#520： The Surprising Origins and Prevalence of Bigorexia and Male Body Image Issues
Episode Stats
Summary
A quarter of people with eating disorders are male, and there are millions of men in America silently struggling with obsessing over how they look, even to the detriment of their careers and relationships. In this episode, Dr. Roberto Olivardia, co-author of the book, The Adonis Complex: How to Identify, Treat, and Prevent Body Obsession in Men and Boys, joins Dr. Brett McKay to discuss the growing problem of male body image issues.
Transcript
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Brett McKay here and welcome to another edition of the Art of Manliness podcast and we typically
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associate body image issues with women. My guest today says that a quarter of people
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with eating disorders are male and that there are millions of men in America silently struggling
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with obsessing over how they look even to the detriment of their health, careers and
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relationships. His name is Dr. Roberto Olivardia. He's a professor of clinical psychology at
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Harvard and the co-author of the book, The Adonis Complex, How to Identify, Treat and
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Prevent Body Obsession in Men and Boys. We begin our conversation discussing how the Adonis
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Complex manifests itself in men and why male body image disorders are a fairly recent phenomenon.
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Roberto and I then dig into how the ideal male body has changed over the past few decades
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and how we've seen these inflated standards of male attractiveness show up in advertising,
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movies and even action figures. Roberto then shares possible causes of male body image issues,
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which include, interestingly enough, increasing gender egalitarianism in the West. We then dig
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into specific ways body image issues appear in men, including bigorexia or muscle dysmorphia,
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in which super jacked dudes think they're still too scrawny. Roberto then explains how eating
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disorders like bulimia or anorexia manifest themselves differently in men compared to women.
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And we end our conversation discussing the line between caring about how you look in a healthy way
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and having a disorder, what to do if you're having problems with body image issues, and what
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parents can do to inoculate their sons from the Adonis Complex. After the show's over,
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check out our show notes at aom.is slash Adonis Complex. Roberto joins you now via clearcast.io.
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All right, Dr. Roberto Olivardia, welcome to the show.
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So you co-authored a book about, it came out 20, almost 20 years ago.
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It's been a while. It's called The Adonis Complex,
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How to Identify, Treat, and Prevent Body Obsession in Men and Boys.
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I remember seeing this book when it first came out. I thought it was interesting because it's
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all about body issues that men have, but that's something we typically associate with women.
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So let's talk about the Adonis Complex. How do you all define what it is sort of on a big picture
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Sure. So when we, as researchers and as clinicians, I specialize in the treatment of working with boys
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and men with anorexia and bulimia and binge eating disorder, men who use anabolic steroids because
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they feel like they can't get big enough. And when we were thinking of a title of the book,
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we were sort of trying to think of something that encapsulated all of those manifestations.
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And Adonis is this mythological Greek character. He was half man, half God, and he represented
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the ideal in masculine beauty and strength and in appearance. And so we thought to call it Adonis
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Complex to sort of represent all of the ways that men are striving in this pursuit of the ideal male
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body. And it is strange to think that was almost 20 years ago that that book came out. And I remember
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when it did come out, I mean, there were so many people that said, do boys and men even struggle
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with this? I mean, is this even, how is this a rarity? And unfortunately, it is not a rarity. And
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so our purpose really in getting that book out was to take what we were knowing from the research we
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were doing and clinically what we were seeing and letting people know this is a big problem with
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So I remember in the 80s and 90s, watching like PSAs about anorexia or like binge eating,
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When did you, so there was like an awareness that was happening with women and young women.
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When did you and your colleagues start noticing it with men? Was this like a,
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Fairly. So probably in the late 70s, early 80s, if you look in the scientific literature,
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that's when we started to see eating disorders in males studies start to pop up, but they were
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very limited samples and they were men who were primarily in treatment programs or were hospitalized.
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And I was, when I was a senior in college, I went to Tufts University and I'm from the Boston area.
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And I had known actually a couple of male students who independent of each other had
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disclosed to me that they were struggling with the eating disorders and were completely shameful
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about it. They said they had never told anybody about it. They were silently suffering. And I thought
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this would be something interesting to study. So I actually ended up doing a thesis on it. And as part
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of it, I told my thesis committee, I'm going to place ads in basically every college in the
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Massachusetts area, which we have many in Massachusetts, and just to recruit these men.
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And at that time, unbeknownst to me at that time, that was the first study that had recruited men
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from a community sample. So not men who were patients in hospitals or treatment centers, but
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sort of men who, most of whom may never have sought treatment for it.
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And I remember my committee saying, well, you probably want a plan B because you may not get
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a lot of men respond to this ad. Well, I didn't need a plan B. I actually had many men. I remember
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my answering machine tape was full by the end of a couple of days of men saying, oh my gosh,
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I can't believe you're studying this. I thought I was the only one. And when we brought these men in
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and interviewed them, questionnaires, the overwhelming majority of them had never
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sought treatment for the eating disorder. And in fact, there were some men in that sample who
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were in treatment for depression, for substance abuse, and even in the context of that therapy,
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never disclosed to their therapist that they might've been binging or purging or compulsively
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exercising because of the stigma that they felt they had, that they would be seen as less masculine,
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it's weak, that people would question their sexuality because there was a stereotype that
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it was only something that affected women. So this book was published 20 years ago and you all
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provide numbers, but I imagine those numbers have changed since then. Do we have an idea of how many
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men are dealing with some sort of body issue, whether it's an eating disorder, like they're trying to
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lose a lot of weight or they're spending a lot of time in the gym trying to get bigger? Do we have
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any concrete numbers there? So generally, and part of it is that from the bottom up,
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I mean, males in particular are still heavily under-researched. In fact, less than 1% of research
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on eating disorders is focused on male subjects. So we still need a lot more work in even identifying
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these individuals. But generally speaking, the statistics say about anywhere from 10 to 15
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million men in the US are affected by eating disorders like anorexia, bulimia, binge eating
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disorder. About anywhere from 2 to 3 million men have something called body dysmorphic disorder,
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which is where you are preoccupied with a part of your body. It could be your nose, it could be your
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penis size, it could be your hair, your muscularity, to a point that really gets, is significantly
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interfering in their lives and in which they obsess and often avoid situations because of their negative
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body image. And then when you include what we call subclinical body image and eating disorders,
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so people that might not meet the kind of clinical criteria but are close to it, that amounts actually
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in anywhere from 5 to 10 million men. And in fact, a lot of men might fall right under that radar where
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even in research studies or in treatment samples might not be picked up because maybe they're not,
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because again, a lot of the criteria of how we even define some of these, particularly with eating
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disorders, was almost exclusively based on women. I mean, even the studies, I mean, if you look at some
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of the very popular eating disorder questionnaires and surveys, there'll be items like, I don't like
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my thighs, and you have to rate your level of agreement with that. You know, I don't like my
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butt, I don't like my breasts, you know, terms that are, you know, men don't really relate to the
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concept of thighs. Now, if you ask, if you word that to say, I don't like my quads, you know, I don't,
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I'm not satisfied with my fitness shape or things like that or my muscle size, then you're going to have
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a different endorsement of how men respond to that. So there's still a lot more work
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in identifying. But I know just clinically, with the majority of men that I treat who struggle with
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these things, I am one of few, if not the only person that knows that they struggle with it.
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It's still something that's very, very shameful. Now with the boys that I treat, obviously their
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parents and family members know, I have been seeing a trend where there's better identification
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now and people are coming into treatment earlier, which is a good thing. And at the same time,
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I've also seen an increase in these problems with boys and men.
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So let's talk about what's going on there. As you highlight in the book, like this really wasn't a
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problem, let's say for my grandfather's generation, like that World War II generation.
