The disorder has yet to be recognized as an official disorder and there is controversy over whether it should be considered a type of eating disorder or a type of body dysmorphic disorder. Body dysmorphic disorder is a type obsessive-compulsive spectrum disorder in which an individual has excessive concern about and preoccupation with a perceived defect of their physical appearance. Muscle dysmorphia shares a number of features in common with anorexia and the main differences between them are consistent with the opposing physiques pursued in each condition.
This is the scenario: a guy, say age 21, becomes serious about gaining muscle. He’s 5′ 10″, 7″ wrists, 9″ ankles, average genetics for muscle size-and-proportioned. He’s played sports, but never done more than an occasional resistance workout. Now, he begins a good training-eating-and-resting program. With his genetics, he has the potential for naturally gaining 45 pounds of lean mass if he stays consistent with progressive training/proper eating for a continuous 3 to 4 years.
But, about three months after beginning his training, he starts taking steroids. He does three steroid cycles in the following 18 months, and includes proper post-cycle therapy. That entire time, he’s continuing to consistently train and eat properly. Before the end of two years, he’s gained 45 pounds of lean mass (which with steroids, by the way, is not necessarily typical but neither improbable). At that point, he permanently quits using steroids, but he does continue properly training and eating for another two years. At the end of four years, he carries the same 45 pounds of lean mass.