Body Image & Gym Culture with Angela Bartolome, LCSW | MHF Podcast
You’re listening to the Men’s Health Foundation podcast. I’m David Watson and I’m Tristan Huo. Men’s Health Foundation is a healthcare provider where exceptional care is delivered with cultural competency to meet your individual needs. Specializing in men’s health, caring for all. Each episode, we welcome members of our care team to discuss trending topics in medicine and wellness to help you take charge of your health. When we think about body image issues, most people picture someone wanting to lose weight. But what about those who feel they’re never big enough? On today’s episode, we’re joined by Angela Bartalam, LCSSW, behavioral health director, Men’s Health Foundation, to unpack what bigexia really is, how it shows up, and why compassion, not judgment, is key to helping those who are struggling. Here’s our conversation about bigarexia, the pressures behind it, and the path toward healthier self-perception. Starting with Angela’s definition of bigorexia, I think it’s really important just to keep it as simple as possible. It’s when someone becomes um obsessive or like it just the the perspective of where they are muscularly is being too small or not enough becomes a preoccupation of their thoughts. And that already by itself is like where it can take up more space in their day-to-day functioning. So that impairment is in how they look at themselves in the mirror and instead of seeing their beautiful whole self, they might see like h this is it’s just so small. It’s this it’s not enough versus being a good healthy fit person, right? Yeah. And how would you say that that would differ from other more classic uh dysmorphic disorders or eating disorders? Yeah. Because a lot of other dis dysmorphia or disorders, a lot of the times the the more commonly recognized is like anorexia is they’re not small enough. Everything’s so large and in their perception of themsel. This mole is is taking up their whole face or like you see this this this little love handle might be like it’s that’s all everyone sees. And it’s kind of just the flip opposite side. It’s like the occupation of their their sense of self is in this unhealthy or um unrealistic sense of their self, right? Yeah. And what were what are some common signs you’d say for those who might be struggling with this? Like what would you what would what should people look out for? Yeah. Uh, I think some of the red flags are um someone going to the gym constantly, like two hours every single day, breaking out if they miss a workout because they’re going to lose some gains. Um, they they work out even when there’s injury or they’re sick. Um, checking themselves in the mirror incessantly and avoiding or avoiding them all altogether because of how they see themsel. It’s like it’s not a fit for the version of themselves that they want to see. where kind of we’re like, “Oh, this could be other things, too.” But those are some of the red flags we watch out for. What do you think as far as in gay male spaces like on dating apps or in nightife? Um, maybe in gyms, and neighborhoods. How do you think there’s a pressure? How does that affect their pressure to look a certain way? Just those environments. I think that’s a huge pressure of their environments because there’s so many folks, let’s say, in the gay community that are around each other and aesthetics is a very important uh feature of it, right? And one of the hard parts is that like we’re we kind of become in a fishbowl where everyone’s checking each other out. Um this unspoken competition even within themsel or on their dating apps um you know apps like Grinder, they’re they’re brutal. like you critique each other so intensely already and now it just intensifies the um the the self-perception or like the need to have like I need to have a good shirtless picture or else they’re not going to be seeing me. I’m not going to be um attractive enough. And then a lot of like the bars and the the the club scene can often like really rip rip some guys apart with the attention and like that need for validation and can create this like unhealthy feedback loop where social environments can feel very validating, exciting, and like rejuvenating for folks. This is like all right now we’re going to go in there and it’s going to be a physique competition without it needing to be. Mhm. Do you think that that’s uh a bigger issue in Los Angeles versus in other areas? Not even in Los Angeles. I think in West Hollywood in particular because sure the gay communities in West Hollywood aren’t always enveloped in the the gay communities as a whole, right? And it can feel very isolating and like just a higher concentration of gyms. And where there’s like high-end gyms, there’s a lot of um a lot of fitness oriented um shops, stores, even like just the the the bars and clubs. It’s a lot more prevalent where being sex like sexual appeal is important. And it can be very like hard for someone to gauge some some of the realities of um how valuable they are as a whole person. And how about even on social media? Like I think about when I say that like Instagram, Tik Tok, even Only Fans, like how do you feel like that’s changing the way that men think about their bodies? I think that’s a large part. Like historically people used to think that it’s just women struggling with these um body issues. However, I think these social media just makes it more heightened and harder to challenge and refute when