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But you started seeing it happening in the 70s and 80s. Like what changed? What's going on that's
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causing this uptick? Yeah, so that's absolutely true. So historically, we can document eating
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disorders in women to the 1600s. I mean, it's historically for spiritual, religious, media,
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pop culture, all of those reasons. With men, we really didn't see it so much until again,
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those late 70s, early 80s. And we attribute a couple things to that. So one is that if we,
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and we've done studies looking at even advertising and media, that somebody had the brilliant idea of
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probably realizing, well, hey, we have half the population hating their bodies and profiting off
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of that. Why don't we make the other half of the population not like the way they look and profit off
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of that? And so we started to see, particularly in the early 80s, this rush of advertising featuring
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half-nude male models, things like designer underwear. Think about it. I mean, would our
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grandfathers have cared about designer underwear like Calvin Klein or Armani? Absolutely not.
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It would have been Fruit of the Loom or Hanes, something just very functional. So the idea of
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men even thinking about those things started to become much more advertised for them.
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Also, if you think about the early 80s, in Hollywood, you have people like Sylvester Stallone
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and Arnold Schwarzenegger and actors who clearly rather their bodies were these issues of commodity
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and currency for them as opposed to the Hollywood actors in the 40s and the 50s. But also, we started
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to see a whole tide changing in a very positive way around how women and men started to see
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themselves. And obviously, in the late 60s and in the 70s, we had the women's liberation movement
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and feminist movement, which we talk about in the book as being a very positive cultural change.
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And in that change, it changed the way that women saw their gender roles and the roles that they took.
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And up until that point, men pretty much defined themselves in their masculinity by how strong
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they were, how much money they made. And when that is shared more with women, which again,
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I highlight is a positive thing. But I think one of the ways that now came from that is that men
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had to figure out what it meant to be a man if it wasn't being the breadwinner, when maybe your spouse
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was making more money than you are, or being the strongest person when there could be women in
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positions of strength and power. And the easiest, I guess the most concrete way to do that is through
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the body. That men really, you started to see bodybuilding becoming much more the rage,
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like from Pumping Iron and that documentary. Also, anabolic steroid use became much more accessible
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to the average man. It wasn't just relegated to elite bodybuilding circles that you, you know,
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in the fifties that you would see. So all of that together, I think kind of create this way of like
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how to build a body that is representative of, of being masculine, you know, and a lot of the men
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that I work with who struggle with eating disorders at that issue of masculinity often comes up.
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So that's an interesting point because I've read similar studies in anthropology research about
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when countries that have high levels of gender egalitarianism, you actually see this weird thing
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where the genders start accentuating their differences even more. Correct. Because they
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want to find a way like, Hey, we're saying this way, but how are we different? And so in this case,
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men's like they can put on a lot of muscle and get the big shoulders, something women, you know,
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they can, but not as well as men because they've men have androgen receptors in those muscles
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increase more testosterone. But yeah, I mean, in some countries, women, like they act more feminine,
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even though they can do everything else that a man can do. They're just trying to differentiate
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themselves. Right. It's, it's interesting because one of the, the anthropological studies we came,
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we came across was research of this tribe in Africa called the Wodabi tribe. And this is a tribe where
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women have a lot of, a great degree of sexual liberation. If they decide that their husband is
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unattractive, they could have an extramarital affair and that is sanctioned sort of in the tribe
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and that culture. So men, what we also see is that men in this tribe are very, very astute to their
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body image. I mean, they're, they adorn themselves with certain kinds of colors and feathers and costumes
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and it all actually culminates in the ceremony called the Jerawal ceremony, which is basically a
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male beauty pageant where, you know, men will show off their teeth and their height and their,
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their bodies and adorn themselves again with, with clothing and women will judge them and they'll mock
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and humiliate the men that are not up to par. And the men who are sort of seen as more attractive
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are applauded and, you know, might be, you know, getting, getting some sex that night. So it's
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interesting that in this culture now, it doesn't mean that it's a completely egalitarian culture,
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but at least sexually it is that there's a great degree of sexual liberation. And, and that certainly
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came about, you know, in the seventies and eighties where with the invention of the birth control pill and,
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and again, shifting gender roles and women being seen as individuals who are, could have sexual
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satisfaction and, and are entitled to that, that it did shift this way. And even now, I mean,
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it's so interesting, which is how gender is talked about and, and gender fluidity and everything,
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what we're going to see and how that sort of impacts, you know, the way that body image gets
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looked at even today. It is interesting. I think that I was talking to my wife about that,
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that the studies you guys talked about, about how egalitarianism led to differentiation. I was like,
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we were like, that explains like when you go to the toy store now, there's like a pink aisle and
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then there's like the blue aisle. Like, I don't know, growing up in the eighties, there wasn't
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that there was like Legos and there was, that was it. Like there weren't pink Legos. It was just,
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you had Legos and it's sort of, it's just sort of weird that that that's happened.
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Yeah. So there's a combination of things going here. Egalitarianism. So men are trying to find a
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way to differentiate themselves. So they're putting on muscle. There's the change in advertising
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that's been going on. That's, you know, been, you know, laid, you know, we, we've attributed the
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problem with female body image disorders with these sort of the Photoshop fakeness of beauty
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advertising. And you talk about movie stars. Yeah. Movie stars now, like they're all jacked. Like
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Hugh Jackman is literally jacked. But if you go back to the fifties, like, you know, John Wayne,
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Robert Mitchum, Paul Newman, like they just looked like regular dudes. Like they didn't,
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they weren't like super, they weren't super huge or super jacked.
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Absolutely. I mean, even like with, with cigarette ads featuring the Marlboro man, you know,
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who is this sort of rough and tumble kind of masculine dude that, yeah, he wasn't, he didn't
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have a six pack. And that was, that's all it took. You had to have a certain level of this
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kind of air and confidence about you. I mean, all of those actors of yesteryear certainly had
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a certain confidence and a certain way about them, but it was not connected to their bodies.
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It wasn't sort of connected. I mean, they were seen as attractive men or handsome men by,
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by people. But a lot of times, even the way we think of what we find attractive is often linked
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to what we find in other attributes. If somebody is confident, we tend to find more confident people
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attractive. And so it was a very stark change compared to, you know, you're right, what we
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see now. I mean, with Hugh Jackman, with, I remember when Fight Club, when that movie came
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out and so many of my patients, that was like one of those movies that all of them responded
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to this idea that it, that was a shift actually to where it became less about being just big
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and muscular, like sort of like the kind of pumping iron, but more about looking ripped
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and looking lean. And I remember that movie getting a lot of attention around that, this
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idea that, you know, Brad Pitt had this just cut body. And that was the beginning I felt
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of that shift in that trend to not always being sort of this big muscle and fitness guy in
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the room, but still being very fit and being very defined.
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Yeah. I remember that. That's that scene where that first thing, he has a shirt off and he's
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like, you know, he's carved from wood, I guess it was like this. Yeah. And what, but yeah,
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people saw there like, I want that. But what they forget is that, you know, Brad Pitt was
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probably hadn't eaten anything in like a day, was probably hyper dehydrated, right? To get
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Without a doubt. I mean, some of the, the, in Adonis complex and some of which, most of which
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got in the book, but some of the stuff that didn't get in the book was, you know, interviews
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or people that I had met who talk about, I remember this one woman I met with who was
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an underwear model stylist and photographer. So her job was to photograph men in famous
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underwear ads. And she said that basically they have men wear underwear that is two to
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three sizes too small for them. And perhaps multiple of those underwear, they'll often enhance
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their bulge with everything from Wonder Bread to, you know, sort of sexual toys, anything
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because she said, that's what you're, if you can convince a guy that he's going to have
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a bigger penis wearing an underwear, then he's going to buy it. Or the women in their lives
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or the other men in their lives, in the case of gay men, will buy it for them. And so she
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said, there's so much that she says gets manipulated. I mean, you can manipulate abs. I talked to a
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makeup artist who said that she could draw abs in for men that just don't have a six pack,
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but she could draw them in in a way that could look, I mean, you wouldn't even know the difference.
