Bdd in Men Various Problems

BDD in Men

Various problems concerning female perceptions about body image have long been at the center of debate. In recent years men have also begun to confront negative concepts of body image. Although many people are uncomfortable with their body image, this discomfort can also lead to a serious problem known as Body Dysmorphic Disorder (BDD). The purpose of this discussion is to focus on body dysmorphic disorder as it relates to men. The discussion will focus on muscle dysmorphia, the factors that contribute to the development of body dysmorphic disorder in men and the treatment of the disorder. Let us begin out discussion by defining BDD.

Body Dysmorphic Disorder

According to Veale (2003), BDD is defined as mental disorder, which can be described by obsession with an imagined imperfection in one's appearance. In addition, the person may actually have a slight physical abnormality, but this abnormality is regarded as grossly excessive (Veale 2003). Other elements of BDD include significant distress and the inability to work or interact socially (Veale 2003). The author also asserts that people with BDD are also likely to suffer from obsessive-compulsive disorder (OCD), social phobia, and depression (Veale 2003).

Varieties of people are affected by BDD including those with self-harming behaviors and borderline personality disorder.

Finally the author explains that all suffers of the disorder believe that a part of the body is unattractive (Veale 2003). In most cases, the preoccupation is focused on hair, facial features and skin (Veale 2003). In addition, the preoccupation involves seral parts of the body. The author also reports that the typical complaint involves flaws on the face (whether perceived or actual), asymmetry, body features felt to be out of proportion, incipient baldness, acne, wrinkles, vascular markings, scars, or extremes of complexion, ruddiness or pallor. While some complaints are specific in the extreme, others are vague or amount to no more than a general perception of ugliness. The nature of the preoccupation may change over time, and this may explain why, after cosmetic surgery, the patient's focus may shift to another area of the body (Veale 2003)."

In females body dysmorphia disorder leads to anorexia nervosa and other eating disorders. In males body dysmorphia can lead to muscle dysmorphia. In either case BDD is a disorder that can interfere greatly with daily life and lead to depression and suicidal thoughts.

Body Dysmorphic Disorder in Men

Although body dysmorphic disorder was once mostly confined to women, the disorder is now extremely prevalent in males. According to Phillips & Castle (2001) recent studies have indicated that an increasing number of men are also dissatisfied with their bodies. One study even revealed that 43% of men were not satisfied with their bodies (Phillips & Castle 2001). In addition, Phillips & Castle (2001) asserts that percentage of males with a negative body image has tripled in the past 25 years. Research also reveals that men are just as likely to be dissatisfied with their appearance as women are (Phillips & Castle 2001).

The authors also reveal that body dysmorphic disorder is as common in men as it is in women. According to Phillip & Castle (2001), men with BDD are usually obsessed with their skin, genitals and nose size.

In addition, the majority of males with the disorder engage in repetitive behaviors that are often time-consuming and are aimed at examining and/or concealing the flaw (Phillips & Castle 2001). These repetitive behaviors include camouflaging, comparing their bodies to others, and checking the mirror (Phillips & Castle 2001).

Phillips & Castle (2001) also reveals that a new form of BDD, muscle dysmorphia, is exclusively found in men. According to the authors, muscle dysmorphia is the preoccupation with one's body is too small and inadequately muscular (Phillips & Castle 2001). However, many of the men that suffer with this form of the disorder have unusually large muscles. An article found in the Journal of Sports Behavior reveals body dissatisfaction and body image problems, including muscle dysmorphia, may occur more frequently in males who weight train in high volumes (Pope et al., 1993) compared to the regular exercise population and may predispose them to steroid use...when exercisers use weight training to improve self-esteem, some may come to rely on this training to feel good about themselves (Russell 2002)."

According to the first study about muscle dysmorphia published in the American Journal of Psychiatry in 2000, weightlifters with the muscle dysmorphia were extremely different from weightlifters without the disorder.

For instance, the prevalence of anabolic steroid use, body dissatisfaction, eating attitudes, and lifetime prevalence of mood, anxiety and eating disorders were all measures for which men with and without the disorder differed (First Controlled Study of Muscle Dysmorphia Published, 2005).

In addition, men with this disorder are plagued with the need to workout compulsively, to carefully monitor their diets and to take dietary supplements (Phillips & Castle 2001). This form of BDD can become extremely dangerous and result in the abuse of anabolic steroids (Phillips & Castle 2001). Anabolic steroid abuse is common even amongst those without the disorder. According to Pederson & Wichstrom (2001) the abuse of anabolic steroids can lead to "increased risk of coronary heart disease, liver disease, testicular atrophy, prostate cancer, and breast enlargement in men and decrease in women (Bahrke et al., 1998). Possible psychological side effects include decreased libido, increased aggression including homicide and suicide, affective and psychotic disorders (Pederson & Wichstrom (2001)." Phillips & Castle (2001) explain that the cause of BDD is unknown but it is plausible that the muscle dysmorphia form of the disorder is caused in part by the social pressures imposed on boys to be muscular (Phillips & Castle 2001).