half of the the commenters are saying trash things and any progress someone may make gets knocked down a thousand times over or like these very unrealistic expectations of the body or the self, it can make it really hard to to really gauge where do I fit in all of this? And I think that’s um a big emphasis of social media is often like this ideal perception of life when it’s far from it. And then people can feel even further alienated or even further outside of belonging um because of just the unrealistic expectations or um perceptions. Yeah, totally. It’s it’s clear that there’s a lot of there’s a huge mental toll that these uh dysmorphia create and cause and impact on people. So, uh what would you say is the role that anxiety, depression, or trauma play in in fueling these different body struggles? It’s funny because I feel like that’s usually the that’s the underlying of a lot of this stuff, right? It’s it’s rarely that is standalone. It didn’t come up by itself. Usually anxiety can make a guy very hyperfocused on their body um as something that they can control when the when the world isn’t something they can control. The judgment, the dangers, the politics, they can’t control that, but I can control how fit I am or how much time I dedicate to this because it’s something that you can’t take away from me. And then very similarly like depression messes with the self-worth so that they think that getting bigger or being more ripped is going to make them feel better about themselves when no matter how big they might get, it’s still not matching the way that they perceive themselves. And with trauma, you know, I specialize more than anything in trauma more than anything else. And I feel like that has so many underlying tones of where a lot of issues show up for folks, especially in the gay community, because this this uh childhood bullying, the sexual abuse, the rejection, even the the sense of like not being able to be proud of who they were as as soon as they recognized who they were as a you know, as a whole person, not just as a gay male or a gay man, but just just because they wanted to be. They deserve to be proud of, you know, how fun they are, how enjoyable they are as a person. It can make someone really feel that their body failed to protect them. And so build this armor of muscle and and bigness. And for gay men specifically, minority of the like on top of the stress of everything in the environment like there’s this need for perfectionism and this appearance to be how they can be valued and protected and there is a degree of like you know pretty privilege that folks can gain with that. And so, you know, it’s kind it’s it’s hard to just treat it. I don’t for me I won’t treat it by itself because usually it didn’t come in by itself. Didn’t come It’s not organic. Yeah. It seems very complex and a lot to dismantle. So, what do you think are some kinds of treatments or therapeutic approaches that you would use that you think would be effective for men dealing with u muscle dysmorphia? I mean very commonly I feel like the fundamentals of a lot of therapy and and just really understanding um a person is very CBT oriented where it’s cognitive behavioral therapy. It’s a very solid approach for challenging those uh distorted thoughts about body size about um what they’re looking for in themselves. Um exposure therapy is really helpful where gra guys can gradually reduce the mirror checking or the measuring. Um avoiding certain unhealthy gym behaviors where looking at other men might like make them look down on themselves, right? where we want to look at body focused therapies like somatic work that can help them reconnect to their actual whole self to their sensations versus just the appearance of um the appearances right uh group therapy is always usually helpful if we can get it usually it’s such a specialized request to talk about that but um group therapies that don’t always have to be specific to uh muscle dysphoria but could be general like um anxiety could also help and how it shows up in that obsessive pattern of behavior. So those can help in um realizing that they’re not alone. It’s not something that they’re the only guy dealing with. And it’s not just of course it’s not just West Hollywood, right? It’s and it’s not also not just the gay community. It’s the bodybuilding community. It’s the um just the the community struggling with dysmorphia where like social media just makes it a whole mixed bag of stress. So for me the key to treating it is underlying treating the anxiety and depression that usually come with it and it’s not just the body image stuff but it’s usually what’s driving everything. So if we can treat that the dis um the body dis dysphoria improves also. Mhm. And on top of the therapy and all of these different approaches, how would you say that friends or chosen family members can support somebody who’s going through this? Yeah. I think so much in society, we’re so big on like, oh, I like your hair. I like this. You look good. You look this. You’re looking like you’re losing weight. As as kind and as benign as those compliments can feel and seem, ideally, I hope we get to a point that we’re not commenting on each other’s bodies. is like, “Oh,” or like not like, “Oh, you look great. Oh, you’re getting so big. Oh, look at you. You can tell you’re spending a lot of time at the gym because they can literally can’t hear it.” It’s instead on focusing beyond their issues, like I love how you’ve been