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And so there is so much of that manipulation that we know happens. But I think again, you know,
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there's a lot of attention and I, and I never, it's not about taking the attention away from women,
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but also understanding to put men in the dialogue as well and understanding, you know,
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because there are lots of boys and men who are, who are suffering and I'm seeing it younger also.
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I mean, I've worked with boys as young as nine who struggle with significant body image and eating
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disorders. And I imagine social media has only amplified this even more.
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Oh, without a doubt, without a doubt. That, now that's something that, you know, I've always thought
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if I ever, if we ever do the sort of revised or updated edition of Adonis Complex, it would have,
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we'd have to have a whole chapter just on social media because I have a teenage son who's 14.
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I have a daughter who's 12 and there's no question. He actually showed me an app. I was
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giving a presentation. He said, Oh dad, you should talk about, I think it was called FaceTune. And
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he said, it's this app where people take a picture and by a couple clicks, you can remove all your acne
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off the, you can whiten your teeth. You could, and when you go on, when I, when I think it was on the
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website, there were just as many before and afters of males as there were to females. I mean, they,
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they market to both teenage boys and to teenage girls to basically enhance their appearance.
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And I think it's so destructive because, so, okay, you have this picture now of what your ideal,
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what you have now seen as your ideal self. And now you put that where you put that on Facebook,
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on Instagram, but you don't really look like that. So what is that going to do? It's just a
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setup to just feel even worse about yourself or not. I've worked with adult men who are in the
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dating scene and will put a picture in their dating profile that is kind of, is Photoshopped,
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is enhanced, is using that kind of app. And then they're, they're frightenedly anxious about meeting
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the person on the first date because they don't a hundred percent look that way. And it's just,
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it's, it's so, I find it very destructive. I mean, which is why right now my kids don't have any
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social media and I'm going to try to have it be that way until they're in college.
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I mean, honestly, I think there are a lot of issues with it. I mean, I think it could be very
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helpful, but in terms of, for in other areas and venues, but for a body image, I've seen it
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be nothing but a very negative influence. And also on social media, particularly on Instagram,
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a lot of the influencers there, like they make their money peddling products that improve your
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appearance, right? So weight loss teas, supplements, teeth whitening, whatever. That's how a lot of
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Oh, without a doubt. And, and for people to understand, I mean, how kind of manipulative
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and how they're there. And it sounds, this sounds very, you know, conspiracy, but it's true because
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I had an experience with, it was a very popular men's magazine. I won't name the magazine, but it was
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very popular men's magazine. They did an article when Adonis Complex came out.
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And one of the things I talked about in the article were all these supplements that are
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out there. And I said, some of them are useless. Some of them are actually harmful for you.
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And maybe there are some that might have proven could increase muscle mass by like a very,
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very small percentage. And I basically went on to kind of slip slam them and got a call from the
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editor of the magazine and said, well, you know, we've really want to run this and we want this to be
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the cover story. But a lot of our advertisers are those supplements that you kind of trash.
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And so could you say, would you be willing to say something different about it? And I said,
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no, I feel how I feel about it. And then basically the whole conversation changed where maybe they
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wouldn't run the article. And I said, well, then don't run the article. Like I'm not,
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So they ended up running it. It became, it wasn't as prominently featured as it was originally
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intended to, but they deleted everything that I said about supplements. And I thought, wow,
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isn't this interesting that they're, here's information that I'm sharing with the public
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and they have a right, you know, to edit and I, it's their magazine. However, it is,
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it is motivated from, from profit. You know, it's motivated because these companies basically said,
00:23:52.480
like, we don't like this and we are trying to sell this product. And, you know, so the public
00:23:58.460
is not getting sometimes the right information.
00:24:01.600
So another way that sort of body image has changed for men, you guys showed this too,
00:24:05.580
you guys do a great job. You guys became amateur toy collectors in the process of writing this book.
00:24:09.640
And you show like, you know, show like a, like a GI Joe from the 1960s to a GI Joe from like the
00:24:14.860
late nineties. And like sixties GI Joe, I mean, he just looked like a regular guy,
00:24:19.520
but nineties GI Joe, like he's got biceps that are like the size, like half the size of his waist.
00:24:26.820
Yes. Oh my gosh. Without a doubt. I mean, that was actually a very fun paper that we wrote and
00:24:31.920
we were actually surprised by how, you know, big of a disparity the measurements would be. And that,
00:24:38.640
that's inspired by the very famous Barbie doll study that was done in 1980, which showed that if
00:24:44.520
Barbie were a real life human female, that her dimensions would be completely unrealistic.
00:24:50.520
Like you just couldn't create that body. And, and you may have heard that for years,
00:24:55.940
Mattel was getting a lot of pressure from moms groups and from feminist groups and body image
00:25:01.540
advocacy groups, and they refused to change. And then eventually they did start to change Barbie's
00:25:07.240
proportions. And so technically she is, it's doable to have that body. If you were, you know,
00:25:14.080
severely underweight with breast implants pretty much. And so we thought, what would be the analogy
00:25:19.420
to that? And I thought, well, I used to play with action figures when I was a kid. And so I went to a
00:25:25.120
toy store and with the permission of parents, I said, can I ask your kid, like what kind of action
00:25:30.740
figures they would like? And these boys, and they pulled them out and I bought them all and we measured
00:25:36.040
them. And that's exactly what we found that if these, these like Batman today, the action figure
00:25:42.040
was not Adam West, you know, from the TV show. But what was striking, the most striking about that
00:25:47.660
were the Star Wars action figures, because unlike GI Joe, which you could argue that the GI Joe in the
00:25:53.900
1960 is a different character than the GI Joe in 1990. And yes, even though the GI Joe's now are much
00:26:00.940
more muscular and ripped and, and just leaner. But with Star Wars, it was, so Star Wars came out in
00:26:07.760
the seventies, as you know, and then in the mid to late nineties, when we were doing this study,
00:26:12.620
it was re-released in the theaters because it was digitally remastered. So they re-released the
00:26:16.960
action figure line. So now these are based on the same character. Mark Hamill, Luke Skywalker is the
00:26:22.920
same character from the 1970s movies, 1990s. And those action figures, if you see, you know, anyone can
00:26:29.900
Google it, they're probably, it's probably online, is so strikingly different. It's almost laughable
00:26:34.840
that, I mean, even Mark Hamill, the actor was quoted as saying, oh my God, they put me on steroids
00:26:40.700
when he saw the new action figure. It's just, it's, it doesn't even look like him. His waist size is
00:26:46.440
dramatically smaller. His pectoral muscles are defined with his, his robe open more to show more
00:26:53.080
chest. Han Solo looks like he's been at the gym significantly over the 20 years. I mean, it's just,
00:26:59.040
and that was shocking to us because we're like, why are you changing that? Like you're not even,
00:27:04.860
it, it's not like they made it look more realistic. It actually looks more a further away from what
00:27:10.700
those characters look like in the film. We're going to take a quick break for your word from
00:27:14.200
our sponsors. And now back to the show. And so this has all led to a change in how a lot of
00:27:21.260
American or Western men picture the ideal male body. You've done, you talk about these interesting
00:27:26.520
research studies you did with different types of people, different ages, where you asked them to
00:27:31.160
pick their ideal body. And you asked this to men who were younger, women who were younger and older
00:27:37.540
men. And I thought it was interesting is, you know, a lot of times men focus working on their bodies.
