Background: To compare male bodybuilders to men with eating disorders and control men regarding body image, psychopathology and sexual history. Method: We compared 28 male bodybuilders, 30 men with eating disorders (anorexia nervosa, bulimia or binge eating disorder defined by DSM-IV), and 30 controls, using a battery of questionnaires covering weight history, eating behavior, body image, lifetime history of psychiatric disorders, and sexuality. Eating-disordered and control men were recruited from a college student population and studied during the course of an earlier investigation. Results: Bodybuilders exhibited a pattern of eating and exercising as obsessive as that of subjects with eating disorders, but with a ‘reverse’ focus of gaining muscle as opposed to losing fat. Bodybuilders displayed rates of psychiatric disorders intermediate between men with eating disorders and control men. In measures of body image, the bodybuilders closely resembled the men with eating disorders, but significantly differed from the control men, with the former two groups consistently displaying greater dissatisfaction than the latter. Sexual functioning did not distinguish the three groups except for the item ‘lack of sexual desire’ which was reported significantly more often by both bodybuilders and men with eating disorders. Conclusion: On measures of body image and eating behavior, bodybuilders share many features of individuals with eating disorders.

Fichter MM, Daser C: Symptomatology, psychosexual development and gender identity in 42 anorexic males. Psychol Med 1987;17:409–418.
Anderson A: Males with Eating Disorders. New York, Brunner/Mazel Publishers, 1990, p 35.
Anderson AE, Holman JE: Males with eating disorders: Challenges for treatment and research. Psychopharmacol Bull 1997;33:391–397.
Carlat DJ, Camargo CA, Herzog DB: Eating disorders in males: A report on 135 patients. Am J Psychiatry 1997;154:1127–1132.
Olivardia R, Pope HG, Mangweth B, Hudson JI: Eating disorders in college men. Am J Psychiatry 1995;152:1279–1285.
Mangweth B, Pope HG, Hudson, JI, Olivardia R, Kinzl J, Biebl W: Eating disorders in Austrian men: An intracultural and crosscultural comparison study. Psychother Psychosom 1997;66:214–221.
Mintz LB, Betz NE: Sex differences in the nature, realism, and correlates of body image. Sex Roles 1986;15:185–195.
Drenowski A, Yee DK: Men and body image: Are males satisfied with their body weight? Psychosom Med 1987;49:626–634.
Rosen JC, Gross J, Vara L: Psychological adjustment of adolescents attempting to lose or gain weight. J Consult Clin Psychol 1987;55:742–747.
Moore DC: Body image and eating behavior in adolescent boys. Am J Dis Child 1990;144:475–479.
Pope HG, Katz DL, Hudson JI: Anorexia nervosa and ‘reverse anorexia’ among 108 male bodybuilders. Compr Psychiatry 1993;34:406–409.
Dwyer JT, Feldman JJ, Seltzer CC, Mayer J: Body image in adolescents: Attitudes toward weight and perception of appearance. Am J Clin Nutr 1969;20:1045–1056.
Tucker LA: Relationship between perceived somatotype and body cathexis of college males. Psychol Rep 1982;50:983–989.
Klein AM: Little Big Men. Albany, State University of New York, 1993.
Pasman L, Thompson JK: Body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary individuals. Int J Eat Disord 1988;7:759–769.
Blouin AG, Goldfield GS: Body image and steroid use in male bodybuilders. Int J Eat Disord 1995;18:159–165.
Pope HG, Gruber AJ, Choi P, Olivardia R, Phillips KA: ‘Muscle dysmorphia’: An underrecognized form of body dysmorphic disorder? Psychosomatics 1997;38:548–557.
Pope HG Jr, Katz DL: Bodybuilder’s psychosis. Lancet 1987;1(8537):863.
Porcerelli JH, Sandler BA: Narcissism and empathy in steroid users. Am J Psychiatry 1995;152:1672–1674.
Anderson RE, Barlett SJ, Morgan GD, Brownell KD: Weight loss, psychological, and nutritional patterns in competitive male bodybuilders. Int J Eat Disord 1995;18:49–57.
Anderson SL, Zager K, Hetzler RK, Nahikian-Nelms M, Syler G: Comparison of Eating Disorder Inventory (EDI-2) scores of male bodybuilders to the male college student subgroup. Int J Sport Nutr 1996;6:255–262.
Schwerin MJ, Corcoran KJ, Fisher L, Patterson D, Askew W, Olrich T, Shanks S: Social physique anxiety, body esteem, and social anxiety in bodybuilders and self-reported anabolic steroid users. Addict Behav 1996;21:1–8.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
Wittchen HU, Wunderlich U, Gruschwitz S, Zaudig M: SKID-I – Strukturiertes Klinisches Interview für DSM-IV, Achse 1: Psychische Störungen. Göttingen, Hogrefe, 1997.
Pope HG Jr, Brower KJ: Anabolic-androgenic steroid abuse; in Sadock BJ, Sadock VA (eds): Comprehensive Textbook of Psychiatry, ed 7. Baltimore, Lippincott Williams & Wilkins, 2000, pp 1085–1095.
Gruber AJ, Pope HG Jr: Psychiatric and medical effects of anabolic-androgenic steroid use in women. Psychother Psychosom 2000;69:19–26.
Olivardia R, Pope HG Jr, Hudson JI: ‘Muscle dysmorphia’ in male weightlifters: A case-control study. Am J Psychiatry, in press.
Cohane GH, Pope HG Jr: Body image in boys: A review of the literature. Int J Eating Disord, in press.
Pope HG Jr, Phillips KA, Olivardia R: The Adonis Complex: The Secret Crisis of Male Body Obsession. New York, Free Press, 2000.
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