able to maintain a dedicated schedule for yourself. It seems like you’ve been taking care of like, you know, your energy and that your vibe is, you know, your vibe feels good. Um, and gently calling out when gym or diet stuff is taking over their life because sometimes they might feel like I can’t do I can’t go to my mom’s birthday because I have to do my four hours at the gym. I’m like, okay, so when like hey, can we look at maybe spending two hours there so you can have two hours with your mom? And like not we’re not go the goal is not to shame someone about it but just trying to figure out how they can also incorporate healthy balance in their life again that don’t revolve around their physical appearance or their fitness. You know if they’re open to it help them find a therapist. I mean it’s stuff that I I haven’t had too much of it here yet at MHF. However, people are saying words and tones that I’m like oh I can hear where that behavior is showing up. But I’m here actually treating their anxiety and depression anyway. So I’m going to keep monitoring that. So as a clinician, that’s what I’m, you know, trying to keep a lookout for. And so hopefully hopefully the same as us in the community, we’re looking at their whole person of what would help them feel like included in the community despite how big or small they are. And you know, talking about body image with um you know, in the clinic and in the therapy room, you know, when body image intersects with a sense of masculinity, a desiraability, how do you see those dynamics play out um when you’re working with patients that are clients that you know may be going through this? I feel like it’s something that is goes beyond gay men, too. I feel like it’s something that affects um just about everybody. I feel like certainly a lot of the men I know um this is something that’s just a factor for them that may oftenimes I think a source of insecurity. Um so how do you see that play out? So this can be controversial in how I say this. So but I think that there’s a patriarchal like violence that men also have to like experience of what the standards are of being a good enough man. And I think that for gay men especially navigating this weird space of who they’re attracted to, where their masculinity is, um how they have to perform. It’s this like double blind like um like golden handcuffs that they might also just be stuck with like I love who I am but these things are also weighing in on me. So in sessions, guys can talk and feel like, you know, being masculine enough is is what means that they’re going to be desirable or not, but being too masculine, they might lose their gay identity. So it’s really exploring like what would creating their whole self be or mean to them. Um, and it’s interesting because like as much as in a lot of the gay community that we work with, uh, love the gym and as important as fitness and health is, would you do like would it sacrifice would the gym time sacrifice other parts of your well-being and where you’re now overcompensating from the risk of being too feminine or overcompensating with hyper masculinity through their bodies and you know therapy ideally works to unpack a lot of these messages um of what would make someone worthy or lovable or desirable and helping them separate their actual um attraction patterns from societal pressures. That’s powerful. Do you think that men of color, transmen, or men living with HIV have unique challenges around body image compared to others? Yeah, I I I definitely think so. Um because black Latino men often deal with the racist body of stereotypes being fetishized. Um like looking for that thuggish look or that exotic look versus like someone who just it might not always sound like it’s coming from a racial or discriminant perspective, but that all by itself is like, okay, so I have to be bigger so that I can fulfill this. They’re not going to want I’ve heard this that nobody wants a fat gay man. They have they want me like this. It’s like so they’re experiencing that they have to a persona to fill. And especially when I also like I haven’t heard too much here, but when working in the as a API community, a lot of Asian men will um frequently struggle with being seen as less masculine, especially in gay spaces, leading to a lot of intense pressure to bulk up or to um be this uh like buff like overly muscular guy just to be just as competitive in the dating and desirable community. So, and then like then we add the cultural stuff which is a whole new layer and like family expectations, religious backgrounds, you know, it can really make body dysmorphia feel very isolating. Yeah. Um, that sounds so complicated and there’s so many different elements of that. So, uh, for people who are who might be dealing with this, what do you think they can do to build a healthy relationship with fitness in their bodies? What’s like a good first step for that? I think it’s a lot of one of that’s this is actually one of the harder reasons that coming into treatment can be so hard is because seeing this as a problem or seeing this area as an area of concern. Usually people aren’t going to come in unless there’s a severe injury, there’s been impairments and like they’re struggling in other parts of their life. That’s usually why they might come into treatment. Um, so what they can do to be healthier in their body is just maybe one is having somebody that they trust like not someone social influencer level where they’re um that’s