[Music]
[Applause]
some years ago a young man named Tim
walked into my office Jenny one here
name’s Tim hi Tim and sorry I’ll be
appropriating your name for the entirety
of this talk Tim did not fit the
stereotype of a person with an eating
disorder for starters he was male when
most of my clients were female he was
large and muscular when most of my
clients were thin and skinny and he
spent hours at the gym lifting weights
when most of my clients spent their
hours running on the treadmill later on
I learned that Tim was using drugs to
try and alter his appearance but it
wasn’t using laxatives and diuretics to
try and lose weight he was using
anabolic steroids to try and build
muscle
everything Tim said and did was familiar
to me but with one crucial point of
distinction the intrusive and
preoccupying thoughts that he had about
his body his punishing eating and
exercise routines and his drug use were
aimed toward achieving muscularity and
not thinness Tim had muscle dysmorphia
it was professional bodybuilders who
first noticed it living in California in
the 80s and training in the famous
outdoor gyms of Muscle Beach they called
it bigger Axia a colorful nickname for a
reverse form of anorexia nervosa but
muscle dysmorphia is not limited to
professional bodybuilders just like
anorexia is not limited to runway models
and the disorder doesn’t start with
sufferers wanting to have
larger-than-life muscles the beginnings
are a lot more humble than that common
among sufferers of stories of being
bullied at school for being too scrawny
or too fat of difficult and fraught
ships with friends parents and partners
of a tendency toward perfectionism and
of a lifelong and pervasive sense of not
being good enough or what we might call
low self-esteem and so an earnest desire
to feel better through looking better
results in a gym membership of workout
plan and a diet and they’re certainly
not alone in this over four and a half
million Australians have a gym
membership but at some point for an
increasing number of men and boys this
otherwise benign desire to be more
attractive transforms into something
categorically disordered individuals
with muscle dysmorphia spend over five
and a half hours each and every day
thinking about their muscles and body
size they turn down important social
occasions so that they don’t have to
compromise their dieting or training
they enjoy frequent long and painful
bouts of social isolation as their
relationships with friends partners and
family break down shame guilt anxiety
and embarrassment over one’s body become
their predominant emotional landscape so
much so that in the only study to look
at suicide and muscle dysmorphia fully
fifty percent reported at least one
previous suicide attempt but in the pain
caused by lifting weights with a
sprained wrist was preferable to the
anxiety caused by missing a workout
session not knowing the precise
macronutrient content of the food he
would be served was enough to compel him
to miss a mates wedding now some of you
might be skeptical and I get it there is
a concern that psychologists and
academics like myself are needlessly
pathologizing the otherwise extremely
broad a normal spectrum of human
behavior and experience that we’re
taking boys and men’s earners desire to
be more attractive versions of them
selves and we’re turning it into a
disorder that we should be celebrating
these boys for hitting the gym and
building muscle rather than castigating
them well let me reassure you that a
diagnosis of muscle dysmorphia just like
all eating disorders is not a trivial or
light-hearted matter muscle dysmorphia
entails significant and long-lasting
functional impairment in the lives of
those who have it it cuts across their
personal relationships their job
performance their performance at school
or university and their physical and
mental health and complicating matters
further a lot of individuals with muscle
dysmorphia don’t have great insight into
their condition in the same way that
someone with anorexia can look me in the
eye and convincingly tell me that
they’re obese despite being clearly and
dangerously thin a person with muscle
dysmorphia can look me in the eye tell
me they’re scrawny
despite being objectively very muscular
muscle dysmorphia like all eating
disorders is a very real mental disorder
and we know muscle dysmorphia is
becoming more common because of what
we’re seeing with steroids anabolic
steroids are now the number one most
commonly injected drug among new
injection drug users in this country
that’s ahead of heroin methamphetamine
opioids all other drugs and it’s not
even news it’s been this way for the
past five years they’re not athletes
fewer than one in ten men who use
steroids in this country play any type
