https://phenomenajournal.marpedizioni.it/index.php/phenomena

Vol. 6 No. 2 (2024): July - Decembre 2024
Clinical psychology

Defining vigoroxia: a review of the literature

pdf (Italiano)
Giulia De Cristofano
Sipgi
Maria Barone
Sipgi
DOI: https://doi.org/10.32069/PJ.2021.2.222

Published 2024-09-04

Keywords

  • vigorexia nervosa,
  • body dysmorphism,
  • adolescence,
  • bodybuilding,
  • eating disorders,
  • anabolic androgenic steroids,
  • social anxiety
    • ...More
    Less

How to Cite

De Cristofano, G., Barone, M., De Masis, M., Di Donna, A., Forino, A. A., & Marino, L. (2024). Defining vigoroxia: a review of the literature. Phenomena Journal - International Journal of Psychopathology, Neuroscience and Psychotherapy, 6(2), 1–13. https://doi.org/10.32069/PJ.2021.2.222

Copyright (c) 2024 Giulia De Cristofano, Maria Barone, Maria De Masis, Alessandra Di Donna, Anna Asia Forino, Lucio Marino

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Abstract

Vigorexia, sometimes also known as muscle dysmorphia or bigorexia, is a complex nosological construct characterised by an intense preoccupation with the body and obsessive behaviours related to exercise and diet. This disorder, although often associated with the male fitness and bodybuilding universe, is also emerging among women and adolescents, reflecting the growing impact of the image cult and social media on body perception. This literature review aims to identify risk factors, diagnostic criteria, epidemiology and the relationship with eating disorders and addictions, as well as to examine the role of vigorexia in relationships and adolescence. The data analysis revealed that vigorexia is associated with a number of health risks, including the use of anabolic androgenic steroids and eating disorders. Furthermore, individuals with vigorexia often experience social anxiety related to others' judgement of their physical appearance, which can lead to social isolation and impaired interpersonal relationships. In conclusion, this analysis of vigorexia provides a comprehensive overview of its risks, associated disorders and implications for mental health and social relationships, emphasising the importance of early intervention and targeted preventive strategies to address this emerging phenomenon especially among younger people.

pdf (Italiano)

