Stuart B. Murray

A comparison of eating, exercise, shape, and weight related symptomatology in males with muscle dysmorphia and anorexia nervosa.

In the context of the lack of nosological clarity surrounding muscle dysmorphia, this paper aims to compare the symptomatic profile of muscle dysmorphia and anorexia nervosa in males whilst using measures sensitive to indexing male body image concerns. Twenty-one male muscle dysmorphia patients, 24 male anorexia nervosa patients, and 15 male gym-using controls completed the Eating Disorder Examination-Questionnaire, the Muscle Dysmorphia Disorder Inventory, the Compulsive Exercise Test, and a measure of appearance-enhancing substance use. Men with muscle dysmorphia and anorexia nervosa demonstrated widespread symptomatic similarities spanning the domains of disturbed body image, disordered eating, and exercise behaviour, whilst differences were consistent with the opposing physiques pursued in each condition. Furthermore, correlational analyses revealed significant associations between scores on muscle dysmorphia and eating disorder measures. The present findings provide moderate support for the notion that muscle dysmorphia may be nosologically similar to anorexia nervosa.

Muscle dysmorphia and the DSM‐V conundrum: Where does it belong? A review paper

OBJECTIVE Muscle dysmorphia is a relatively recently identified psychological condition that, since its inception, has been variously conceptualized as an eating disorder and subsequently as a type of body dysmorphic disorder within the somatoform disorders. This review aims to inform and encourage ongoing debate surrounding the diagnostic placement of this disorder. METHOD We present a review and synthesis of the extant literature with a view to informing future decisions regarding the conceptualization of muscle dysmorphia. RESULTS The validity of muscle dysmorphia as a clinical entity has been empirically demonstrated. While the condition bears little semblance to somatization as currently conceptualized, the research suggests a strong conceptual similarity with anorexia nervosa. However, future research needs to utilize more appropriate measures of male eating disorder pathology. Muscle dysmorphia is also inclusive of obsessive compulsive features that are typical to those seen in eating disorder presentations. DISCUSSION We suggest that muscle dysmorphia be reanalyzed through the lens of an eating disorder spectrum. Recognition of muscle dysmorphia as an eating disorder may offer more clinical utility in recognizing the male experience of eating disorder pathology and also help reduce the number of current male cases falling into the EDNOS category.

Evolving eating disorder psychopathology: conceptualising muscularity-oriented disordered eating.

Eating disorders, once thought to be largely confined to females, are increasingly common in males. However, the presentation of disordered eating among males is often distinct to that observed in females and this diversity is not accommodated in current classification schemes. Here, we consider the diagnostic and clinical challenges presented by these distinctive presentations.

The enigma of male eating disorders: A critical review and synthesis

Historically, male presentations of eating disorders (EDs) have been perceived as rare and atypical - a perception that has resulted in the systematic underrepresentation of males in ED research. This underrepresentation has profoundly impacted clinical practice with male patients, in which i) stigmatization and treatment non-engagement are more likely, ii) a distinct array of medical complexities are faced, and iii) symptom presentations differ markedly from female presentations. Further, the marginalization of males from ED research has hindered the assessment and clinical management of these presentations. This critical review provides an overview of the history of male EDs and synthesizes current evidence relating to the unique characteristics of male presentations across the diagnostic spectrum of disordered eating. Further, the emerging body of evidence relating to muscularity-oriented eating is synthesized in relation to the existing nosological framework of EDs. The impact of marginalizing male ED patients is discussed, in light of findings from epidemiological studies suggesting that clinicians will be increasingly likely to see males with ED in their practices. It is suggested that changes to current conceptualizations of ED pathology that better accommodation male ED presentations are needed.

Muscle dysmorphia symptomatology during a period of religious fasting: a case report.

We present a case of muscle dysmorphia in a Muslim male, whose muscle dysmorphia symptomatology markedly escalated during a period of religious fasting, in which abstinence from food and liquid during daylight hours was endorsed. This case represents the first attempt to delineate the relative centrality of eating versus exercise practices in muscle dysmorphia presentations, and suggests that the maintenance of muscle dysmorphia is inclusive of a central eating component, irrespective of exercise status, lending support to the notion of conceptualising muscle dysmorphia within an eating disorder spectrum. Implications and further research are discussed.

