“Bigger, stronger, sicker”, integrative psychological assessment for muscle dysmorphia: Case studies of two young women bodybuilders

Over the past three decades, the development of knowledge about muscle dysmorphia has enabled the scientific community to gain a better understanding of its etiopathogenesis and mechanism. However, few cases have been described, due to the absence of screening protocols and treatment guidelines. The aim of the current study was to evaluate muscle dysmorphia symptomatology, through an integrative psychological assessment, in two young women bodybuilders. In the first case study, we will focus on Mrs. I., who practices recreational bodybuilding, suffers from muscle dysmorphia with a form of eating disorder, and uses illegal APEDs. For the second case study, we will focus on Mrs L., who suffers from muscle dysmorphia, but with a predominant form of body dysmorphic disorder. The two case studies provided a nuanced view of muscle dysmorphia symptomatology, leading to a better understanding of this pathology and its comorbidities, particularly in relation to eating disorders, body dysmorphic disorders and pathological exercise. Our study highlights the importance of an integrative psychological assessment of muscle dysmorphia and shows the interest of using a pluri-modal approach in its diagnostic, whether for the field of psychopathology or sports psychology.