A new wave of concern is sweeping through families and health professionals as muscle dysmorphia—commonly called “bigorexia”—gains traction among children and teenagers worldwide. Recent research and high-profile warnings from mental health experts signal that this body image disorder, often overlooked and misunderstood, is swiftly becoming a public health issue, including for Thai families who may traditionally associate eating disorders more with thinness than muscularity. The phenomenon forces a reconsideration of how we talk to children about bodies, exercise, and the subtle pressures lurking online.
Muscle dysmorphia is a psychological condition—classified as a form of body dysmorphic disorder—characterized by a persistent, distorted self-image focused specifically on muscular size. Sufferers become obsessed with building muscle, often regardless of actual physique, and may engage in excessive gym routines, drastic dietary measures, and in some instances, dangerous supplementation or steroid use. According to a 2019 study cited by health professionals, as many as 22% of adolescent boys engaged in muscularity-oriented disordered eating behaviors, with statistics pointing to a steady rise in recognition and diagnosis among males, who have historically flown under the radar in eating disorder discourse (HuffPost).
For Thai readers, the surge in bigorexia is especially pertinent as Westernized physical ideals and social media gain traction in local popular culture. Gym culture in Bangkok and other urban centers has burgeoned; supplements and performance-enhancing substances are increasingly advertised in both traditional and digital media. While prevalence data for Thailand is still sparse, global evidence is clear: muscle dysmorphia is not just a foreign phenomenon. In settings where social acceptance and peer comparison are strong, as in many Thai schools, the impact of these body ideals is likely magnified. A systematic review provided prevalence estimates for muscle dysmorphia ranging from 1% to as high as 54% when using broad screening measures (PubMed Central; PubMed).
Key developments in the research spotlight the role of social media as a major driver for bigorexia’s growth. Platforms like Instagram, TikTok, and YouTube have made it easier than ever for young people to not only consume images of so-called “ideal” bodies but also to compare themselves relentlessly to these often-unrealistic standards. Influencers and celebrities, sometimes achieving their physiques with the help of professional trainers, severe regimens, and sometimes even unhealthy methods, fan these flames by curating glamorous yet deceptive images of muscular perfection. One US-Canada study recently found a strong association between consuming muscularity-related social media content and higher rates of muscle dysmorphia symptoms (PubMed; STAT News).
In an interview with HuffPost, a national director of eating disorder programs at a leading US healthcare facility described bigorexia as a disorder fed by a toxic mix of biological, psychological, and sociocultural pressures. “A family history of mental health conditions, especially those related to body image or anxiety, may increase the chance,” the expert explained. “Likewise, people with low self-esteem, perfectionism or obsessive-compulsive tendencies are more vulnerable.” The effect is compounded when children are exposed to trauma or bullying—a risk factor not unfamiliar to Thai students, who may face teasing over their bodies or athletic performance at school.
A pediatrician specializing in eating disorders among boys and men warned that medical and school professionals often underdiagnose muscle dysmorphia because some of its behaviors—like weightlifting and disciplined eating—are socially encouraged. As a result, the disorder is easy to miss. In Thailand, where gym attendance has risen and protein supplement sales boomed after COVID-19 restrictions lifted, this normalization could effectively hide dangerous mental health patterns until they become entrenched.
Leading local clinicians are now encouraging Thai families to look beyond the narrow portrayals of eating disorders as solely the purview of girls striving for thinness. One Bangkok-based psychiatrist specializing in adolescent mental health, noted, “Behaviors like obsessive exercise, compulsive supplement use, and withdrawal from social eating due to rigid food rules are red flags for muscle dysmorphia—signs any parent or teacher should take seriously, regardless of the child’s gender or body type.”
Global research underscores the consequences of unaddressed bigorexia: not just psychological distress and impaired social functioning, but increased risk of physical complications from overtraining, nutrient deficiencies, and in some cases, steroid abuse (Psychiatry-Nutrition). Among Thai bodybuilders and recreational gym-goers, anecdotally, there is already an active market for testosterone products and anabolic steroids (JSTOR), further raising the stakes for those with undiagnosed muscle dysmorphia.
Why is bigorexia flourishing now, especially among children and teens? The answer, experts say, lies at the intersection of social media, advertising, and cultural shifts about masculinity. “Not only are young people consuming body ideals from the media, but they feel pressure to produce content and display their own bodies on social media,” a psychology professor at Bryant University told HuffPost. Kids may not be aware that these influencers employ full-time professionals, endure harsh diets, or manipulate their photos. “None of it is real. In the hands of an impressionable young person, this is a very dangerous dynamic and recipe for psychological disaster", he warned.
For Thai youth, whose self-esteem is often shaped by social conformity and peer approval, exposure to these digital standards can be particularly risky. Psychologists warn that excessive focus on appearance, achieved through obsessive exercise and restrictive dieting, begins harmlessly but escalates into compulsions that disrupt school and family life. Patterns of skipping family meals, secrecy around food, persistent negative comments about one’s own physique, and near-constant time spent in pursuit of muscular gains warrant intervention.
What can parents and educators do to help? The consensus among global and Thai experts is clear: direct, open conversations about body diversity and the truth behind curated online personas are key. Limiting screen time is helpful, but not always feasible. Instead, engaging children about how images are produced—discussing the reality behind an actor’s regimen, for instance—can help demystify the myth of the “perfect body.” Modeling positive language about body function and self-worth, instead of appearance alone, is crucial. One clinical director at a healing center recommends grounding family conversations in “body respect”—highlighting that caring for the body is about health, sleep, hydration, and emotional well-being, not just external looks.
For Thailand, a country balancing rapid modernization with deeply rooted cultural traditions, this advice resonates. Buddhist values that encourage moderation, self-reflection, and acceptance of impermanence provide a useful lens by which to challenge extreme aesthetics and help youth find balance amid external pressures. At the same time, school policies should ensure that bullying and body shaming are not tolerated; teachers and guidance counselors must be trained to recognize signs of muscle dysmorphia as readily as they do eating disorders like anorexia.
Healthcare professionals advocate for early intervention. If a parent suspects a problem, prompt conversations with the child are critical. Warning signs include: preoccupation with appearance or food that interferes with daily life, guilt about missing workouts, withdrawing from social eating events, and extreme distress over perceived flaws. Where necessary, referral to mental health specialists—psychiatrists or psychologists experienced in body image issues—is recommended. Many therapeutic approaches, including cognitive behavioral therapy, can help youth challenge distorted beliefs and build resilience (Frontiers in Public Health; PMC).
Looking forward, experts worldwide call for more robust public health programs, especially in Asia, to educate communities about body image and muscle dysmorphia. In Thailand, campaigns that explicitly target male body image without stigma are overdue, as are research studies mapping the local landscape of these disorders. Policy makers could also require that supplement advertisements—ubiquitous in Thai gyms—carry health warnings about the dangers of unregulated products and the psychological risks of body image obsession.
Though global research continues to evolve, one message rings loud and clear: muscle dysmorphia is not a far-off problem relevant only to Western societies. As Thai youth navigate an increasingly connected, competitive, and media-saturated world, the need for vigilance, understanding, and supportive dialogue has never been more urgent.
For parents, teachers, and Thai communities at large, the actionable steps are simple but powerful: spark conversations about how bodies truly function, nurture critical thinking about media images, celebrate diversity in size and strength, and seek help without shame if warning signs appear. Through these actions, we can safeguard the next generation from the invisible but growing shadow of bigorexia.