of sport and that’s if I’m generous and
include non-traditional sports like
boxing and MMA the modern-day
demographic profile of new injection
drug use in this country is boys and men
who simply want to look better and I’m
willing to bet that’s news to most
people in this room
tragically we’re limited in what we can
do for individuals who use steroids
regardless of whether or not they have
muscle dysmorphia because the research
simply hasn’t been done on how to safely
diskant
knew the numerous types and combinations
of steroids that are out there
you know for example I had a young man
who was taking equipoise this is a
veterinary steroid we used to give to
racehorses he said to me Scott what’s
gonna happen if I stay on this long term
I said I don’t know mate maybe you’ll
win the Melbourne Cup admittedly the
short-term side effects of steroids are
sensationalized but they work steroids
work and that’s why we get long-term
users because once your self-esteem is
wrapped up in the size of your muscles
why would you come off and that’s when
you risk the long-term irreversible
cardiovascular and endocrine
complications infertility and a lifetime
of testosterone replacement therapy so
why why now why is muscle dysmorphia and
anabolic steroids only on our radar now
well boys just like girls are influenced
by the bodies they are exposed to behind
me you see action figurines of Luke
Skywalker and Han Solo from the original
release of the Star Wars trilogy and on
the right you see the rerelease they’ve
adopted that classic bodybuilder pose of
big arms and broad shoulders and a
muscular chest and this is an analogue
to the Barbie dolls that are widely
recognized and criticized marketed to
young girls and it’s not limited to
action figures research shows this same
pattern of increasing muscularity in
fitness magazines television movies
video games and increasingly in social
media there is no gene in boys genetic
code that immunizes them from the
influence of these messages you know the
title of this talk is a bit of a
misnomer when I submitted it to Ted it
was called muscle dysmorphia the male
eating disorder but muscle dysmorphia is
not anymore a male eating disorder than
anorexia is a female eating disorder men
can get anorexia and women can get
muscle dysmorphia the takeaway message
of
this talk is that as society places
increasing value on those aspects of
physical appearance that can be modified
through diet or exercise whether its
body fat or muscle or some new
combination thereof we create the
environment in which eating disorders
can flourish eating disorders are moving
targets they change in response to the
types of bodies that our society values
among its constituents and muscle
dysmorphia is just the latest
manifestation of our cumulative over
investment in our physical appearance so
what do we do about it we fight back be
mad and criticize standards that teach
boys and girls that the most important
sense or source of their self-worth is
their physical appearance let’s
celebrate bodies for their function and
not just their form
let’s dismantle the stigma that men and
boys don’t care about their appearance
because that is patently false and while
we’re at it let’s get rid of the stigma
that people with eating disorders are
vain or narcissistic or somehow have
only themselves to blame for their
predicament criticize traditional
notions of masculinity that discourage
men from speaking openly about their
appearance and don’t just do that offer
young boys substantial and genuine
alternatives to masculinity that they
can work with and that resonate with
them an on an individual level for those
boys and men who do worry about their
appearance you have to seek help and I
know that’s hard I’ll bring it back to
Tim you know Tim sought help and now
he’s okay
he’ll never be cured per se and I don’t
like the word cured in mental health
he’ll always be a bit more likely to
think about his physical appearance more
prone to feeling poorly about himself
when he sees images of muscular men and
compares themselves or compares himself
to them but he is recovered he knows the
personal boundary that distinguishes the
otherwise benign interest in physical
appearance that we all have from the
muscle dysmorphia that once consumed his
every waking moment and we can all find
that personal boundary and we should if
not for our own betterment than for the
betterment of future generations because
whether we want to or not
they will absorb not only the values
about physical appearance that we try
and teach them but the broader values of
the society that they live in which
through our inaction we reinforce but
with persistent challenge and courage we
can change it’s been a privilege thank
you
[Applause]
[Music]
[Applause]
[Applause]
