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Bigorexia: one eating disorder classified as EDNOS
EDNOS (Eating Disorder Not Otherwise Specified) are those eating disorders not well understood or characterized. More specifically, the Diagnostic and Statistical Manual – 4th Edition (DSM-IV) defines EDNOS as a "category of disorders of eating that do not meet the criteria for any specific eating disorder". Among them there is one called Bigorexia. Other names for this type of EDNOS are vigorexia, reverse anorexia nervosa, Adonis Complex, or muscle dysmorphia. Bigorexia is a very specific type of body dysmorphic disorder.
People with bigorexia, mainly men, become obsessed with the idea that they are too small, skinny, or not with enough muscular build-up. Patients who experience this strange eating disorder have, in fact, well above average muscular consistency and it is common among weight lifters and body culturists.
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As with any EDNOS, bigorexia is difficult to diagnose. People with bigorexia are constantly examining themselves in a mirror and frequently comparing themselves with others. They have delusions of being underweight or below average in musculature. They also hate their reflections and usually become distressed if they miss a workout session or one of their meals. Neglecting jobs, relationships, or family because of exercising is common. Also, it is not rare for people with bigorexia to take anabolic steroids.
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As a poorly understood disorder, there are no known treatments for Bigorexia and research is needed in this area. However, long term psychological counselling could help. Since depression is one of the main consequences of bigorexia, drugs may be used to treat this condition. One of the problems with this disorders as that men are slow to recognize that they have a problem so treatment and managing of the disease is difficult if people do not come forward. Support from family and friends is essential to overcome bigorexia.
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Hildebrandt, T. et al. 2006. Comprehensive Psychiatry, Vol 47(2), 127-135.
Phillips, K.A. 2005. The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. Oxford Press. New York US