What is gymorexia and which are the symptoms

"The word vigorexia comes from the Latin “vigor” (strength; vigor) and “orexis” (hunger; appetite), so literally it could be translated as “hunger for strength.” It is used to indicate a psychological condition caused by an altered perception of one's body, which causes one to see physical defects where they do not exist or are otherwise limited," explains Dr. Vanelli.

Vygorexia (or bigorexia), also called “muscle dysmorphia” or “Adonis complex,” is defined in the Diagnostic and Statistical Manual (DSM-5) as a distorted perception of one's body that triggers an obsessive worry that it is not muscular enough, resulting in a compulsion to exercise.

In years past, this condition was described as a form of anorexia nervosa (reverse anorexia), but closer observation of its characteristics has shown that the dysfunctions that mark it are not related to reduced nutrition, but rather to one's muscle mass.

The diagnosis of vigorexia is made by the psychiatric specialist in the presence of certain symptoms, such as:

• excessive concern that one's body is not sufficiently fit and muscular;
• strenuous exercise programs, even injuries, that go to take up a lot of one's daily time;
• strict diets based on low-calorie and high-protein foods;
• abuse of dietary supplements and/or drugs (hormones, diuretics, etc.) to enhance muscle mass;
• training and caring for one's body that comes before one's personal life (family, social, and work);
• using many, if not all, of one's economic resources for the enhancement of one's muscle tone;
• constantly looking in the mirror in search of imperfections or, conversely, avoiding looking in the mirror if one has not been able to undergo one's exercise routine;
• discomfort, anxiety and discomfort if you are unable to follow your scheduled workout.

Vigorexia and orthorexia, drunkorexia, pregorexia

Vigorexia, in its aspect of also being obsessed with an eating regimen that promotes muscle toning, can often be confused with other specific food and fitness obsessions, with which, in any case, it might still be accompanied. Among these, the following should be particularly mentioned: 

• orthorexia: obsession with healthy eating;
• drunkorexia: fasting in order to consume alcohol, and the calories it contains, without gaining weight;
• pregorexia: eating as little as possible during pregnancy to avoid weight gain.

Vigorexia can affect anyone regardless of age and sex, although in recent years there is evidence of an increase in it especially among young adults. Groups that seem to be most affected by it:

• males, particularly in the age of 25-35, followed by the 18- to 24-year-old age group,
• body building individuals: according to some research, about 10% of body builders would have vigorexia

The causes of this disorder are not yet fully known, however, factors have been identified that may promote its occurrence, such as:

• bullying, due to physical defects such as being overweight, suffered in childhood;
• idealization of certain beauty prototypes due to erroneous cultural and social factors;
• genetic familiarity (family members with obsessive-compulsive disorders and/or eating disorders).

Vigorexia often induces self-punishing behaviors such as strenuous workouts, with all the physical and mental consequences these can bring, such as:

• physical and organ function damage, such as cardiovascular disease, loss of kidney function, osteo-articular problems etc. due to a diet high in protein and often low in fat and carbohydrates and/or prolonged physical exertion
• impotence problems related to the use of anabolic drugs;
• impairment of personal emotional balance and social-affective relationships;
• anxiety or mood symptoms and disorders with depression and in the most serious cases suicidal thoughts. This is due to social isolation and excessive preoccupation with one's physical appearance.

"Individuals with vigorexia typically lack perception of their condition, as well as the need to seek help. For this reason, therefore, the disorder is often diagnosed late, when it is already in an advanced stage," Dr. Vanelli concludes.

The course of treatment is individualized and is developed following a multidisciplinary approach in which the treatment of first choice is cognitive-behavioral psychotherapy, combined with drug therapy that may result, for example, in the prescription of medications such as antidepressants.