Efficacy of cognitive-behavioral therapy in reducing muscle dysmorphia symptoms among Turkish gym goers: A pilot study

Muscle dysmorphia (MD) is a disorder marked by an obsessive focus on muscularity, often leading to excessive exercise, rigid dieting, and use of performance-enhancing drugs (PEDs). While Cognitive-Behavioral Therapy (CBT) is known to be effective for various body image disorders, its specific effects on individuals with MD have been less studied. This qualitative case series involved seven male participants, aged 35–55, all diagnosed with MD and with a history of anabolic steroid use, undergoing a 12-week manualized CBT intervention. The study aimed to explore how CBT impacts their body image perceptions, exercise behaviors, steroid use, and emotional responses. Data were collected through participant feedback during therapy sessions, with thematic analysis revealing significant shifts in body image perception and reductions in compulsive behaviors and steroid use. Despite these improvements, participants experienced feelings of loss and anxiety as they modified their routines, and some reported relapses under stress, indicating the chronic nature of MD. The findings suggest that CBT effectively reshapes cognitive and behavioral patterns in MD sufferers but also highlight the need for ongoing support to manage the disorder's emotional complexities and prevent relapses. Future research should focus on long-term and individualized therapeutic approaches to better support those with muscle dysmorphia.