some years ago a young man named Tim
walked into my office Jenny one here
name’s Tim hi Tim and sorry I’ll be
appropriating your name for the entirety
of this talk Tim did not fit the
stereotype of a person with an eating
disorder for starters he was male when
most of my clients were female he was
large and muscular when most of my
clients were thin and skinny and he
spent hours at the gym lifting weights
when most of my clients spent their
hours running on the treadmill later on
I learned that Tim was using drugs to
try and alter his appearance but it
wasn’t using laxatives and diuretics to
try and lose weight he was using
anabolic steroids to try and build
muscle
everything Tim said and did was familiar
to me but with one crucial point of
distinction the intrusive and
preoccupying thoughts that he had about
his body his punishing eating and
exercise routines and his drug use were
aimed toward achieving muscularity and
not thinness Tim had muscle dysmorphia
it was professional bodybuilders who
first noticed it living in California in
the 80s and training in the famous
outdoor gyms of Muscle Beach they called
it bigger Axia a colorful nickname for a
reverse form of anorexia nervosa but
muscle dysmorphia is not limited to
professional bodybuilders just like
anorexia is not limited to runway models
and the disorder doesn’t start with
sufferers wanting to have
larger-than-life muscles the beginnings
are a lot more humble than that common
among sufferers of stories of being
bullied at school for being too scrawny
or too fat of difficult and fraught
ships with friends parents and partners
of a tendency toward perfectionism and
of a lifelong and pervasive sense of not
being good enough or what we might call
low self-esteem and so an earnest desire
to feel better through looking better
results in a gym membership of workout
plan and a diet and they’re certainly
not alone in this over four and a half
million Australians have a gym
membership but at some point for an
increasing number of men and boys this
otherwise benign desire to be more
attractive transforms into something
categorically disordered individuals
with muscle dysmorphia spend over five
and a half hours each and every day
thinking about their muscles and body
size they turn down important social
occasions so that they don’t have to
compromise their dieting or training
they enjoy frequent long and painful
bouts of social isolation as their
relationships with friends partners and
family break down shame guilt anxiety
and embarrassment over one’s body become
their predominant emotional landscape so
much so that in the only study to look
at suicide and muscle dysmorphia fully
fifty percent reported at least one
previous suicide attempt but in the pain
caused by lifting weights with a
sprained wrist was preferable to the
anxiety caused by missing a workout
session not knowing the precise
macronutrient content of the food he
would be served was enough to compel him
to miss a mates wedding now some of you
might be skeptical and I get it there is
a concern that psychologists and
academics like myself are needlessly
pathologizing the otherwise extremely
broad a normal spectrum of human
behavior and experience that we’re
taking boys and men’s earners desire to
be more attractive versions of them
selves and we’re turning it into a
disorder that we should be celebrating
these boys for hitting the gym and
building muscle rather than castigating
them well let me reassure you that a
diagnosis of muscle dysmorphia just like
all eating disorders is not a trivial or
light-hearted matter muscle dysmorphia
entails significant and long-lasting
functional impairment in the lives of
those who have it it cuts across their
personal relationships their job
performance their performance at school
or university and their physical and
mental health and complicating matters
further a lot of individuals with muscle
dysmorphia don’t have great insight into
their condition in the same way that
someone with anorexia can look me in the
eye and convincingly tell me that
they’re obese despite being clearly and
dangerously thin a person with muscle
dysmorphia can look me in the eye tell
me they’re scrawny
despite being objectively very muscular
muscle dysmorphia like all eating
disorders is a very real mental disorder
and we know muscle dysmorphia is
becoming more common because of what
we’re seeing with steroids anabolic
steroids are now the number one most
commonly injected drug among new
injection drug users in this country
that’s ahead of heroin methamphetamine
opioids all other drugs and it’s not
even news it’s been this way for the
past five years they’re not athletes
fewer than one in ten men who use
steroids in this country play any type
of sport and that’s if I’m generous and
