Variants: Muscle Dysmorphia

Muscle dysmorphia (MD) is a specifier of body dysmorphic disorder (BDD) characterized by intrusive thoughts surrounding muscularity and associated compulsive behaviors. Core features of MD include preoccupation with muscle size, compulsive weight training, avoidance of body exposure, and substantial psychiatric comorbidity. Regarding assessment for MD, multidimensional self-report MD measures should be prioritized since specific MD symptoms show significant relationships with associated comorbidity. Furthermore, when assessing for MD, clinicians should ensure that eating disorders are ruled out, given high symptom overlap between these conditions. Despite the severity of MD, treatment options are scarce. Cognitive behavioral therapy for BDD may be selected as an initial treatment approach, as this modality is efficacious in treating BDD, contains an MD module, and has been used in MD cases. However, the use of this modality to specifically improve MD symptoms requires empirical investigation. Additional therapeutic techniques that may be effective in reducing MD symptoms include techniques from empirically supported modalities for related disorders, such as enhanced cognitive behavioral therapy for eating disorders or dialectical behavior therapy. In conclusion, MD is a specifier of BDD that requires future research on treatment efficacy, assessment, and clinical course of symptoms.