00:27:41.980
They think, well, what a woman wants is a super muscular shredded guy. But when you ask women,
00:27:51.040
Right. So that, that was a great study. That was my dissertation actually from when getting my PhD
00:27:57.460
where, so we developed this computer program called the somatomorphic matrix. And when you go on the
00:28:04.440
computer, you're presented with an image that is corresponds to a certain percent of body fat
00:28:09.340
and a certain percent of muscularity. So unlike women with body image, generally that most women
00:28:16.780
being overweight and being over fat are the same thing. So women, you know, they step on a scale.
00:28:23.160
If they see a number that's too high, they don't like that, you know, if they feel that they're
00:28:27.920
overweight. With men, what made those studies often invalid is that a lot of those earlier studies,
00:28:34.300
when they would do for men, because with women, they would present them with different images,
00:28:38.820
not on a computer, but on a piece of paper. And they would say, what's your ideal?
00:28:42.140
How do you perceive yourself? And what these, for heterosexual women, how do you think that,
00:28:47.300
what are men's ideal of the women's body? And invariably, what you find is women prefer an
00:28:53.920
image that is very underweight, often like restrictive. They see themselves as fatter than
00:29:00.120
they actually are. And they think that men want them to be thinner than men actually want them to be.
00:29:05.240
So when those studies were done with men, they kind of said, well, men aren't really
00:29:10.640
dissatisfied because some men want to lose weight, some want to gain weight, and so it cancels each
00:29:15.620
other out. Well, what they weren't accounting for was muscle mass and muscularity. Because most of the
00:29:21.200
men that I work with, they don't mind if they're 250 pounds, let's say, when they're, you know,
00:29:26.880
quote unquote, supposed to be 200, as long as they're all muscle. So being overweight really is
00:29:32.140
less integral to their body image is, is seeing themselves as being over fat. So when we did that
00:29:38.840
study, and these were college men who were, had to pick what is their ideal body? How do they see
00:29:44.840
themselves? And these were heterosexual men. How do you think a woman your age wants how, what she
00:29:51.460
prefers? And we found that men preferred a body image that was about eight pounds less body fat,
00:29:58.700
which was actually not that significant. However, that had 25 pounds more muscle, which was
00:30:05.880
statistically significant. And then when we actually polled women and had women take the study,
00:30:11.840
the survey, we found that women preferred a less muscular body than what men thought women preferred.
00:30:19.980
And what was actually the very interesting to me was, I had hypothesized that men's ideal body
00:30:27.080
would be, would match what he thought the, that women would prefer. And in fact, that wasn't true.
00:30:34.060
That in fact, men preferred a body that was even bigger than what they thought the average woman
00:30:39.600
even preferred. But the, the factor that really shone through was how big they thought the average guy
00:30:46.660
was. So there was something very important about men being bigger than other men, even if that was
00:30:54.100
to the exclusion of what women actually preferred. Now, one could argue, maybe if you're the biggest
00:30:59.000
guy in the room, you have your choice of any partner in the room or you have the best
00:31:04.120
options. But the fact that that variable didn't even pan out where it really didn't even matter what
00:31:09.700
women preferred. It just mattered how big they were as compared to other men.
00:31:13.880
Yeah. I wonder when I read that, I wonder if it's like, are men really doing it for like women or are they
00:31:18.660
just trying to compete with other men, right? It's like, you know, there's that, you know, saying like
00:31:22.360
my, I think I've heard like women don't dress for men, they dress for other women. Right. And when
00:31:27.060
there's like, there's an intra sexual competition going on between men.
00:31:31.800
Oh, I think so. Yeah. I think there's definitely something, the idea of, you know, men in a locker
00:31:36.900
room, you know, kind of comparing penis size and men in the gym, you know, looking at their, their
00:31:42.820
muscles and who's bench pressing. And we see it with women, as you mentioned as well. I mean,
00:31:47.100
there have been studies that have had, that have asked men how attractive they find women
00:31:53.000
wearing makeup is. And actually a lot of men, you know, prefer less makeup, you know, than more
00:32:00.220
for women. So that there are, there's definitely this intra sexual competition going on. Now, whether
00:32:06.420
that's for this ultimate goal of, again, having the most options to, you know, who you mate with and
00:32:13.180
and whatnot, that, you know, remains to be, you know, seen. But without a doubt, I mean, a lot of
00:32:18.620
them, the men that I work with, particularly the ones who are obsessed with their muscle size and
00:32:24.020
muscularity, they're more concerned about how weak they feel they look in comparison to other men.
00:32:32.580
And they're constantly comparing themselves to, is that guy bigger than me? Is he more muscular than me?
00:32:37.900
And part of it is that what makes body image problems so, you know, so difficult for people
00:32:44.080
is that it doesn't really have to do with the body. It's more around what we feel we get by having an
00:32:50.800
ideal body. So it's, if I have this ideal body, then I'm going to be more confident. I'm going to be
00:32:57.060
more powerful. I'm going to be seen as more attractive. It's, it's all of that, that we have to sort of
00:33:02.580
break down and unpack in, in working with these boys and men. Well, one more thing with the study
00:33:08.360
you did, not only did you pull college age men and women, but you also pulled like older men and
00:33:13.600
women, like I think in their fifties or sixties. And what I thought was interesting there, there was
00:33:17.120
no difference between men and women on what they thought the ideal male body was.
00:33:21.660
Right. Yeah. That there is something, I mean, with, with body image, we do see changes kind of,
00:33:27.940
you know, developmentally. Um, although I have, I work with men in their forties and fifties who
00:33:33.860
either struggle with eating disorders or who have body dysmorphic disorder. They, you know,
00:33:39.640
they don't want to have wrinkles and they don't want their hair to go gray or they don't want to
00:33:44.660
lose their hair. Um, and I've been seeing more of that, but typically in, in previous body image
00:33:51.420
research, you, people tend to get more satisfied with their body image as they age, which is
00:33:57.860
interesting because we associate being older with kind of, you know, being not liking sort of our
00:34:04.100
bodies. But actually I don't, I think part of that is, you know, when you get older, you value health
00:34:09.300
a lot more, you become much more aware of your mortality. And so, you know, you kind of realize
00:34:15.700
that there's almost something very trivial about worrying about how other people see you when you
00:34:21.660
have sort of a more fully lived experience. Um, but it's very normative for us to worry about that,
00:34:27.740
when we're younger. And again, it's not just around, Oh, I want people to like my skin and
00:34:33.500
my hair and my body, but I want to be accepted. I want to have connections. I want to have
00:34:38.520
relationships. And unfortunately there's a cultural script around, well, a way to get that is by
00:34:45.940
looking good or the only way to get that is by looking a certain way.
00:34:51.120
Well, so let's delve in deeper to some of these different ways the Adonis complex manifests itself.
00:34:55.820
So you mentioned muscle dysmorphia or body dysmorphia in one of that ways you guys call
00:35:00.360
this bigorexia, which you introduced a whole new word of the lexicon. So this idea that,
00:35:05.360
you know, so it's the opposite of anorexia where people, someone thinks they're, they're
00:35:09.340
fatter than they really are. Bigorexia is someone is not as muscular as they think they really are.
00:35:16.880
Right. That they, their fear is that they're not as muscular as in fact that they can be.