Disordered eating and the muscular ideal

Letter to the editor, so I thought that no abstract would be required. Please clarify if this is not the case. Also, the field on our website which asks you to choose the subject area to which your manuscript is primarily relevant does not contain psychology-related areas (it seems to contain mostly biology-related areas), so I chose Neuroscience.

The emotional regulatory features of bulimic episodes and compulsive exercise in muscle dysmorphia: a case report.

Muscle dysmorphia is a recently identified psychiatric condition, whose relationship to the eating disorders remains unclear. This case describes an adolescent male who met diagnostic criteria for both an eating disorder not otherwise specified and muscle dysmorphia, allowing the first examination of read muscle dysmorphia presentations. This case suggests that muscle dysmorphia may present inclusive of episodes of binge eating and purging in addition to compulsive exercise, which may serve an emotional regulation function. We suggest that the assessment of muscle dysmorphia include a comprehensive assessment of all eating disorder features including bulimic symptoms, and that treatment address these features. Clinical implications for the conceptualization of muscle dysmorphia are discussed.

An investigation of the transdiagnostic model of eating disorders in the context of muscle dysmorphia.

AIM Muscle dysmorphia is a psychiatric disorder that has been conceptually linked to eating disorders, although its precise nosology remains unclear. To further investigate this notion, the present study examined the applicability of the transdiagnostic model of eating disorders to muscle dysmorphia. METHOD One hundred and nineteen male undergraduate students completed self-report measures of multidimensional perfectionism, mood intolerance, self-esteem, interpersonal problems, and muscle dysmorphia symptomatology. RESULTS Self-oriented perfectionism, socially prescribed perfectionism, mood intolerance, and low self-esteem significantly predicted muscle dysmorphia symptomatology, whereas other-oriented perfectionism and interpersonal problems did not demonstrate significant predictive value when accounting for the other transdiagnostic constructs. DISCUSSION The transdiagnostic model of eating disorders may potentially be applied to enhance our understanding of the maintenance of muscle dysmorphic features in addition to eating disorder symptomatology.

Self‐stigma of seeking treatment and being male predict an increased likelihood of having an undiagnosed eating disorder

OBJECTIVE To examine whether self-stigma of seeking psychological help and being male would be associated with an increased likelihood of having an undiagnosed eating disorder. METHOD A multi-national sample of 360 individuals with diagnosed eating disorders and 125 individuals with undiagnosed eating disorders were recruited. Logistic regression was used to identify variables affecting the likelihood of having an undiagnosed eating disorder, including sex, self-stigma of seeking psychological help, and perceived stigma of having a mental illness, controlling for a broad range of covariates. RESULTS Being male and reporting greater self-stigma of seeking psychological help was independently associated with an increased likelihood of being undiagnosed. Further, the association between self-stigma of seeking psychological help and increased likelihood of being undiagnosed was significantly stronger for males than for females. DISCUSSION Perceived stigma associated with help-seeking may be a salient barrier to treatment for eating disorders-particularly among male sufferers.

Threatened masculinity and muscularity: an experimental examination of multiple aspects of muscularity in men.

Two studies examined the threatened masculinity theory of male body dissatisfaction, which posits that threats to masculinity result in increased muscle dissatisfaction. In Study 1, a masculinity threat was followed by tasks examining confidence in physical ability and perceptions of current and ideal body shapes. Results showed that men who experienced a masculinity threat reported lower confidence in their physical ability and perceived themselves as less muscular than men who experienced an affirmation of their masculinity. In Study 2, men were asked to report their intention to increase muscularity and their appearance anxiety following a threat to masculinity. Results showed that men reported lower appearance anxiety and drive for muscularity when their masculinity was threatened than when their masculinity was affirmed. This apparent contradiction can be explained by noting that men may be motivated to deny appearance concerns following a threat to masculinity, as such concerns are equated with femininity.