References

  1. Vasiliu, O., Vasile, D., Mangalagiu, A. G., Petrescu, M. B., Candea, C. A., Tudor, C., ... & Bratu-Bazic, R. E. (2020). Current treatment of posttraumatic stress disorder—A review of therapeutic guidelines and good practice recommendations. RJMM, 123, 241-248.
  2. Gorrell, S., & Murray, S. B. (2019). Eating disorders in males. Child and Adolescent Psychiatric Clinics, 28(4), 641-651.
  3. 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.
  4. Martenstyn, J. A., Maguire, S., & Griffiths, S. (2022). A qualitative investigation of the phenomenology of muscle dysmorphia: Part 1. Body image, 43, 486-503.
  5. Pope, H., Phillips, K. A., & Olivardia, R. (2000). The Adonis complex: The secret crisis of male body obsession. Simon and Schuster.
  6. Di Grigoli, A. R. (2022). L’irriducibilità dei disturbi alimentari maschili. Uno sguardo pedagogico sull’intersezione tra corporeità, genere e cultura. The irreducibility of male eating disorders.
  7. Vasiliu, O. (2023). At the Crossroads between Eating Disorders and Body Dysmorphic Disorders—The Case of Bigorexia Nervosa. Brain Sciences, 13(9), 1234.
  8. Pope Jr, H. G., Katz, D. L., & Hudson, J. I. (1993). Anorexia nervosa and “reverse anorexia” among 108 male bodybuilders. Comprehensive psychiatry, 34(6), 406-409.
  9. Pope Jr, H. G., Gruber, A. J., Choi, P., Olivardia, R., & Phillips, K. A. (1997). Muscle dysmorphia: An underrecognized form of body dysmorphic disorder. Psychosomatics, 38(6), 548-557.
  10. Martenstyn, J. A., Maguire, S., & Griffiths, S. (2023). A qualitative investigation of the phenomenology of muscle dysmorphia: Part 2. Body Image, 44, 78-92.
  11. Olivardia, R., Pope Jr, H. G., & Hudson, J. I. (2000). Muscle dysmorphia in male weightlifters: A case-control study. American Journal of Psychiatry, 157(8), 1291-1296.
  12. Murray, S. B., Rieger, E., Touyz, S. W., & De la Garza García, Lic, Y. (2010). Muscle dysmorphia and the DSM‐V conundrum: Where does it belong? A review paper. International Journal of Eating Disorders, 43(6), 483-491.
  13. Murray, S. B., Rieger, E., Hildebrandt, T., Karlov, L., Russell, J., Boon, E., ... & Touyz, S. W. (2012). A comparison of eating, exercise, shape, and weight related symptomatology in males with muscle dysmorphia and anorexia nervosa. Body Image, 9(2), 193-200.
  14. Martenstyn, J. A., Touyz, S., & Maguire, S. (2021). Treatment of compulsive exercise in eating disorders and muscle dysmorphia: protocol for a systematic review. Journal of Eating Disorders, 9(1), 1-7.
  15. Arslan, M., Yabancı Ayhan, N., Sarıyer, E. T., Çolak, H., & Çevik, E. (2022). The effect of Bigorexia nervosa on eating attitudes and physical activity: A Study on University Students. International Journal of Clinical Practice, 2022.
  16. Foster, A., Shorter, G., & Griffiths, M. (2015). Muscle dysmorphia: Could it be classified as an addiction to body image?. Journal of Behavioral Addictions, 4(1), 1-5.
  17. American Psychiatric Association (2013). Manuale diagnostico e statistico dei disturbi mentali – Quinta edizione. DSM-5. Tr.it. Raffaello Cortina, Milano, 2015.
  18. Duran, S., Çiçekoğlu, P., & Kaya, E. (2020). Relationship between orthorexia nervosa, muscle dysmorphic disorder (bigorexia), and self-confidence levels in male students. Perspectives in Psychiatric Care, 56(4).
  19. Riccobono, G., Pompili, A., Iorio, C., Carducci, G., Parnanzone, S., Pizziconi, G., ... & Pacitti, F. (2020). An instrument for the evaluation of muscle dysmorphia: The Italian validation of the adonis complex questionnaire. Brain and Behavior, 10(7), e01666.
  20. Nieuwoudt, J. E., Zhou, S., Coutts, R. A., & Booker, R. (2015). Symptoms of muscle dysmorphia, body dysmorphic disorder, and eating disorders in a nonclinical population of adult male weightlifters in Australia. The Journal of Strength & Conditioning Research, 29(5), 1406-1414.
  21. Olivardia, R., Pope Jr, H. G., Borowiecki III, J. J., & Cohane, G. H. (2004). Biceps and body image: the relationship between muscularity and self-esteem, depression, and eating disorder symptoms. Psychology of men & masculinity, 5(2), 112.
  22. Devrim, A., Bilgic, P., & Hongu, N. (2018). Is there any relationship between body image perception, eating disorders, and muscle dysmorphic disorders in male bodybuilders?. American journal of men's health, 12(5), 1746-1758.
  23. Hildebrandt, T., Langenbucher, J., & Schlundt, D. G. (2004). Muscularity concerns among men: development of attitudinal and perceptual measures. Body Image, 1(2), 169–181. https://doi.org/10.1016/j.bodyim.2004.01.001
  24. Cafri, G., Olivardia, R., & Thompson, J. K. (2008). Symptom characteristics and psychiatric comorbidity among males with muscle dysmorphia. Comprehensive psychiatry, 49(4), 374–379. https://doi.org/10.1016/j.comppsych.2008.01.003
