Muscle dysmorphia in gay men: when you never feel big enough
How the pressure to be muscular can turn into muscle dysmorphia, and how to build a healthier relationship with your body.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
Training hard can be great for mental health. But for some gay men, the goal keeps moving. No matter how much muscle you build, you still feel small. That pattern has a name: muscle dysmorphia.
What muscle dysmorphia is
Muscle dysmorphia is a form of body dysmorphic disorder where someone believes they’re too small or not muscular enough, despite evidence to the contrary. It’s more common in gay and bisexual men than many people realize.
Signs to watch for
Spending hours checking your body, skipping social plans to train, feeling panicky if you miss a workout or a meal plan, hiding your body, and considering steroids or SARMs are common signs.
Why it happens
Social media, dating apps and parts of gay culture often spotlight one ideal body. For some men, muscle also becomes armor against old experiences of bullying or feeling different.
Help that works
CBT for body image, support for anxiety or depression and sometimes medication can help. The goal isn’t to stop training. It’s to train from a place of health, not fear.
A gentle next step
A free 15-minute phone consult is an easy way to see if Wellthy Psychiatry feels like the right fit for you.
This article is for general education and isn’t medical advice. If you’re in crisis, call or text 988, the Suicide & Crisis Lifeline, or call 911.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. He sees clients in San Francisco and by telehealth across California.
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