Every day for a year, Mike Lombardi arrived at his gym at 5 a.m.
After three hours of lifting weights, he would leave for work, often arriving late. It was back to the gym at lunch for stomach crunches, then again in the evening to work his shoulders, maybe his legs.
This was not the behavior of a disciplined man. It was the behavior of a sick man.
Lombardi suffers from muscle dysmorphia, a little-known obsessive-compulsive disorder found mostly in men. Those who have it grow huge muscles from constantly working out and often using anabolic steroids, but are never satisfied with their bodies.
Lombardi, 47, of Providence, R.I., quit steroids a year ago after two years of therapy. He still works out twice a day.
“I’m not where I need to be,” he told RedEye. “My stomach isn’t right yet.”
Like those who suffer from anorexia, men with muscle dysmorphia–sometimes referred to as bigorexia or reverse anorexia–loathe their bodies, become preoccupied with everything that goes in their mouths, are perfectionists and have low self-esteem, says Roberto Olivardia, a Harvard professor who co-wrote, “The Adonis Complex: The Secret Crisis of Male Body Obsession.”
“We don’t know why some men will gravitate towards that versus bulimia or anorexia,” he says.
Chicago psychotherapist John Moore says he has several patients who show severe signs of the disorder:
— The men practically live at their gym.
— They miss work and family events in order to work out.
— They tear muscles and ligaments from excessive weight lifting.
Much of the problem, Moore says, can be traced to a lack of self-esteem.
“When they look in the mirror they never feel big enough, and they’re always comparing themselves to other men,” he says.
Olivardia says his book, published in 2000, made more people aware of the disorder.
“After our book came out, I’ve gotten many more calls and e-mails from men across the country from anywhere from L.A. to Idaho to New York that have said they struggle with it,” Olivardia said. “They couldn’t believe that they read something that so adequately described them.”
The recent emergence of muscle dysmorphia is the result of impossible standards that men have only recently been exposed to, similar to the female “beauty myth,” therapists say.
Psychology Today has conducted body image surveys three times since 1972, and each time men were found to be more dissatisfied with the way they look. In 1972, 15 percent reported being dissatisfied. That number rose to 34 percent in 1985 and 43 percent in 1997, the most recent survey.
There are now plenty of men’s fitness magazines, high-profile pro athletes are reportedly using steroids–with effects plain to see–and even muscle-bound action figures, such as G.I. Joe, are thought to be a factor.
“The ideals for men are now unrealistic,” says Ann Kearney-Cook, a clinical psychologist in Cincinnati who has treated patients with muscle dysmorphia. “We now see that because of steroid and other drug use that the men who you see on movie magazines or in the media have that kind of v-shaped body.”
Moore and Olivardia don’t counsel patients to quit working out. The goal is to alter behaviors such as looking in the mirror too often or taking steroids.
Lombardi, a social worker who has told his story on national TV outlets including CNN and ABC, says steroids were easy to obtain. He had to go to the emergency room several times because of dehydration from working out too much, as well as for steroid abuse, he says.
“I heard thyroid medicine works good with growth hormones,” Lombardi says. “I read the wrong thing, basically. I was taking four times” the suggested amount for a single day.
Overmedicating is just one symptom of muscle dysmorphia. Other behaviors are more subtle.
Many weight rooms have wall-to-wall mirrors, ostensibly for weight lifters to admire themselves. For some, that may be the case. But not for people who hate their bodies.
“When they look in the mirror, they’re not looking at a vanity like some people might assume,” Olivardia said. “They’re not saying, ‘Oh, I look great, and I can’t get enough of myself.’ They’re looking in the mirror and picking themselves apart.”
There is still much to be learned about muscle dysmorphia–a subset of body dysmorphic disorder–including how many people suffer from it.
According to Olivardia, hundreds of thousands of men may show some or all characteristics of the disorder, but an accurate number is unknown. What’s certain is it’s vastly underreported.
Kearney-Cook says men don’t come forward because they equate being muscular with being masculine.
For them, “it’s important to be masculine,” she says. “And then to think they have a disorder that somewhat mimics female problems is humiliating.”
Lombardi, who is 6-foot-1, believes he started to develop the disorder after ballooning to more than 400 pounds a few years ago.
Once his weight got down to 228, he decided to add muscle, and it hasn’t stopped. He’s now at 284 pounds but says his weight can fluctuate 10 pounds, up or down, in a single day.
He still gets on a scale from 10 to 20 times a day, but his steroid abuse is in the past. After once taking 80 legal supplements a day, he says he is now down to a handful of vitamins. The worst is over for him, he believes, and by going public he hopes to help others.
“I think it’s important,” Lombardi says. “Because a lot of people are getting carried away these days.”
– – –
Do you think you may have bigorexia?
Check the list given to RedEye by Harvard professor Roberto Olivardia, co-author of “The Adonis Complex: The Secret Crisis of Male Body Obsession,” to see if you have any of the characteristics of muscle dysmorphia.
— Preoccupation with body image.
— Checking mirrors often to see how your physique looks.
— Avoiding places in which your body would be seen.
— Wearing multiple layers of clothing to make yourself look bulkier.
— Eating certain foods only because they will promote muscular growth.
— Feeling that most of your self-esteem rests on how you feel about your physique.
— Taking steroids or compulsively working out to the point where you could be suffering from torn ligaments and sore joints because you feel you need to get big.
Living with the disorder
Harvard professor Roberto Olivardia, who has treated men with muscle dysmorphia, says many of his patients are obsessive about what they put in their mouths, and not just food.
Some choose toothpaste based on the sodium content, he says. One man wouldn’t kiss his girlfriend because he feared getting calories through her saliva, and another refused to lick postage stamps because, he believed, they had calories.
Olivardia says the men who suffer from muscle dysmorphia become experts on nutrition and can often know more about it than nutritionists do. But not all their odd behaviors revolve around food.
“I had a patient who was lifting cinder blocks in his back yard when he wasn’t in the gym,” Olivardia says. [J.G.]
– – –
Manly men
It’s hard to escape images of buff male bodies in pop culture. A few notable contributions to the genre include:
Magazines: Men’s Health paved the way for men’s fitness magazines and is chock-full of perfect abs. There’s usually a nice six-pack splashed on the cover, and headlines promising perfect bodies.
Movies: It’s one thing for an action hero and former wrestler like “The Rock” to weigh in at 275 pounds of mostly muscle. But even a serious actor like Brad Pitt showed his backside in last year’s “Troy,” for which he reportedly trained for months to get the body of a god.
Music: Usher (above), seldom seen on stage wearing a shirt, is a poster boy for pin-up abs.
Toys: Experts say many boys may get their body ideal from playing with G.I. Joe action figures, just as many girls get their body ideals from Barbie-style dolls.
Sports: Recent scandals involving Olympic athletes and Major League Baseball prompted Congressional hearings on steroid use and increased testing. Steroid use among high school students more than doubled from 1991 to 2003, according to the Centers for Disease Control and Prevention. More than 6 percent of the 15,000 high school students who responded to the CDC’s 2003 National Youth Risk Behavior Survey acknowledged taking steroid pills or shots at least once. [ RedEye ]
———-
jgreenfield@tribune.com