include non-traditional sports like
boxing and MMA the modern-day
demographic profile of new injection
drug use in this country is boys and men
who simply want to look better and I’m
willing to bet that’s news to most
people in this room
tragically we’re limited in what we can
do for individuals who use steroids
regardless of whether or not they have
muscle dysmorphia because the research
simply hasn’t been done on how to safely
diskant
knew the numerous types and combinations
of steroids that are out there
you know for example I had a young man
who was taking equipoise this is a
veterinary steroid we used to give to
racehorses he said to me Scott what’s
gonna happen if I stay on this long term
I said I don’t know mate maybe you’ll
win the Melbourne Cup admittedly the
short-term side effects of steroids are
sensationalized but they work steroids
work and that’s why we get long-term
users because once your self-esteem is
wrapped up in the size of your muscles
why would you come off and that’s when
you risk the long-term irreversible
cardiovascular and endocrine
complications infertility and a lifetime
of testosterone replacement therapy so
why why now why is muscle dysmorphia and
anabolic steroids only on our radar now
well boys just like girls are influenced
by the bodies they are exposed to behind
me you see action figurines of Luke
Skywalker and Han Solo from the original
release of the Star Wars trilogy and on
the right you see the rerelease they’ve
adopted that classic bodybuilder pose of
big arms and broad shoulders and a
muscular chest and this is an analogue
to the Barbie dolls that are widely
recognized and criticized marketed to
young girls and it’s not limited to
action figures research shows this same
pattern of increasing muscularity in
fitness magazines television movies
video games and increasingly in social
media there is no gene in boys genetic
code that immunizes them from the
influence of these messages you know the
title of this talk is a bit of a
misnomer when I submitted it to Ted it
was called muscle dysmorphia the male
eating disorder but muscle dysmorphia is
not anymore a male eating disorder than
anorexia is a female eating disorder men
can get anorexia and women can get
muscle dysmorphia the takeaway message
of
this talk is that as society places
increasing value on those aspects of
physical appearance that can be modified
through diet or exercise whether its
body fat or muscle or some new
combination thereof we create the
environment in which eating disorders
can flourish eating disorders are moving
targets they change in response to the
types of bodies that our society values
among its constituents and muscle
dysmorphia is just the latest
manifestation of our cumulative over
investment in our physical appearance so
what do we do about it we fight back be
mad and criticize standards that teach
boys and girls that the most important
sense or source of their self-worth is
their physical appearance let’s
celebrate bodies for their function and
not just their form
let’s dismantle the stigma that men and
boys don’t care about their appearance
because that is patently false and while
we’re at it let’s get rid of the stigma
that people with eating disorders are
vain or narcissistic or somehow have
only themselves to blame for their
predicament criticize traditional
notions of masculinity that discourage
men from speaking openly about their
appearance and don’t just do that offer
young boys substantial and genuine
alternatives to masculinity that they
can work with and that resonate with
them an on an individual level for those
boys and men who do worry about their
appearance you have to seek help and I
know that’s hard I’ll bring it back to
Tim you know Tim sought help and now
he’s okay
he’ll never be cured per se and I don’t
like the word cured in mental health
he’ll always be a bit more likely to
think about his physical appearance more
prone to feeling poorly about himself
when he sees images of muscular men and
compares themselves or compares himself
to them but he is recovered he knows the
personal boundary that distinguishes the
otherwise benign interest in physical
appearance that we all have from the
muscle dysmorphia that once consumed his
every waking moment and we can all find
that personal boundary and we should if
not for our own betterment than for the
betterment of future generations because
whether we want to or not
they will absorb not only the values
about physical appearance that we try
and teach them but the broader values of
the society that they live in which
through our inaction we reinforce but
with persistent challenge and courage we
can change it’s been a privilege thank
you
[Applause]
[Music]
[Applause]
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