Other men develop body dysmorphic disorder, a pathological preoccupation with a particular body part they believe is flawed. About 1 percent to 2 percent of American men have body dysmorphic disorder, Hollander estimates. Of those, about 25 percent have bigorexia, he says. Men with bigorexia are prone to depression, using anabolic steroids and forgoing social events to spend several hours a day at the gym, lifting weights. Some continue to exercise even after they've suffered a serious injury, such as a dislocated shoulder, Hollander says.
Doctors say a variety of causes contribute, from brain chemistry to the media.
Hollander believes bigorexia is a type of obsessive compulsive disorder, which drives people to repeat an action or a behavior over and over. Men with bigorexia often look at themselves in the mirror frequently, eat a strange or restrictive diet and exercise until exhaustion. But the media also play a role, he says. In men's magazines, advertisers prey on the insecurities of many men, using modern-day Adonises with washboard abs, broad shoulders, slim waists and white teeth to peddle diet aids, fitness machines, baldness remedies, vitamins and an array of other products. Indeed, in the American media, men's looks count more than ever, Olivardia says.