Bigorexia: when sport becomes a drug!

Bigorexia: when sport becomes a drug!

Being addicted to sport, to the point of isolating yourself and putting your health at risk, is a real psychiatric pathology known as bigorexia. It would not be as rare as we think, with 3% of the sports population affected. How do you know if you have it? What are the symptoms ? What care for these patients? The answers from Marie Chaput, dietician, psychonutritionist and sports coach in Aix en Provence.

Practicing physical activity regularly is one of the main recommendations of health organizations, as part of the fight against a sedentary lifestyle. Sport is also widely valued by today’s society, which tends to push for success and performance. It is therefore difficult to imagine that the practice of a sport could be excessive to the point of becoming problematic, or even dangerous. And yet, like any addiction, bigorexia can lead to isolation and great psychological distress. But where does the passion end and the addiction begin? How to diagnose bigorexia and treat it? Answers from a dietician and psychonutritionist.

Definition: what is bigorexia

Sometimes called sporoolism, bigorexia is the addiction to physical and sporting activity. It is a behavioral addiction and a real psychiatric disorder with potentially serious consequences. “Bigorexia results in an irrepressible need to practice physical activity without taking into account one’s physical limitations, exhaustion or possible injuries, with a progressive loss of all other centers of interest.” summarizes Marie Chaput.

Bigorexia was identified in 1976 by Dr. William Glasser, an American psychiatrist, who then spoke of a positive addiction as opposed to addictions considered negative for alcohol or drugs. The doctor based his work on long-term observation of high-level athletes who regularly exercise, as well as occasional runners.

The concept of positive addiction, created in 1976 by Glasser, describes an addiction to sports practice, which he describes as positive in order to distinguish it from classic addictions considered negative – alcohol, drugs, etc. has two main types of bigorexia:

  • The obsession with always building up more muscle, also called muscle dysmorphia or reverse anorexia, which most often affects young men;
  • The obsession with reducing one’s fat mass as much as possible, by practicing an endurance type sport (often running, triathlon, trails, etc.) called athletic bigorexia, which concerns a lot of women.

What are the symptoms of sports addiction?

There are criteria for addiction to physical exercise, which were described by Dr Veale in 1991, and taken up by Véléa (2002)1.

  • Tolerance : The person constantly increases their level of exercise in order to obtain a feeling of accomplishment;
  • Withdrawal : In the absence of exercise, she experiences negative effects such as anxiety, irritability, restlessness or difficulty sleeping;
  • Loss of control : Reflects the impossibility of reducing the level of exercise or stopping the practice for a certain period of time;
  • The effects of intention : concerns the inability to stick to a planned routine, exceeding the planned time devoted to exercise;
  • The weather : a large part of the time of the day revolves around sport (preparation, commitment and recovery);
  • Reduction of other activities : recreational, social, professional…
  • The continuity : It is the continuation of the practice despite the fact that the activity creates or exacerbates physical, psychological and/or problems with others.

Overall, the signs of bigorexia are close to those of any addiction: obsessive behavior, social isolation, loss of interest in other activities, denial, repercussions on personal, family and professional life, etc.

Bigorexia can be accompanied by eating disorders, such as orthorexia (obsession with eating healthily) or anorexia in women who want to reduce their body fat as much as possible. explains Marie Chaput. For bigorexic bodybuilders, diet also turns into an obsession, generally with a diet rich in proteins and very controlled in carbohydrates and fats.

What are the causes of bigorexia?

Bigorexia is a psychological illness, directly linked to the quest for a perfect body. “Social networks, advertisements and the media which convey biased images of human bodies – slender for women and muscular – for men, largely fuel self-image disorders.” regrets the psychonutritionist. This addiction is often associated with dysmorphia, namely a distorted vision of one’s own body, whatever its transformation. The dysmorphic patient may lose weight or gain ever more muscle, he always only sees its imperfections.

The practice of sport continues to be recommended by health organizations and glorified by today’s society, which certainly contributes to the rise of bigorexia and also to making it more difficult to identify by those around us and those who suffers from it” explains Marie Chapput.

This addiction is in fact more insidious than alcoholism or drug addiction, because sport is generally associated with health and well-being, so much so that we tend to forget that it can also be a source of dependence and therefore suffering.

There is also a hormonal factor in bigorexia, which is directly linked to the well-being hormones (dopamine, norepinephrine and serotonin) secreted during exercise, with a so-called “dopaminergic” reward circuit altered by an addictive terrain. Concretely: the more the person does sport, the more they are pumped with hormones throughout the day, and the more they develop a high tolerance threshold which makes the “lack” faster and more significant.

How to diagnose bigorexia?

Bigorexia is a psychological illness that requires diagnosis by a health professional, whether an addictologist or psychiatrist. However, in case of doubt, a questionnaire (EDSR = Exercise Dependence Scale-Revised)2 was developed to allow a self-screening for sports addiction in 21 items, which can be offered for all types of sports and all types of athletes.

Risks and dangers

The dangers of bigorexia are both psychological, linked to social isolation and the loss of interest in anything other than sport, and physical because the body is pushed to the limit. Tendinitis, muscle tear, physical exhaustion, stress fracture or even heart attack in the most extreme cases… are thus possible risks of bigorexia. “The dangers of bigorexia are also eating disorders, and in particular anorexia, which is the psychiatric illness with the highest mortality rate. adds Marie Chaput.

Management of bigorexia

As in most addictive disorders, the treatment of bigorexia is multidisciplinary with addictology doctors, psychologists and possibly dietitians and nutritionists. There are centers specializing in addiction which offer comprehensive support.

Unlike other addictions (drugs, alcohol), the objective of treatment is not complete withdrawal with abstinence, but the readjustment of the practice in order not to put one’s body in danger and to escape from addiction. addiction. The doctors will also encourage the patient to diversify their sporting practice and to discover other activities and interests, in order to renew social ties. “Cognitive behavioral therapy, also called brief therapy, generally gives good results. It can be accompanied by drug treatment, such as anti-depressants which act on the brain circuits of stress and reward, involved in addiction. As with all addictions, treatment is delicate, often with relapses. The involvement of the patient is therefore essential, he must be an actor of his change” insists Marie Chaput.