The truth behind "the bigger the better": muscle dysmorphia as an expression of cultural and social standard influence

Body Dysmorphic Disorder (BDD) is a complex scenario characterized by the excessive concern and preoccupation of an imaginary body defect or a slight physical anomaly. Since its inclusion in psycho-pathological nosography nearly thirty years ago, BDD evolution through the years has provided an indirect measure of how the sociocultural environment could influences body image perceptions. Multiple factors have collaborated in these changing parameters, with a major responsibility certainly ascribable to the entertainment business and its notable capability to promote and establish new standards in terms of beauty and physical attractiveness. Additionally, technological advancement and world-wide-web exponential enlargement have substantially contributed into the spreading of new ideas of the "healthy" and "attractive" male and female body. On one side, this complex amalgam of social, psychological and cultural factors have generated a wholesome drive to improve one's own body shape and reach new social status through this, with an increase of self-efficacy, self-esteem and other psychological features ascribed to an increased well-being. On the other hand, there have been some distortions in body image standard setting, with the onset of previously unimaginable pathological conditions like muscle dysmorphia (MD), a subtype of BDD also known as "reverse anorexia". In the last 20 years, several authors have reported evidence of body image disturbances in male and female weightlifters, with an MD prevalence higher than what could be expected, especially in non-professional bodybuilders and, more importantly, also in non-competing gyms customers. Moreover, a cultural-dependentmodulation of MD expression seems present, as we recently documented in a study on Italian professional and non-professional bodybuilders, where a different organization of MD symptoms have been found in respect to US bodybuilders. In this chapter, we will cover all principal features of BDD and MD, in terms of their diagnostic criteria and treatment opportunities, and subsequently discuss possible cultural and gender related differences linked to muscularity and physical attractiveness in modern society. © 2013 Nova Science Publishers, Inc.