Publication:

Is the “dream physique” a mental health paradox? A mixed-methods study on body image perception among adult male bodybuilders from Kolkata, India

Background The rise of bodybuilding for aesthetic purposes has increased the risk of body image disorders among males. This study aimed to determine the magnitude of body image dysmorphia (BID), identify its associated factors, and explore the perspectives of adult male bodybuilders in an urban area of West Bengal.

Methods An explanatory sequential mixed-methods study (QUAN → qual) was conducted among 123 adult male bodybuilders in gymnasiums in Dum Dum, Kolkata. In the quantitative phase, study participants were selected via simple random sampling and interviewed using tools, including the PHQ-9, EAT-26, and bodybuilders image grid-original (BIG-O). The qualitative phase was followed by five key-informant interviews (KIIs) with experienced gym trainers, selected via purposive sampling. Quantitative data were analysed using SPSS 16.0, while qualitative data underwent thematic analysis.

Results The overall magnitude of BID was 68.2%, with 56.9% experiencing fat-related BID and 45.5% muscle-related BID. Participants desired significantly lower fat content and higher muscle mass compared to their current state (p value <0.001). Factors significantly associated with BID included depression (p value <0.001), eating disorders (p value <0.001), shorter training duration (p value 0.009), and anabolic steroid use (p value 0.025). Qualitative findings identified “perceptual drivers”, “psychological impact”, and “high-risk lifestyle factors”, such as social media influence.

Conclusions A significant portion of bodybuilders suffer from BID, which is linked to clinical depression and disordered eating. The “beginner’s trap” makes novices particularly vulnerable. Strategic interventions, including mental health screening in gyms, trainer training, and stricter regulation of anabolic steroids, are recommended.