do not make good choices, are lazy, do not care about health and are a burden on society.
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Body acceptance is asking people to respect and treat people humanely regardless of body size.
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Fundaro calls body acceptance “healthism: a societal phenomenon, instead of beliefs, that health is something that people are responsible for pursuing, and that if you are potentially sick or currently sick, it’s your moral responsibility and citizen duty to pursue health and to overcome all obstacles that might be in your path, even though the access to health is not equitable from person to person.”
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However, body acceptance, or “healthism,” influences our beliefs about what it means to be in a fat body and whether it is acceptable.
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The body acceptance/ body positivity started out in the fat acceptance movement in the late 1960s, according to Fundaro. But it has expanded beyond body acceptance because “body diversity is about more than body size.”
In 2021, American singer Lizzo called out the body positivity movement saying that fat people are still getting the short of end of the movement. Instead of preaching body positivity, some are practicing body neutrality.
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“The body positive movement urges people to love their bodies no matter what they look like, whereas body neutrality focuses on what your body can do for you rather than what it actually looks like, said Associate Director of Communications at the National Eating Disorders Association Chelsea Kronengold in an interview with USA Today.
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Photo courtesy of Annemarie LePard
“What Lizzo is really saying is, ‘Whether or not I’m healthy, it is of no consequence to you, [it is] not your business, so accept that I’m going to be in this big body, and I don’t have to justify it by saying I have healthy obesity,” said Fundaro. “Sometimes obese people are healthy … and what some people are saying is, ‘I don’t have to justify my body size with health; I get to exist in this body no matter what my health status is.’”
On the reverse, there are people in the limelight who wear their bodies with confidence, only to lose the weight, or make a significant change to their appearance, a few years later like actress Rebel Wilson.
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“It’s so confusing because when people think acceptance, they think that it means not changing,” said Fundaro. “They think that means that if you accept this body right now that means that you have committed to staying in this body.”
Photo courtesy of Getty; Saskia Lawaks
But the term “acceptance” is misunderstood, according to Fundaro.
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“Acceptance is just about contacting the present moment – being aware of reality and not arguing with it,” Fundaro said. “This is the body I am in, [and] there’s nothing that I can do to change my body in this immediate moment.”