00:35:21.600
Some of the men I work with muscle, so we, you're right. So it was first we called it bigorexia and
00:35:27.040
then we kind of changed it to a more clinical name of muscle dysmorphia. And some of these men I work
00:35:33.180
with are very muscular guys. I mean, they're objectively big guys, muscular guys, but they
00:35:39.960
don't see it just like the 80 pound woman with anorexia who really thinks she's fat. So these are
00:35:46.440
not the guys that you would see at Venice beach with their shirts off kind of pumping. They,
00:35:51.400
even though they might have those bodies, they come to my office on a 90 degree day and they have
00:35:55.860
long sleeve shirts on because they fear that someone might see their quote unquote scrawny legs,
00:36:00.920
scrawny arms. They might be wearing pants because they don't want people to see their scrawny,
00:36:05.160
puny legs. They work out incessantly. A lot of them do steroids. So it, it is very much like
00:36:13.200
everything you see with anorexia, but just kind of almost as if the pendulum is just swinging in the
00:36:18.180
other direction. And in fact, studies that I've done that have compared men with anorexia with men
00:36:24.160
with muscle dysmorphia find that they actually look more similar than different in a lot of profiles
00:36:30.180
because it's, we kind of see it as just the same thing. It's just different variants of the same
00:36:35.460
thing. And I mean, so you mentioned like the extreme cases where people are wearing baggy clothes,
00:36:40.080
but you also highlight in this book, you know, people that you saw, men, you saw that,
00:36:43.760
you know, their muscle dysmorphia got in the way of their career. Like they, they got fired from
00:36:48.620
their jobs. They're spending too much time at the gym, got in the way of healthy relationships
00:36:52.520
because they're, you know, spending time with their significant other. They were spending time
00:36:56.400
at the gym where they're just bugging their significant others. Like, am I big enough? Am I
00:36:59.040
big enough? Am I big enough? And like, you know, for some people like that, that insecurity is
00:37:02.920
unattractive. Oh, absolutely. I mean, it, it really is. I, you know, when we started talking about
00:37:09.000
this and doing research, I mean, unfortunately it didn't garner any sympathy from people because
00:37:14.320
people were like, oh, you know, bodybuilders, like, oh, they're so vain and they're so arrogant
00:37:18.920
and, and all that. But this is not that, like, this is not vanity any more than an eating disorder
00:37:25.260
is about vanity. You know, we shouldn't look at someone with anorexia and think, oh, they're just
00:37:29.880
doing that for attention. It's all about, it's a, it's a serious, serious issue. And with the,
00:37:34.980
the men that I work with, they really feel like they're, almost their survival sort of depends
00:37:41.580
upon their, the way their body is. And so they will do anything. I mean, I've had, you know,
00:37:48.060
calls from, I remember a call from a dad I got years ago whose son, he was 18, struggled with,
00:37:54.020
with this. And he said, it started with his son asking, dad, do I look as muscular today as I did
00:37:59.700
yesterday? Is that guy across the street, does he look bigger than I do? Do you, do, does my bicep
00:38:06.320
look as big as it did, you know, yesterday? And he said it started out maybe three to four times a
00:38:10.340
day. And it got to a point where he literally counted, it was, it was up to 80 to 90 times a
00:38:16.240
day his son was asking for reassurance. And in, he said it was almost like delusional. And there's,
00:38:23.220
it's this incredible anxiety around it. And, and instead of, you know, going, you know,
00:38:29.820
to functions that they're supposed to be going to school or work, they were at the gym working out.
00:38:35.860
They felt compelled to do it. These are men who are boys and men who, if there was, you know,
00:38:42.720
I live in the Boston area, we get blizzards sometimes in the winter and gyms will close,
00:38:47.020
that they will have serious panic attacks. Some of them will feel suicidal if they feel
00:38:53.080
like they're losing muscle mass. I mean, it seems very strange probably to a lot of people to,
00:38:58.840
to hear, but, you know, if we think about it, if we flip it to eating disorders, you know,
00:39:03.700
15 to 20% of men and women with eating disorders will die. And of that 15 to 20%, half are due to
00:39:12.700
suicide and the other half are due to the medical complications of the eating disorder. But there's
00:39:18.240
a high suicide rate in this population and body dysmorphic disorder or BDD of which muscle
00:39:24.320
dysmorphia is, is a subtype of body dysmorphic disorder. It has outside of bipolar disorder
00:39:30.800
and schizophrenia and depression has one of the highest suicide rates. So these are individuals,
00:39:36.120
this is not, again, somebody who is just kind of vain. It's, it's much more serious than that.
00:39:43.260
I mean, as you talk about in the book, it's, you know, it's actually, there's a, there's an
00:39:47.340
element of obsessive compulsive disorder going on there. Like someone who would, you know,
00:39:51.600
you know, compulsively wash their hands are probably more likely to obsessively work out
00:39:55.720
of the gym if, you know, they caught that bug for whatever reason.
00:39:58.760
Yes. So we, we think of in, in psychiatric disorders, we sort of can group them almost in
00:40:05.000
different families, so to speak. And one of the families that share a genetic and underlying
00:40:10.320
genetic predisposition is what we call the obsessive compulsive spectrum disorders that includes OCD or
00:40:16.600
obsessive compulsive disorder, body dysmorphic disorders in that there could be generalized
00:40:21.620
anxiety disorder, trichotillomania, which is compulsive hair pulling, you know, certain
00:40:26.820
variants of panic disorder that all kind of have this genetic. So we'll, in doing family history
00:40:33.540
studies, uh, oh, anorexia would certainly be in there that you might find kind of runs in families
00:40:39.500
as well, that a lot of the people that I've treated for muscle dysmorphia, you'll often see
00:40:44.420
a family member that might not have muscle dysmorphia, but will likely have OCD, a history
00:40:50.100
of anorexia, you know, something of that. It just doesn't, you'll often see it run, run in families.
00:40:56.980
So what's the treatment for muscle dysmorphia like, like for extreme cases?
00:41:02.220
Yes. So typically the, the men that I see with muscle dysmorphia, they come into my office,
00:41:07.920
they never say, I want to come in and stop working out. They often come in because their
00:41:13.300
lives have hit a real bottom. They've gotten fired from their third job because they are late
00:41:19.040
constantly because they're at the gym. They are getting it, their wife is divorcing them
00:41:23.440
because they are, you know, chronically obsessed, you know, with, with this and they won't leave the
00:41:29.600
house, let's say for social functions because they feel that they don't look good enough.
00:41:33.880
So in that treatment is a combination of what we would call cognitive behavioral therapy,
00:41:40.160
which would include really looking at their cognitions or their thoughts. Things like,
00:41:45.440
if I lose muscle mass, then nobody will like me. If I go out in public and people see me as weak
00:41:52.020
and, and you try to examine with them the evidence for that, you know, how, how accurate are these
00:41:57.920
thoughts? And most of them are not, there's a very, almost this level of delusionality that you'll see
00:42:04.160
in individuals with, with body dysmorphic disorder, um, where, you know, they'll say,
00:42:09.480
oh, that person is looking at me clearly because they think I look ugly or they think I look too
00:42:14.640
skinny. And it's like, no, they're looking at you because you just walked in the room or they could
00:42:19.560
be looking at you because you look like their brother or because you have this cool shirt on.
00:42:24.100
And there are many other reasons someone could be looking at you or they might think you're
00:42:27.520
attractive. So you try to really work at deconstructing those thoughts. And then the
00:42:32.760
behavioral part is anything that they're avoiding, you expose them to something called exposure plus
00:42:39.300
response prevention therapy, which is the hallmark of treatment for obsessive compulsive disorder.
00:42:44.580
So if somebody, for example, has contamination fears and they're avoiding touching doorknobs and
00:42:50.220
shaking people's hands, the, the best and really only way that you can treat that is having the
00:42:55.580
person touch doorknobs and not only touch doorknobs in other people's hands, but touching dirty toilet
00:43:01.540
seats and not washing their hands for an hour or two and basically have them get used to the anxiety.
00:43:08.200
We call it the process of habituation, that they're habituating to the anxiety and recognizing
00:43:12.640
that the anxiety will come and go. What goes up must come down.
