The prevalence and risk factors of muscle dysmorphia in amateur male bodybuilders in the eThekwini Municipality

Abstract

Background Muscle dysmorphia (MD), which falls within the spectrum of Body Dysmorphic Disorder, is an increasingly common psychological condition worldwide. Within the bodybuilding community, “bigorexia” manifests when bodybuilders perceive themselves as having much less muscle mass than they actually do, which resorts to the use of performance enhancing drugs (PEDs). Although PEDs are prescription based, illegal use/excessive use can result in physiological and mental complications. Furthermore, the lack of research on MD in developing countries, such as South Africa, warrants investigations pertaining to the development of certain risk factors as well as the pathogenesis of the preoccupation of muscularity in MD. This will assist medical practitioners, such as chiropractors, in identifying and understanding MD risk factors and lead to improved patient management. Methods: The research utilised a quantitative, descriptive, cross-sectional survey approach. The study targeted enrolling at least 196 amateur male bodybuilders from five chosen gymnasiums within the eThekwini Municipality area. Following the acquisition of informed consent, participants completed the modified Adonis Complex Questionnaire (ACQ). The collected questionnaire data were analysed using IBM SPSS version 25. Results: The main findings of this study showed that most participants (65.8%) reported a minor concern of MD, 32.1% reported a moderate concern of MD and only 2% reported a serious concern for MD in the eThekwini Municipality. The prevalence of MD in amateur male bodybuilders showed a weak positive correlation with selected self-reported risk factors (low self-esteem, childhood victimisation, anxiety, perfectionism, eating disorders, PEDs and social media. The regression analysis revealed that unhealthy eating behaviours accounted for 19% of the variance, followed by anxiety, victimisation, and social media influence, which accounted for 10.4%, and self-esteem and perfectionism, which accounted for 3.9%. Only 2% of participants expressed having a serious concern of body image dissatisfaction, therefore, MD was found to not have any influence on the quality of life of majority of the selected participants in this study. The quality of life of the 2% of participants with a serious concern of MD may have been influenced psychosocially and physically. The aim, objectives one, two, three as well as the alternate hypothesis, which states that MD is present in some amateur male bodybuilders in the eThekwini Municipality were achieved in this study. Conclusions: The key findings showed that there was a 2% prevalence of MD amongst the participants in this study. There was a weak positive correlation of self reported risk factors for developing MD which included low self-esteem, anxiety, depression, childhood victimisation, perfectionism, social media influence and an unhealthy relationship with food. In terms of quality of life, MD did not have a significant influence on the participant’s perception of their quality of life. Chiropractors play an essential role in patient care due to injuries caused by over-exertion/over-training as a result of MD. Therefore, collaborative treatment plans with other healthcare professionals, such as psychologists, nutritionists and physicians is necessary to provide full comprehensive care for individuals with MD. By working together, healthcare professionals can create integrated treatment plans that consider all aspects of an individual’s health. This holistic approach can improve overall treatment outcomes as it ensures that all contributing factors to MD can be addressed.