their baseline, but someone that they can set boundaries around like what is appropriate gym time. Um what is like talking to their doctor about like hey how are my just general like fitness levels? um minimizing like hey when there’s injury this is how I can not worsen my injury by having a boundary of not working out and really like exploring the activities that they genuinely enjoy and if it also in includes like getting fit and healthy great but hopefully focusing it on that. But if the gym becomes something that’s more stressful or adds another layer of anxiety and and sadness or like helplessness, then let’s pull someone into like, hey, would you want to talk to a therapist or would you want to just even talk to someone who just would want to hear you out in a comm in a pure community setting? Um there’s a lot of folks who who’ve already gone through it and it might not have been such a huge um problem where it was pervasive for months or years on end but like hey I started noticing my unhealthy habits and this is what I did to take care of myself and feeling very comfortable and proud of who you know what this meant for me. Um, I think just also that peer leadership means a lot because as a cis heterosexual woman, like it’s easy to be like, what do you know? Very true. What do I know? Nothing compared to what you want to share with me and what I can offer and your humility and my humility. Hopefully, we find the same page together. I’d love to ask if someone is like, you know, they’re scrolling on Instagram, they’re on Tik Tok, whatever, maybe a dating app, maybe they’re on Grinder, and maybe it gets them to start feeling bad about their body. Um, what’s a sort of quick mental reset they could do in that moment to shift gears? It’s funny because like I I harp on this a lot. A lot of us forget that we don’t breathe regularly or like healthfully. We breathe because we’re holding our breath. Um, we breathe because we’re trying not to pass out, but just to connect with our body. It’s our only regulatory system that we like cognitively have control over. So, how often do we use it just to like check in with how our body feels? Use it so that like, hey, is anything sore? Does anything need a rest? Does does my body hurt? Or do I feel good? And I think that’s one of the strategies that I’d hope people just incorporate. Um, and I and I know like in the gay community and also very marginalized communities, feeling isolated is so common at some point. So building that community intentionally might be one day at a time of just talking to your doctor, talking to your provider about like, hey, do you know anyone that might be someone to talk to or just bounce ideas from? We might have to use the label of therapy just to feel like, hey, like I need to build community. Fine. My job is to work on finding community with you. Not necessarily with you, but where do you feel safe and where can we pull them in? That’s a really great answer. Um, I think sort of in summary, what is one thing that you think our listeners can take away that they can apply to their own lives in terms of building their own self-esteem or reevaluating how they look at their own body? I think it’s one thing it’s to build that mind body connection takes work because our society isolates us from community, isolates us from being part of ourselves where our productivity is value. I think if you have the luxury and the privilege to connect with yourself and and work on that, please take it t take up that time and space. You deserve it. And we might not all be the best fit for what you’re looking for, but let’s figure out who is. And it might not be therapy. It might be a community space. It might be like um a recovery group. It might be just folks who just like walking together. Maybe they don’t do the gym, but they just want to walk together because it’s a social network. So, I think community is so nourishing and it’s such a life force that we underestimate its healing properties. Um, so I always try to use that as a platform because I’m not a very traditional like therapy fixes everything. No, community was healing before we had the terms of therapy. So, let’s bring that back. Beautiful. Exactly. Thank you so much, Angela. Really appreciate the conversation and all of the all of the tips. Thank you. Thank you. A huge thank you to Angela Baralame LCSW for sharing her insights on vigorexia, body image, and mental health. We hope this conversation encourages reflection, compassion, and understanding for yourself and others. If you or someone you know is struggling with body image or related mental health concerns, remember that help is available and that reaching out is a sign of strength. To make an appointment for our behavioral health services at men’salth foundation, visit men’shealthfound.org or call us at 3105501010.
In this episode of the Men’s Health Foundation Podcast, we sit down with Angela Bartolome, LCSW and Behavioral Health Director at MHF, to talk about “bigorexia”: a form of body dysmorphia centered around muscle size and perceived physical adequacy. Angela breaks down what bigorexia looks like in everyday life, why it can be difficult to recognize, and how it can impact mental health, relationships, and well-being. She also shares grounded, compassionate strategies for improving self-talk and self-image, and offers guidance for seeking support or treatment when navigating body image concerns.
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