“Do You Even Lift, Bro?”: Correlates of Muscle Dysmorphia Symptomatology in Filipino Male University Students

Abstract

Muscle Dysmorphia (MD) is a subtype of Body Dysmorphic Disorder (BDD) and is marked by the desire to increase muscularity and reduce body fat. MD is typically more prevalent among younger male populations, and it often drives comorbid disorders, including substance abuse, eating disorders, and social anxiety. Despite the growing literature on MD, it remains understudied in certain racial/ethnic populations, such as Filipinos. Acculturation, defined as the process in which an individual adopts, acquires, and adapts to a new cultural environment as a result of immigration, influences body image by reshaping an individual’s perceptions of beauty and muscularity standards. Guided by the Social Ecological Model (SEM), this study aimed to determine the severity of MD symptomatology among Filipino male university students in the United States and evaluate the associations among acculturation, MD symptomatology, and anabolic-androgenic steroid (AAS) use and ideation. An anonymous primary data survey administered through Qualtrics was disseminated to university students who met the inclusion criteria. R statistical software was used to conduct all data analyses, including descriptive statistics, linear regression in a structural equation model framework, and logistic regression. Results show that Filipino men showed a higher MD symptom severity than other populations previously studied. Structural equation models revealed that language use and preference (LUP) were negatively associated with drive for size (DS) (β = -0.25, p = 0.004) and functional impairment (FI) (β = -0.29, p \u3c 0.001) but positively associated with appearance intolerance (AI) (β = 0.31, p = 0.004). Additionally, ethnic social relations (ESR) were negatively associated with AI (β = -0.19, p = 0.045). Logistic regression indicated LUP was negatively associated with AAS use (OR = 0.90, 95% CI [0.82, 0.97], p = 0.007), but ESR was positively associated with AAS use (OR = 1.37, 95% CI [1.15, 1.66], p \u3c 0.001). Meanwhile, ESR (OR = 1.18, 95% CI [1.04, 1.34], p = 0.01) and FI (OR = 1.14, 95% CI [1.01, 1.28], p = 0.03) were positively associated with the likelihood of AAS ideation. These findings will help emphasize the importance of body image issues, particularly in men, and guide the development of public health interventions based on the SEM