  25. Edwards, C., Molnar, G., & Tod, D. (2017). Searching for masculine capital: Experiences leading to high drive for muscularity in men. Psychology of Men & Masculinity, 18(4), 361.
  26. Badenes-Ribera, L., Rubio-Aparicio, M., Sánchez-Meca, J., Fabris, M. A., & Longobardi, C. (2019). The association between muscle dysmorphia and eating disorder symptomatology: A systematic review and meta-analysis. Journal of behavioral addictions, 8(3), 351–371. https://doi.org/10.1556/2006.8.2019.44
  27. Grunewald, W., Troop-Gordon, W., & Smith, A. R. (2022). Relationships between eating disorder symptoms, muscle dysmorphia symptoms, and suicidal ideation: A random intercepts cross-lagged panel approach. The International journal of eating disorders, 55(12), 1733–1743. https://doi.org/10.1002/eat.23819
  28. Nagata, J. M., McGuire, F. H., Lavender, J. M., Brown, T. A., Murray, S. B., Greene, R. E., Compte, E. J., Flentje, A., Lubensky, M. E., Obedin-Maliver, J., & Lunn, M. R. (2022). Appearance and performance-enhancing drugs and supplements, eating disorders, and muscle dysmorphia among gender minority people. The International journal of eating disorders, 55(5), 678–687. https://doi.org/10.1002/eat.23708
  29. Murray, S. B., Griffiths, S., Mond, J. M., Kean, J., & Blashill, A. J. (2016). Anabolic steroid use and body image psychopathology in men: Delineating between appearance-versus performance-driven motivations. Drug and alcohol dependence, 165, 198-202.
  30. Lofrano-Prado, M. C., Prado, W. L., Barros, M. V. G., & de Souza, S. L. (2015). Eating disorders and body image dissatisfaction among college students. ConScientiae Saúde, 14(3), 355-362.
  31. Michalska, A., Szejko, N., Jakubczyk, A., & Wojnar, M. (2016). Nonspecific eating disorders-a subjective review. Psychiatria polska, 50(3), 497-507.
  32. Cruz-Sáez, S., Pascual, A., Wlodarczyk, A., & Echeburúa, E. (2020). The effect of body dissatisfaction on disordered eating: The mediating role of self-esteem and negative affect in male and female adolescents. Journal of health psychology, 25(8), 1098-1108.
  33. Zeeck, A., Welter, V., Alatas, H., Hildebrandt, T., Lahmann, C., & Hartmann, A. (2018). Muscle Dysmorphic Disorder Inventory (MDDI): Validation of a German version with a focus on gender. PloS one, 13(11), e0207535.
  34. Malcolm, A., Pikoos, T. D., Castle, D. J., & Rossell, S. L. (2021). An update on gender differences in major symptom phenomenology among adults with body dysmorphic disorder. Psychiatry Research, 295, 113619.
  35. Dakanalis, A., Zanetti, A. M., Riva, G., Colmegna, F., Volpato, C., Madeddu, F., & Clerici, M. (2015). Male body dissatisfaction and eating disorder symptomatology: Moderating variables among men. Journal of health psychology, 20(1), 80-90.
  36. Devrim, A., Bilgic, P., Aslantas, B., & Hongu, N. (2017). Relationship between muscularity concerns and body checking behaviors in Turkish bodybuilders. The FASEB Journal, 31, lb436-lb436.
  37. Stanford, S. C., & Lemberg, R. (2013). A clinical comparison of men and women on the Eating Disorder Inventory-3 (EDI-3) and the Eating Disorder Assessment for Men (EDAM). In Current findings on males with eating disorders (pp. 76-92). Routledge.
  38. Kanayama, G., Hudson, J. I., & Pope Jr, H. G. (2009). Features of men with anabolic-androgenic steroid dependence: A comparison with nondependent AAS users and with AAS nonusers. Drug and alcohol dependence, 102(1-3), 130-137.
  39. Kanayama, G., Hudson, J. I., & Pope Jr, H. G. (2010). Illicit anabolic–androgenic steroid use. Hormones and behavior, 58(1), 111-121
  40. Hitzeroth, V., Wessels, C., Zungu‐Dirwayi, N., Oosthuizen, P., & Stein, D. J. (2001). Muscle dysmorphia: a South African sample. Psychiatry and Clinical Neurosciences, 55(5), 521-523.
  41. Pope, C. G., Pope, H. G., Menard, W., Fay, C., Olivardia, R., & Phillips, K. A. (2005). Clinical features of muscle dysmorphia among males with body dysmorphic disorder. Body image, 2(4), 395-400.
  42. Motl, R. W., Conroy, D. E., & Horan, P. M. (2000). The Social Physique Anxiety Scale: an example of the potential consequence of negatively worded items in factorial validity studies. Journal of applied measurement, 1(4), 327-345.
  43. Scott, L. A., Burke, K. L., Joyner, A. B., & Brand, J. S. (2004). Examining the stability of the 7-item social physique anxiety scale using a test-retest method. Measurement in Physical Education and Exercise Science, 8(2), 57-62.
  44. Cole, J. C., Smith, R., Halford, J. C., & Wagstaff, G. F. (2003). A preliminary investigation into the relationship between anabolic-androgenic steroid use and the symptoms of reverse anorexia in both current and ex-users. Psychopharmacology, 166, 424-429.
