PHOTO: Scott Webb
Text: Alejandra Misiolek
I have just received my daily google alerts on Eating Disorders and one of them was entitled: Body building changed my life and saved me from anorexia. You can see pictures of a young lady “before and after” body building and you can read how now she can eat 6000 kcal and before she would starve. And I ask myself, did it really save her from anorexia, or her ED simply converted into a bigorexia?
In this post I will write about bigorexia and orthorexia which are camouflaged Eating Disorders that are disguised into something that comes across as healthy.
Let´s first define what these are:
Bigorexia is a psychological disorder also called corporal dysmorphia or Adonis complex in a popular language, which is characterized by an excessive and unhealthy preoccupation to gain muscle and an unrealistic perception of one´s body that is seen as less muscular or smaller than it actually is. This muscular dysmorphia causes anxiety and obliges the person to dedicate a great proportion of their lives to muscle building.
Orthorexia, on the other hand, is an obsessive worry about consuming only healthy food. On the outside it looks as promoting health but paradoxically its obsessive character leads to social isolation and an excessive concentration on food. People with orthorexia lose their natural manner of intuitive eating, dedicate a lot of time to thinking about and planning what they are going to eat, and these behaviors cause anxiety and impair their functioning on other areas of their lives.
While it is true that doing exercise and eating healthily, although in an obsessive way, can safe one´s life because anorexia or bulimia can lead to death, they are still considered psychological disorders because they cause significant suffering and impair the daily functioning. Both bigorexia and orthorexia preserve the same psychological basis as the “classical” Eating disorders: the excessive concentration on the body and food. The importance food and body play in their lives and in their identity, self-esteem or emotion regulation, is still the same as in other EDs.
How does a person switch from anorexia or bulimia into bigorexia or orthorexia?
A frequent phenomenon is when we concentrate on treating the symptoms and not the person and their suffering. When we create a dissonance in such a person related to self-harm, they can stop harming their body and “take care” of their body. But the problem remains: they are doing it because they need to prove their value and regulate their emotions through their body.
The danger of orthorexia and bigorexia is that in our society sport and healthy eating are exactly what is promoted, so they can go unnoticed and even be admired and promoted.
So how do we help people with such disorders?
The interventions shouldn´t be any different from the ones we would apply for anorexia, bulimia or binge eating disorder. Constructing a strong sense of identity and self esteem not related to food or body and learning to understand one´s own emotions – where they come from, what they mean, what to do with them and how to process them; are the most helpful interventions in the therapeutic process. If we don´t treat the basis of the disorder, the person will only change the superficial symptoms and switch from one psychiatric label to the other.
De Psiquiatría, A. A. (2014). Manual diagnóstico y estadístico de los trastornos mentales: DSM-5.
Dunn, T. M., & Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating behaviors, 21, 11-17.
Mosley, P. E. (2009). Bigorexia: Bodybuilding and muscle dysmorphia. European Eating Disorders Review: The Professional Journal of the Eating Disorders Association, 17(3), 191-198.