Factors that Influence the Development of BDD in Men

As we mentioned previously in the discussion in recent years there has been an increase on the amount of pressure placed on boys and men to have a certain body type. According to an article published in Sex Roles: A Journal of Research the media has played an influential role in displaying these ideal body types (Grieve, Lorenzen, & Thomas, 2004). The article explains that People are bombarded daily with their culture's stereotypical images of attractiveness from magazines, television, films, billboards, and other electronic and print media. This constant exposure to ideal body types (which are often quite unrealistic for most individuals to obtain) can make individuals more sensitive and conscious about their own bodies, and can evoke comparisons between themselves and unrealistic media images of thinness and/or muscularity (Grieve, Lorenzen, & Thomas, 2004).

The article goes on to state that images which place a great deal of emphasis on the appearance of the body have the most significant impact on women. However, the impact that these images have on men has not been examined as closely. The article asserts that the changes in the ideal body type for men can be seen in toy action figures and male models in advertisements.

Since very little research exist concerning the impact of the "ideal body image" on men in their study Grieve, Lorenzen, & Thomas, (2004) sought to evaluate the direct effects of exposure to ideal body types on body satisfaction in men. More specifically the participants viewed some very muscular models to examine the impact that it would have on their perception of their own bodies. One-hundred-four college men participated in the study (Grieve, Lorenzen, & Thomas, 2004). The researchers hypothesized that the participants' "self-rated body satisfaction would decrease after viewing advertisements of muscular men. The second hypothesis under study was that mens' self-rated body satisfaction would remain constant after viewing advertisements of average men (Grieve, Lorenzen, & Thomas, 2004)."

The results of the study indicate that that even limited exposure to these images can dwarf the way that men view their bodies and lead to muscle dysmorphia in the same way the image of thin women can lead to eating disorders in female (Grieve, Lorenzen, & Thomas, 2004). The results of the first hypothesis was supported as men's self-rated body satisfaction indeed decreased after seeing men that were extremely muscular (Grieve, Lorenzen, & Thomas, 2004). An additional analysis of the significant time-by-image-exposure interaction revealed that that scores on the BA decreased for the men who were shown muscular images (Grieve, Lorenzen, & Thomas, 2004). This additional analysis confirms previous research, which asserts that exposure to media of stereotypical attractiveness, results in decreased body satisfaction (Grieve, Lorenzen, & Thomas, 2004).

The results of the second hypothesis found that men's self-rated body satisfaction did remain constant after viewing images of non-muscular men (Grieve, Lorenzen, & Thomas, 2004). These results are consistent with those from previous research with women which found that exposure to media images of average women does not influence body satisfaction (Grieve, Lorenzen, & Thomas, 2004). Overall the research indicates that Similar to women who look to the media for cultural standards of an attractive body ideal, men may also be susceptible to interpreting a muscular body ideal from media images. A possible implication could be that in order to obtain the unrealistic muscular ideal, men may try to gain muscle mass and, consequently, increase their risk for developing muscle dysmorphia (see Olivardia, 2001, for diagnostic criteria), similar to women who try to lose weight to obtain the unrealistic ultra-thin ideal and increase their risk for developing eating disorders (Grieve, Lorenzen, & Thomas, 2004)."

In addition, to media images that bombard men there are also biological factors that influence the development of BDD in men.

According to an article entitled "Bigger Isn't Always Better - muscle dysmorphia in men" the most severe cases of muscle dysmorphia involve a biological predisposition for the disease (Bartlett 2001). The author explains that from a biological standpoint the man suffering with the disease has a form of obsessive-compulsive disorder (Bartlett 2001). For instance someone who washes his hands 10 times per day is normal, however washing your hands one hundred times per day to the point that it hampers with the rest of your life is a symptom of a greater problem (Bartlett 2001). According to the article this example is used to illustrate "there isn't anything pathological about going to the gym regularly or dieting," but there is a problem when "a huge number of boys and men work out beyond a normal range so that it becomes a source of distress" and affects all areas of their lives (Bartlett 2001)."

Treatments for BDD in Men

People with BDD are treated in many ways. The most common treatment for men involves surgical, dermatological and other types of non-psychiatric treatment (Phillips & Castle 2001).

However, the research indicates that such treatments are usually not effective (Phillips & Castle 2001). In addition, many male patients are so dissatisfied with the results that they experience severe depression, become suicidal, become violent towards the doctors or sue the doctors (Phillips & Castle 2001).

It has been suggested that educating patients about the disorder combined with psychiatric treatment is the only way to reduce the symptoms of the disorder..

Hong (2000) asserts there are differing opinions about the treatment that can be used for muscular dysmorphia. For instance, Eric Hollander, M.D. Of the Mount Sinai School of Medicine posits that the use of the drug Clomipramine can be beneficial in the treatment of the disorder (Hong 2000). Clomipramine has the effect of increasing serotonin levels in the brain, which can alleviate the symptoms caused by the disorder (Hong 2000). An increase in Serotonin levels is essential because the chemical turns off the brain processes, which tell a person when there is an abnormality in the body (Hong 2000). When serotonin levels are low, these brain processes are not turned off, which results in skewed perceptions of self (Hong 2000). According to Hollander, Clomipramine can alleviates the symptoms and improve them by 25 to 35% (Hong 2000).

On the other hand, James Rosen, M.D., a clinical psychologist and professor at the University of Vermont posits that therapy may be adequate enough treatment for many suffers of muscular dysmorphia (Hong 2000). According to the article this treatment would involve teaching the patients to understand when their feelings are unsubstantiated (Hong 2000). Rosen asserts that treatment for muscle dysmorphia would include eliminating the idea that the exercisers would lose control of themselves if they missed a workout (Hong 2000).