The mirrors bolted to the walls of Sydney’s bodybuilding gyms are crowded with impossibly muscled men. It’s a smorgasbord of peak health and physical perfection.

But Joey Sheather can pick them. The men who have bulked-up too fast, whose passion for fitness has tipped over into obsession. The ones who will never be satisfied no matter how hard they shred or how much body fat they lose.

Their muscles are not just physical shows of strength. They are an attempt to forge emotional armour, says Sheather, a veteran personal trainer at Camperdown Fitness.

“These guys are trying to fix their feelings of inadequacy by building their physiques,” he says. “They throw themselves into physical activity to have something to focus on other than those painful thoughts.”

Muscle dysmorphia is anorexia’s burly counterpart. It’s the body dysmorphic disorder known as “bigorexia” that predominantly affects men.

People with muscle dysmorphia are consumed by an obsession that they are too small or underdeveloped and may take drastic and damaging steps to bulk-up, such as compulsively exercise, harmful diets and anabolic steroid and peptide abuse.

“It’s very obvious,” Sheather says of the increasing number of scrawny men whose bodies erupt with the rippling muscles of seasoned body builders with seemingly negligible effort.

The use of performance and image-enhancing drugs (PIEDs) doesn’t necessarily point to muscle dysmorphia, and not every individual with muscle dysmorphia uses PIEDs. But researchers says the rising rates of PIED use of is the canary in the coal mine of an emerging public mental health issue.

“You get clients who might achieve something really positive, whether it’s a strength goal or body fat loss, but all they are focused on is picking at the negative,” Sheather says.

His job has become part personal trainer, part counsellor as he watches the increasing creep of muscle dysmorphia among his clients and more broadly among the growing culture of hulking masculinity on the gym floor and online.

“I had a client who was very unhappy and struggling emotionally. He had a very tough childhood and always felt isolated. He came to the gym to build himself a fantastic physique but he would go through some really down, really dark times.”

One day, instead of training, Sheather pushed the young man into his office where a life coach counsellor was waiting for him. “We didn’t train that day. It was the best thing I could do for him,” Sheather says.

Sheather says he is often left emotionally exhausted after an endless procession of clients “mentally unload”.

“We still train but often it’s more important to them that I just listen and support them as they pour their hearts out,” he says.

The changing shape of eating disorders

As Scott Griffiths sat in his undergraduate lecture on eating disorders, incongruous images of the burly acquaintance at his local gym muscled their way into his thoughts.

“The lecturer described how people with anorexia would [invariably] obsess about their weight, exercise compulsively, run flat-out on the treadmill, worried about what they ate and abuse laxatives and diuretics.

“The guy at the gym was different, but then not so different,” Dr Griffiths says, now a National Health and Medical Research Council early career fellow.

He obsessed about his protein intake and muscle mass. He wasn’t running on the treadmill, he was lifting weights and instead of abusing laxatives his drugs of choice were steroids, says Griffiths.

Then it clicked.

“Not all eating disorders are about thinness,” saysGriffiths.

Modern eating disorders are often intrinsically fused with body-image issues. The coveted body type du jour for men is not a slender frame, but the opposite.

– Kate Aubusson

Read More: Muscle dysmorphia: How idealised masculinity became the new eating disorder

Image by J1 Koy from Unsplash