00:43:16.700
And when it goes, you realize that that, that, that feeling that you have that compels you to do
00:43:24.200
the compulsion or to avoid a situation that if we just stick through the emotion, kind of get through
00:43:31.120
it, that we realize that nothing bad is actually happening, that it's just, it's our mind kind of
00:43:36.940
thinking that way. And then with muscle dysmorphia, I'll work on things. A lot of the men that I've
00:43:42.260
treated with muscle dysmorphia also tend to have social anxiety, other sort of conditions and
00:43:47.540
disorders that I think feed into it. So we might do some assertiveness skills and social skills.
00:43:53.760
Some of them have histories of trauma, of sexual or physical abuse, which makes sense, you know,
00:43:59.620
building a big body becomes a way of defending yourself and not looking weak. If in the case,
00:44:06.460
I've worked with gay men who have muscle dysmorphia, who have used their bodies as a way to kind of
00:44:12.540
fight against this sort of homophobic stance that gay men are inherently less masculine than
00:44:19.300
heterosexual men, which, you know, isn't necessarily true. And that there are, you know, gay men and
00:44:25.720
straight men that, you know, whose gender identity is very different than their sexual orientation.
00:44:30.100
But I've worked with a number of gay men who really got into building their bodies as a way of
00:44:35.820
no one kind of questioning their masculinity, because unfortunately, gay men have to defend
00:44:41.440
their masculinity because of their sexual orientation. So there are a lot of different
00:44:45.660
causes that can feed into it. And so we try to address those roots. But most importantly,
00:44:51.920
honestly, is just getting them to do these behaviors. Not, you know, if they're weighing themselves 20
00:44:58.100
times a day, we remove the scale and how do you tolerate not knowing what your weight is and still
00:45:05.420
going out that day and not wearing the long sleeve shirts when it's 90 degree weather.
00:45:10.720
And I'll do these kind of exposures where I'll walk outside my office with the patient and they
00:45:14.640
have to wear short sleeves and shorts and we walk in a crowded place and it could be, and it works.
00:45:24.180
Right. So, okay. One part of the Adonis complex is bigorexia, muscle dysmorphia. Another part you
00:45:29.800
mentioned is men with eating disorders and it's something we typically associate with women.
00:45:34.060
Thanks for those PSAs in the 80s and 90s. But here's a question. So how, is there a difference
00:45:38.380
between the way men and women manifest or experience eating disorders? Like they do it differently?
00:45:44.500
Sure. Absolutely. So for the most part, it can look very similar. I would say that the
00:45:52.240
main difference is if you take with anorexia, that the overwhelming, I mean, certainly any woman I've
00:46:00.840
ever treated with anorexia, their goal is to look skinny and to look very thin. And that's kind of
00:46:10.360
their straightforward goal. With the majority of boys and men that I've treated for anorexia,
00:46:15.920
that they don't identify with the word skinny. They don't want to be skinny. They want to be
00:46:21.380
lean. And they'll say to you, and they say to me all the time, I know that I look really thin. So in
00:46:30.000
some ways, they actually have a clearer perception of what their body looks like. However, I am so
00:46:36.720
fearful of being fat and gaining weight that I just, I'm kind of stuck in this. But if you told
00:46:45.420
me that every bite of food that I ate would immediately convert into muscle in my body,
00:46:51.480
then I wouldn't have a problem eating. And of course, and what I tell these boys is, well,
00:46:56.960
in order to create muscle, you need to have fat. Like your body isn't going to just create muscle
00:47:01.500
without having fat. And so there is that bridge where you have to eat and you're going to need to
00:47:08.500
have a certain amount of body fat. And your body has to trust that you're going to hold on to a
00:47:13.020
certain amount of body fat. Because if you have no body fat, you will die. Your body won't be able
00:47:18.520
to survive. And so a lot of the males I treat, and what's interesting is that this actually almost
00:47:24.760
becomes a helpful factor in the treatment because they're not totally wedded in this ideal of being
00:47:32.900
skinny. But for them, it's the fear of that bridge. Now, a lot of times these men can lapse into muscle
00:47:41.120
dysmorphia. So when they start to gain weight and they're so fearful of gaining fat that they lapse into
00:47:47.520
this muscle dysmorphia paradigm. And so we tried to prevent that. So that's a big difference.
00:47:53.860
With bulimia nervosa, which is binge eating coupled with compensating behaviors like self-induced
00:48:00.300
vomiting or laxative use, compulsive exercise. Generally speaking, we don't see as much laxative
00:48:06.440
use with men as we would see with women. I would say I see just as much self-induced vomiting.
00:48:11.540
But certainly the overexercise is probably more common as a purging method. Whereas with women,
00:48:19.060
you'll see the self-induced vomiting or fasting. So women who might binge eat and then don't eat for
00:48:24.520
two days and then binge eat. This sort of almost like a coupling of anorexia and bulimia.
00:48:30.280
And then with binge eating disorder, which basically just got recognized since the mid to late 90s,
00:48:37.140
that unlike anorexia and bulimia, which certainly affect more women than men,
00:48:42.900
a binge eating disorder is almost at about a 50-50 gender distribution. Now, having said that,
00:48:48.700
what's very important for people to know is that about 25% of people who struggle with eating disorders
00:48:54.500
are male. And that is something that years ago, it would have been maybe less than 1% of individuals
00:49:04.820
with eating disorders are male. And studies have shown that if you look in treatment centers,
00:49:11.660
about perhaps 1 in 16 to 1 in 20 eating disorder patients are male. But in the community,
00:49:19.480
it's about 1 in 4 people with an eating disorder are male, which means there are a lot of men out
00:49:24.840
there who never come through treatment doors. Now, part of that is a lot of treatment centers don't
00:49:30.520
accept men. A lot of eating disorder programs are just exclusively for women. And then again,
00:49:36.820
some of that comes from just men themselves not having a hard time seeking treatment.
00:49:41.580
Something you also talk about in the book when it comes to eating disorders in men,
00:49:46.060
for a lot of these men, it starts off in high school if they were like a wrestler.
00:49:50.700
And it requires that cutting weight, and they do these extreme measures to get as much body weight
00:49:56.660
off of them as possible. And then after wrestling is over, it's still with them.
00:50:02.380
Yes. That was the very first study I did actually on eating disorders in men. I got calls actually
00:50:08.280
from a lot of wrestlers who... And I didn't have a wrestling team in my high school. I didn't know
00:50:13.200
any wrestlers when I was younger who said, oh, I could gain and lose 20 pounds in two to three days.
00:50:21.240
And I thought, how is that even possible for someone to do that? But then I got many calls from
00:50:26.220
various wrestlers from various colleges saying, talking about these practices. And the men that I
00:50:33.040
included in the study were men who engage in these behaviors even after wrestling season. But it opened
00:50:40.300
my eyes to sort of this practice of cutting your weight down and then binging and putting the weight
00:50:47.060
back on. And interestingly, there are sports, ballet dancing or wrestling or football, where weight
00:50:54.620
is very sort of is an integral variable. However, what I found in general and in patients that I work
00:51:02.040
with is, yes, engaging in these sports can sometimes trigger and create eating disorders in individuals,
00:51:08.460
particularly if you don't have healthy modeling from coaches or peers. However, a lot of the patients
00:51:16.160
that I work with who had eating disorders sometimes will gravitate to sports that emphasize keeping and
00:51:23.720
maintaining a certain body weight, almost like it's kind of fueling something that was already there to
00:51:29.880
begin with. But then it absolutely exponentially makes it worse. And that's a tough population in
00:51:37.160
general too, because I've worked with college students who are highly, highly competitive athletes,
00:51:42.300
whose college scholarships are because of their sport, who some of them are, you know, could be
00:51:48.400
Olympic athletes. And to them, you know, they see their eating disorder as something that's almost
00:51:55.460
integral to their success. And the fear of being, of not engaging in these behaviors mean, well, maybe I'm
00:52:03.380
not going to be as good of an athlete, then I'll lose my scholarship and I'm going to disappoint everyone
00:52:07.440
and I won't make it, I won't make these goals. And it's, it's a much harder sort of navigation to that, but it still
00:52:16.460
comes down to and what it ultimately comes down to in recovery for these people is you, they've had to
00:52:22.600
choose, you know, living or, you know, doing well in these sports because I've worked with men who are 20, 21 who have
00:52:30.340
had heart attacks because of their bulimia. It's very, very dangerous. We are not meant to treat our
00:52:37.360
bodies this way. And your body will do very, very strange things when you're, you know, making yourself
00:52:43.460
vomit all the time, when you're not eating, when you should be. It can really mess up the way your heart
00:52:49.040
regulates itself and your, you know, other parts of your body functions, your organ functions work.
