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The Secret Crisis of Male Body Obsession
By Harrison G. Pope Jr., MD; Katharine A. Phillips, MD; Roberto Olivardia, PhD
The Free Press, a Division of Simon &Schuster Inc.
288 pp $25

In the junior high school gym, boys split into teams for games of basketball. Of course, there will be the ancient fear of being picked last. But there are boys who cringe even more at hearing the words "Shirts and Skins." There are anxious moments as the decision is made: Which team will go shirtless to the world for the duration of the game?

One boy doesn't want to show his "bird chest." Another dreads exposing the baby fat around his middle. Yet another is more worried about showering in the locker room, ashamed that his pubic hair hasn't grown in yet. Is this just part of the insecurity of puberty, an awkward step in the rite of passage, or is it early evidence of body image problems that will haunt them into adulthood?

Until recently, studies of men's insecurities about their bodies were absent from most medical and psychology journals, college classrooms, and discussions about gender. And more importantly, in the view of the authors of The Adonis Complex, men do not voice these fears, even when driven to excessive behavior. Many men are obsessed with imagined physical shortcomings, which they often internalize because they're embarrassed to reveal their discomfort, the authors say.

Harvard professor of psychiatry Harrison G. Pope, psychiatrist and Katharine A. Phillips, associate professor of psychiatry at Brown University School of Medicine, and McLean Hospital psychologist Roberto Olivardia caused a stir in 1996 when they published a paper on a syndrome, mainly affecting men, which they described as "an underrecognized form of body dysmorphic disorder." Body dysmorphic disorder (BDD) is a psychological illness in which people are obsessed with that they think is a flaw in their appearance, and this obsession becomes so severe as to interfere with daily life. The researchers found that an increasing number of men are convinced they're shamefully ugly because they're not lean and muscular enough (often despite evidence to the contrary). They obsessively overdiet and overexercise to correct the imagined defect. Pope and his colleagues named this disorder "muscle dysmorphia."

Picking up where that study left off, the authors argue in The Adonis Complex that the influx of women into previously "male" positions in the workplace within the last 30 years has led to a "threatened masculinity" syndrome. Women are now CEOs, police chiefs, and airplane pilots. Now, some men believe the only place to achieve manliness is through their bodies, the authors argue.

The researchers trace a burgeoning trend of steroid use, an increase in advertising images of barely dressed male models with washboard abs, and a boom in men's fitness magazines during the same time frame. Add it all up, they say, and you've got an unrealistic and unattainable male body ideal.

Drawing on 15 years of research in the form of surveys, charts, ads featuring male body images, and interviews with men from downtown Boston to the Austrian countryside, the researchers argue that this unreachable ideal has subjected men to many of the same ills that women have faced historically.

Studies exposing the humanly improbable proportions of Barbie dolls led Pope, Phillips, and Olivardia to theorize that there must be a male equivalent. They found it among popular action figures such as Batman, Han Solo, and G.I. Joe. Photos track G.I. Joe from an insignificant-looking soldier in the '60s to a bulging superhero in an apparent steroid rage in the '90s. This metamorphosis, the authors argue, mirrors men's growing obsession with muscularity.

The authors use extensive case studies to show there are other signs that men's attitudes towards their bodies have changed -- and not for the better. In discussing his case of muscle dysmorphia, a lean and well-chiseled 230-pound bodybuilder in his early 20s explained that he was so worried about looking weak he'd sewn an extra button on his shirt cuffs to tighten the sleeves so his arms would look bulkier. Another wouldn't even take off his shirt to tan in his own backyard in the event that "a plane went by and looked down." Several men said their relationships failed due to body image problems. One man wouldn't kiss his girlfriend for two weeks for fear he'd acquire unwanted calories through her saliva. Several turned to steroids as the only way to approach the chiseled physiques on the muscle magazine covers.

Eating disorders, another previously understudied problem in men, popped up in many of the subjects as a means to staying lean. As a result of one man's anorexia, his 5-foot-10 frame went down to 85 pounds after he went on a diet of three pieces of lettuce a day (one with ketchup).

Most people would recognize this as a problem if a woman took to eating so little. But for a man who knows he has an eating problem, there is often no place to go. Here, too, the authors emphasize the need for men to have places where they can come forward and voice these problems. Is a man likely to join an eating disorder help group when he's the only male in the bunch?

Men and boys are far behind on the learning curve in openly confronting the media's impossible ideals, the authors argue. "Traditionally, 'real men' aren't supposed to worry about what they look like, much less go around confessing [it] to others." They believe this silent suffering is responsible for the desperate nature of the more shocking stories.

"Jeremy hated his calves, thinking they looked too big. To decrease their size, he tied them up with a rope at night while he slept, to the point that they turned blue due to lack of circulation. He also slept with a clothespin on his nose, trying to make it smaller. In desperation, after several plastic surgeons had refused surgery, he deliberately smashed his nose with a hammer. 'That way, they'd have to fix it,' he said."

Many of these tales come across as rather sensational, and you almost expect the authors to discover an underground society, a kind of "fight club," where men brawl till they're bloody to prove or reclaim their manhood. But the authors make it a point to keep the research scientifically grounded. They're quick to discourage use of the word "bigorexia," a buzzword often used to describe muscle dysmorphia, because it implies that an eating disorder is necessarily involved. They're also careful to clarify another point -- muscle dysmorphia is not, technically, a new condition, as some articles claim, but actually a type of obsessive-compulsive disorder in which exercise is the compulsive act. Further, in the face of these extreme anecdotes, they make it a point to remind readers that a man who works out frequently and eats a careful diet does not necessarily have an unhealthy preoccupation.

The book lists 28 questions designed to help you recognize body dysmorphic disorder in yourself or someone you know: "Do you sometimes miss things (such as social events, work, or school) because you feel too unattractive to be seen?" or "Does your son seem preoccupied with looking like extremely muscular men in bodybuilding magazines, comic books, television, or movies?" For the more clinically minded, there is an appendix with the American Psychiatric Association's criteria for diagnosing BDD and eating disorders.

Some of their broad analysis opens the door to criticism. For example, a timeline comparing milestones in women's liberation and changes in male body image points out that the publication of the feminist health guide Our Bodies, Ourselves and the first penis-lengthening surgery both occurred in 1970. What kind of parallel does this invite? Also, the book's organization is at times a bit clumsy, and the authors repeat the same conclusions and arguments throughout the book. Some readers may feel that the wide range of topics the authors tackle is too much to take on -- in fact, any given chapter could warrant its own book.

These minor complaints aside, The Adonis Complex offers an intriguing overview of concepts only just beginning to emerge in popular culture, and for this reason it's a valuable read for both sexes. Men, in particular, may find it both timely and provocative. Armed with some of the theories, you might reevaluate your pursuit of an abdominal "six-pack" as though it were the Holy Grail. And what about the long sleeves you used to wear, even in summer, to cover what you thought were skinny wrists? Are you still carrying these hangups around with you, somewhere? This book shines light on men and boys and what they see -- or think they see -- in the mirror, but rarely ever share.

-- Benj Vardigan is a senior editor for Consumer Health Interactive and the winner of an Outstanding Young Journalist award from the Northern California chapter of the Society of Professional Journalists.

Last updated July 31, 2009
Copyright © 2000 Consumer Health Interactive

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