  45. Hall, R. C., Hall, R. C., & Chapman, M. J. (2005). Psychiatric complications of anabolic steroid abuse. Psychosomatics, 46(4), 285-290.
  46. Miller, K. E., Hoffman, J. H., Barnes, G. M., Sabo, D., Melnick, M. J., & Farrell, M. P. (2005). Adolescent anabolic steroid use, gender, physical activity, and other problem behaviors. Substance use & misuse, 40(11), 1637-1657.
  47. Hallgren, M., Pope Jr, H. G., Kanayama, G., Hudson, J. I., Lundin, A., & Källmén, H. (2015). Anti-social behaviors associated with anabolic-androgenic steroid use among male adolescents. European addiction research, 21(6), 321-326.
  48. Hauger, L. E., Westlye, L. T., & Bjørnebekk, A. (2020). Anabolic androgenic steroid dependence is associated with executive dysfunction. Drug and alcohol dependence, 208, 107874.
  49. Hauger, L. E., Sagoe, D., Vaskinn, A., Arnevik, E. A., Leknes, S., Jørstad, M. L., & Bjørnebekk, A. (2019). Anabolic androgenic steroid dependence is associated with impaired emotion recognition. Psychopharmacology, 236, 2667-2676.
  50. Copeland, J., Peters, R., & Dillon, P. (2000). Anabolic-androgenic steroid use disorders among a sample of Australian competitive and recreational users. Drug and alcohol dependence, 60(1), 91-96.
  51. Griffiths, S., Jacka, B., Degenhardt, L., Murray, S. B., & Larance, B. (2018). Physical appearance concerns are uniquely associated with the severity of steroid dependence and depression in anabolic–androgenic steroid users. Drug and alcohol review, 37(5), 664-670.
  52. Benlloch, T., & Consuelo, M. (2022). A propósito de la vigorexia: más allá de un trastorno dismórfico. Delimitación diagnóstica y causas de este trastorno. Rev. esp. drogodepend, 73-83.
  53. Pezzo, R., Pescina, D., & Fagiolari, F. (2019). New addictions. A race towards the goal of independence. Rivista di Psicopatologia Forense, Medicina Legale, Criminologia, 24(3).
  54. Hagger, M. S., & Stevenson, A. (2010). Social physique anxiety and physical self-esteem: Gender and age effects. Psychology and Health, 25(1), 89-110.
  55. Hart, E. A., Leary, M. R., & Rejeski, W. J. (1989). Tie measurement of social physique anxiety. Journal of Sport and exercise Psychology, 11(1), 94-104.
  56. Portman, R. M., Bradbury, J., & Lewis, K. (2018). Social physique anxiety and physical activity behaviour of male and female exercisers. European Journal of Sport Science, 18(2), 257-265.
  57. Rica, R., Solar, M., Moreno-Encinas, A., Foguet, S., Compte, E. J., & Sepúlveda, A. R. (2022). Physical appearance perfectionism: psychometric properties and factor structure of an assessment instrument in a representative sample of males. Frontiers in Psychology, 13, 806460.
  58. Bergunde, L., & Dritschel, B. (2020). The shield of self-compassion: A buffer against disordered eating risk from physical appearance perfectionism. PloS one, 15(1), e0227564.
  59. Festinger, L. (1954). A theory of social comparison processes. Human relations, 7(2), 117-140.
  60. Schneider, C., Agthe, M., Yanagida, T., Voracek, M., & Hennig-Fast, K. (2017). Effects of muscle dysmorphia, social comparisons and body schema priming on desire for social interaction: an experimental approach. BMC psychology, 5, 1-9.
  61. Arigo, D., Schumacher, L., & Martin, L. M. (2014). Upward appearance comparison and the development of eating pathology in college women. International Journal of Eating Disorders, 47(5), 467-470.
  62. Bucchianeri, M. M., Serrano, J. L., Pastula, A., & Corning, A. F. (2014). Drive for muscularity is heightened in body-dissatisfied men who socially compare. Eating disorders, 22(3), 221-232.
  63. Nagata, J. M., DeBenedetto, A. M., Brown, T. A., Lavender, J. M., Murray, S. B., Capriotti, M. R., ... & Lunn, M. R. (2022). Associations among romantic and sexual partner history and muscle dysmorphia symptoms, disordered eating, and appearance-and performance-enhancing drugs and supplement use among cisgender gay men. Body image, 41, 67-73.
  64. Barthels, F., Meyer, F., Huber, T., & Pietrowsky, R. (2017). Orthorexic eating behaviour as a coping strategy in patients with anorexia nervosa. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22, 269-276.
  65. Quick, V., Eisenberg, M. E., Bucchianeri, M. M., & Neumark-Sztainer, D. (2013). Prospective predictors of body dissatisfaction in young adults: 10-year longitudinal findings. Emerging Adulthood, 1(4), 271-282.
  66. Pigozzi, F., Lucidi, F., & Isidori, E. (Eds.). (2021). L'educazione antidoping: modelli, metodi e strategie. Franco Angeli.
  67. Guerra, G. C., Paone, A., Lionetti, F., Spinelli, M., Fasolo, M., & D'Urso, G. (2024). The Role of Psychological Parental Control and Internalizing Problems in the Etiology of Vigorexia and Orthorexia in Adolescence. Children (Basel, Switzerland), 11(2), 259. https://doi.org/10.3390/children11020259