00:52:55.680
And I've seen it happen and it's, it's, it's disturbing. And so that's what I think people
00:53:01.480
have to recognize. This is a public health issue. Yeah. And the sad irony is you said not only can
00:53:06.420
these cause these extreme health complications, but it also just, even if that doesn't happen to
00:53:10.900
you, it's probably hindering the athlete's performance, right? Because that extreme weight
00:53:15.540
loss can, you know, wreak havoc on your hormones. Oh, without, absolutely. And then, right. And then when you
00:53:20.740
bring in hormones into all of this, I mean, that is, you know, the interesting thing with,
00:53:25.220
particularly the men with muscle dysmorphia who use anabolic steroids of which about, I would say
00:53:30.740
about 50% of the men that I've worked with who have muscle dysmorphia will use steroids and it makes
00:53:35.440
sense. I mean, steroids are quick and easy way to gain muscle, except that it has so many adverse
00:53:41.780
medical effects to it. But one of which is that when you inject or bring in testosterone into your body,
00:53:49.600
your body stops producing its own natural testosterone because it basically says, oh,
00:53:54.820
we're getting it from somewhere else. We don't need to make it anymore. And so it can actually
00:53:59.900
create these sort of feminizing effects of gynecomastia, which is like breast enlargement,
00:54:05.480
testicular shrinkage, impotence, all of these things that of course go against what any man,
00:54:11.700
you know, would want and can actually create like a dependence on steroids. So it's not a dependence
00:54:17.660
in the same way that we would talk about with cocaine, for example, but it is, it's a physiological
00:54:23.500
dependence in that when men who do steroids for a period of time and they stop doing them
00:54:28.880
and their bodies are not just going to kick right back into producing testosterone,
00:54:34.640
their bodies will kind of lose that muscle mass and sometimes create these sort of feminizing effects
00:54:40.040
because now they're not getting any sort of free, you know, this free range of testosterone in their
00:54:44.340
bodies. So it, and then what that does to them mentally, you know, the concept of roid rage,
00:54:49.340
of being incredibly aggressive, low frustration tolerance. I've absolutely seen that happen.
00:54:54.600
That is a real thing. Some people would say it's a myth. It is not a myth. It's been scientifically proven.
00:55:00.720
I mean, it wreaks havoc on all of those things. And especially if you're a teenager who's struggling
00:55:05.260
with these things, these are, you know, particularly the boys I work with,
00:55:09.200
it is a critical, critical window in like some of the habits that they're doing and the ways that
00:55:15.900
they might be, you know, being very destructive in their bodies could literally affect them the rest
00:55:20.720
of their life. So that's why it's so important to get treatment, you know, as quickly as possible
00:55:26.120
and specifically during those developmental windows. But quickly to go back to the athletes
00:55:31.020
that when I have worked with athletes who have recovered, all of them will say,
00:55:35.200
oh my gosh, it is so much better. And I'm so much a better athlete being healthy. You know,
00:55:41.340
it's similar to, you know, a lot of musicians who, when I've worked with who are sober from drug addiction,
00:55:47.620
you know, who have attributed their creativity to drug use, realize, no, I'm still a creative person.
00:55:53.380
I can still write good songs and I can still be artistic and just actually be more mentally stable
00:56:01.360
And so I think a point we should make, which we haven't, but I think, you know, it's been implicit.
00:56:04.760
Like you're not talking about not caring about how you look at all. Like that's not the solution.
00:56:11.260
Like you should, you know, of course, be fit, exercise, basic grooming. You want to put out
00:56:16.500
that that's, that's, that's all good. It's like when it becomes all consuming and it becomes like,
00:56:22.100
it just, it ruins other aspects of your life. That's when it's a problem.
00:56:25.820
Correct. And I'm glad you brought that up because that is something that I get, you know,
00:56:30.880
we get accused of a lot is, is saying that we are promoting the Pillsbury Doughboy or I've heard it
00:56:37.920
so many, I mean, I've done radio shows where callers call in and, you know, they think, oh, you, you know,
00:56:42.680
just want everyone to be obese and not care about the way they look. No, that's not at all.
00:56:47.300
I, you know, first and foremost, I want people to be healthy. I want people to be physically healthy,
00:56:51.660
psychologically healthy. And at the same time, I want you to have a healthy body image. And part
00:56:57.640
of body image is I, to look, to feel good about the way you look. Like I, you know, wear certain
00:57:04.200
clothes that I feel, you know, fit me well and that I feel good about and kind of express who I am. I,
00:57:11.160
you know, style my hair in a certain way and, you know, do I go to the gym and I run. And so it's not
00:57:17.640
that I do that for health reasons, but I also do it for body image reasons. But like you said,
00:57:22.640
it doesn't dominate me, you know, and that's where I usually water it down to, you know, the line when
00:57:30.080
people ask me, like, what's that line that gets crossed over? And to me, it's, you know, are you
00:57:35.460
doing something that's destructive or that's unhealthy? So if you're engaging in purging behavior and
00:57:40.980
restrictive eating and anabolic steroid use and substance abuse that's meant to lose weight,
00:57:46.660
that's not healthy. If your self-esteem is primarily rested upon the way you look,
00:57:54.060
you're headed for disaster because there's one thing I can guarantee you is you will look different
00:57:59.500
five years from now than you do, you know, from now. Our bodies are changing. We age. So, you know,
00:58:07.120
can some, can you feel good about the way you look? And that represents some of your self-esteem?
00:58:12.100
Sure. But if the majority of your self-esteem is built on that or built on, honestly, you know,
00:58:18.420
anything that has any sort of comparative effect, like if you're primarily your self-esteem is based
00:58:24.600
on, let's say, your academic performance, that can be very tricky too because there are people that
00:58:30.700
could be getting better grades than you do and people who are higher ranked, you know, than you
00:58:34.840
are. But if you base your self-esteem on your intellect, well, that's something that's going to
00:58:39.600
carry with you the rest of your life. And it doesn't depend upon other people. It doesn't depend
00:58:44.000
upon the approval of other people. If your self-esteem is on your sense of humor, is on the
00:58:49.580
way you treat people, those are consistent factors. But when it's something on body image, it's dangerous
00:58:55.320
territory because then it means that there's a fragility around that self-esteem because your body
00:59:01.140
image today, I mean, even if we look at trends in what is even considered attractive, it could be
00:59:07.640
totally different 10 years from now. And so where does that leave people? And if it's impairing or
00:59:13.340
getting in the way of your life functioning, your social functioning, your relationships, your jobs,
00:59:19.280
your careers, then it's a problem. You know, that's when you know, okay, wait a minute. If the whole goal
00:59:24.900
is to be happy and this, the pursuit of this is actually getting in the way of my marriage,
00:59:31.620
is getting in the way of my friendships, then how is that fulfilling that goal of being happy?
00:59:36.880
Something is off there. So absolutely. I mean, I want people to, you know, celebrate their body
00:59:43.180
image and to have a good relationship with it. Go to the gym, be healthy, eat well, but it's more
00:59:49.080
around not crossing that line, which can get very dangerous. And so if you feel like you have crossed
00:59:55.980
that line, it sounds like you should probably get professional help. This is probably not something
00:59:58.920
you probably can do on your own. Correct. Absolutely. I highly recommend it. And, you know,
01:00:03.980
especially, you know, for men who in general are less likely to seek therapy, to know that there
01:00:09.540
are people who really do understand it. A lot of the men that I work with will say, you know,
01:00:15.500
they come to see me because they know I wrote Adonis Complex, or they saw something and they
01:00:20.680
thought, oh, okay, I'm clearly not the first person that this, you know, psychologist has seen
01:00:26.220
with this. And there are many people who have experience with this. And so to absolutely seek
01:00:31.880
treatment because it can be a very, very tormenting disorder, eating disorders, body dysmorphic
01:00:39.260
disorder, it can get quite, quite severe. So please just, yeah, I just urge people to seek help if it
01:00:45.000
crosses that line. And if you're a parent of a boy, I mean, as you say, a lot of the people you see
01:00:49.420
are young men, like boys and teenagers. Correct.
01:00:52.060
And something you can start doing, I guess, is having that conversation with them when they
01:00:54.760
start bringing things up. Like, hey, dad, am I more muscular than yesterday? Doesn't mean he has
01:01:01.720
body dysmorphic disorder, but it's a time where you can have that conversation about it, right? It's
01:01:07.460
like, hey, what's going on there? Why are you concerned about that or whatever?
01:01:10.660
Absolutely. I mean, it's very normative. I mean, I remember being a teenager. It's very normative
01:01:16.440
to be insecure and to be insecure about your body image, especially when you're going through
01:01:21.360
puberty. I would not want to go through puberty again. And so I tell parents, don't be alarmed
01:01:28.180
that when you hear someone even say, oh, I hate my body. I hate the way this looks. Oh, I hate...
01:01:34.020
That's normative. But you definitely want to engage in it because I wouldn't dismiss it as
01:01:42.640
just normative either. So I don't overestimate it, but don't underestimate it either. And just
01:01:47.920
have conversations and notice, well, if he's saying, oh, I hate the way I look, but he's not
01:01:53.480
going out with his friends that night because his hair doesn't look right, then that's more
01:01:59.040
concerning. Versus he might say, oh, I don't like this acne, but he's still going out and he still
01:02:04.520
has friends and having a good time. That's sort of more normative. So to definitely keep your eye out,
01:02:10.660
especially for boys, because we're taught to be aware of how we talk about body and food with our
01:02:16.460
daughters as we should be. But we don't think about our sons in this. And many parents that I
01:02:23.800
work with will often feel very guilty. And I tell them not to because as parents, we all do the best
01:02:29.920
that we can do. And we don't know what we don't know all the time. But they'll say, it never occurred
01:02:36.240
to me to be aware of how I talk about my own body. And this is for moms or dads around my son.
01:02:43.360
Or it didn't even occur to me to say to my son, hey, you're looking a little chubby there,
01:02:48.540
that that could really produce a problem. Whereas no one, or hopefully people aren't
01:02:54.780
talking to their daughters that way. So that's another part that we just want to get awareness
01:02:59.720
out there is that, especially nowadays where with social media and everything, you're out there.
01:03:06.720
I mean, think about it as a teenager. You could be at a party and a picture could be taken of you.
01:03:11.700
And let's say you don't look your best. And now it's like all over social media. It's just,
01:03:17.380
there's more of an exposure in general to these young people to have to put a certain pressure
01:03:24.440
Yeah. I think it's also, you can have that conversation that we've had with young girls
01:03:28.000
about, okay, that picture of the model in the ad has probably been photoshopped, et cetera.
01:03:32.180
Like have that same conversation with your boys. Like, hey, that men's health cover model,
01:03:35.680
you know, he's probably been fasting and cutting weight and it's probably been photoshopped some.
01:03:41.220
So it's like not, it's not possible to look like that all the time. And I've even, I've had that
01:03:45.720
conversation with my son, he's eight. And you'll see some like really jacked dude. And he's like,
01:03:50.360
dad, cause I power lift. And he's like, dad, why don't you look like that guy? And like the guy,
01:03:54.140
of course, is like super ripped. I don't look like that. And I have to explain to him, well,
01:03:57.540
just because your muscles are ripped doesn't mean you're necessarily strong,
01:04:00.080
right. And healthy. And it's been, it's been good. And like, you know, he's eight, but like
01:04:04.160
he gets it. Like, I think sometimes we underestimate what our kids can understand.
01:04:08.660
That's absolutely true. I a hundred percent agree with that. And I have those same conversations with
01:04:13.080
my, with my son around, you know, that and around, you know, also just with celebrities. I mean,
01:04:18.920
this is their career, you know, that if, if the rock suddenly lost all of his muscle mass,
01:04:24.860
his career would be, you know, he'd lose his career for the most part. I mean,
01:04:29.180
his career is built upon, you know, that body. Now, could he act in movies, you know, without
01:04:34.640
that body? I'm sure, but he certainly wouldn't be getting the roles he's getting now. So his,
01:04:39.860
his livelihood is dependent upon that. So he has to go to the gym and he has to be super aware of
01:04:47.320
his diet and that's his job, you know, in that way. And I'm not saying, I'm not even commenting on
01:04:53.020
whether it's healthy or not, but just for people to understand it's, it's easier when your
01:04:58.300
livelihood is kind of dependent, you know, on that, even though, and again, I'm not even saying
01:05:02.680
that that's always a healthy thing, but when the average kind of ordinary individual looks at
01:05:08.420
someone and says, Oh, like, I want to look like that. It's like, well, but that person is spending
01:05:13.060
hours upon hours to look that way. And that's even assuming that everything you're seeing is not
01:05:18.760
Photoshopped, you know, but they have a trainer that they work with four hours a day and they have
01:05:23.700
a cook that's making, you know, but absolutely. I, I've had those same conversations even when my son
01:05:28.880
was young and he, he could, they could absorb a lot more than we think they can.
01:05:33.020
Yeah. You explained it like they don't, yeah, they looked like that at that moment. They probably
01:05:36.280
didn't look like that the next day. You know, like, you know, like Brad Pitt doesn't look like Brad
01:05:40.780
Pitt and fight club in that one scene anymore. It's a 50 year old guy now. Well, Roberto, this has
01:05:45.860
been a great conversation. Do you, is there someplace people can go to learn more about what you're doing,
01:05:49.620
your work? So unfortunately I don't have any social media and I don't have a website. And I,
01:05:55.520
you know, usually just urge people, if you Google my name, you know, you'll see articles, you'll see
01:06:01.200
YouTube videos of, of, from different outfits and platforms of whether it's in this topic of eating
01:06:07.280
disorders in men, or I also specialize in working with individuals with ADHD and learning disabilities.
01:06:12.520
So you'll see, you know, my name associated in that field as well. But yeah, if you, if you Google my
01:06:17.740
name, you'll see YouTube videos or things like that, documentaries around this particular issue.
01:06:24.180
Well, Roberto Olivardia, thanks so much for your time. It's been a pleasure.
01:06:27.080
Oh, absolutely. It's been a great pleasure for me as well.
01:06:30.420
My guest today was Dr. Roberto Olivardia. He's the co-author of the book, The Adonis Complex.
01:06:34.800
It's available on amazon.com and bookstores everywhere. You can check out our show notes
01:06:38.040
at aom.is slash adonis complex, where you find links to resources, where you delve deeper into this topic.
01:06:47.740
Well, that wraps up another edition of the AOM podcast. Check out our website at
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