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Roberto Olivardia

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Men have body dysmorphia too. That's why some use this drug.

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So steroids are basically synthetic derivatives of testosterone, the male hormone that is implicated in muscle growth. And it could be either injected, taken orally. Sometimes there are creams, some that will target certain muscle groups, some that are more fast acting, some that are sort of more slow acting.

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Men have body dysmorphia too. That's why some use this drug.

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And now we're talking about an action figure that's based on the same character that somehow was, you know, manipulated to sort of be a lot more muscular. So there is this trend and I'm not suggesting, you know, because again, it's all correlational that watching these movies is going to develop body dysmorphia and whatnot. And at the same time, we can't underestimate the,

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Men have body dysmorphia too. That's why some use this drug.

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the impact of kind of seeing sort of a lot of this imagery in terms of how we internalize it. Because we know from research, even when people know that they're looking at a Photoshopped image, for example, if that looks ideal to them and they don't look that way, then their body self-esteem starts to decrease. Wow.

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Men have body dysmorphia too. That's why some use this drug.

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Yeah, I think first is the right information to just about health. And with that is, you know, healthy eating, healthy exercise. These are great things. And then the most important part is what are you looking to achieve? And that's where we get into the heart of the matter. People could be saying, I want to be more assertive. I want to be more in control.

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Men have body dysmorphia too. That's why some use this drug.

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I'm like, well, we can learn assertiveness skills. You don't have to have a certain body to be assertive person.

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Men have body dysmorphia too. That's why some use this drug.

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Exactly. It's like if you want to be healthy and you want to build a body by working out and it's within healthy domains, absolutely. Go for it. That's great. But if you assume that you're going to be granted all these things by having that body, that's where it loses something.

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Men have body dysmorphia too. That's why some use this drug.

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I just met with a man yesterday in his mid-20s and he said, yeah, if I just build the perfect body, then I'll be immune to any kind of rejection. And this is someone who has a history of a lot of trauma in his life. And I said, unfortunately, that's not the case. Like being human is going to open us up to pain at times.

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Men have body dysmorphia too. That's why some use this drug.

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So the work we have to do is how to deal when those rejections happen, because we can't prevent that. And a lot of times what people do is they just don't put themselves in the arena and then that they limit themselves and their world gets small. And I'm like, no, that's an avoidance. So we want to put you in the arena and, and give you the skills of dealing with that rejection.

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Men have body dysmorphia too. That's why some use this drug.

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But the body is not the shield for that. Wow.

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Men have body dysmorphia too. That's why some use this drug.

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Thank you for having me. It's my pleasure, Brittany.

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Men have body dysmorphia too. That's why some use this drug.

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Interestingly, now studies show that the primary risk factor is negative body image.

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Men have body dysmorphia too. That's why some use this drug.

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Yeah, so these are typically men, although there are some women who can have muscle dysmorphia, who think, despite the fact that they could be fit, they could be very muscular, by any objective standard be seen as a big guy, they think of themselves as looking too scrawny, too puny, too skinny.

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Men have body dysmorphia too. That's why some use this drug.

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Even if they can admit or see themselves as looking muscular, they fear if they don't work out, then they're going to lose all their muscle tomorrow. They will constantly compare themselves to other people. And then the compulsive behaviors are they might be working out multiple hours a day at the gym. A lot of avoidant behaviors.

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Men have body dysmorphia too. That's why some use this drug.

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The guys that I treat with muscle dysmorphia are not the ones that would be sporting their muscles in Venice Beach, for example. Okay. These are the guys who, despite being in good shape, they might wear long sleeve shirts on a 90 degree day because they think their arms look too puny or too scrawny.

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Men have body dysmorphia too. That's why some use this drug.

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Exactly. And then because of that, as you can imagine, like if the preoccupation is on muscle size and you have a substance like anabolic steroids, which can create muscle growth, there's a high percentage of these men that then are at risk for using anabolic steroids.

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Men have body dysmorphia too. That's why some use this drug.

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Yeah. So for 30 years, I've been researching treating boys and men with eating disorders. And interestingly, my research was first on the typical presentations of eating disorders, things like anorexia, bulimia, binge eating disorder in boys and men.

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Men have body dysmorphia too. That's why some use this drug.

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And then I would post ads for studies and I would get a lot of calls from men that said, well, I used to be anorexic where I starved myself, but I realized I didn't want to be skinny. I just wanted to be lean. And then they would say, it's almost like the pendulum swung in the other direction.

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Men have body dysmorphia too. That's why some use this drug.

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I'm still as obsessed with food, except I'm eating the food, but now I'm obsessed with working out and getting big and muscular. Mm-hmm. So muscle dysmorphia, that's a term that we coined my colleagues and I because we hadn't really heard of this. One of the studies I conducted years ago that actually compared men with muscle dysmorphia with men with anorexia nervosa.

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Men have body dysmorphia too. That's why some use this drug.

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And we found that they scored fairly similarly on a number of different scales. It was just a different manifestation. So they were just as dissatisfied with their bodies.

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Men have body dysmorphia too. That's why some use this drug.

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They were just as obsessive compulsive about calories and food and things to the point where the kind of toothpaste he might brush his teeth with is going to be scrutinized because of the amount of sodium or sugar alcohols or things like that. I mean, we're talking... really granular level.

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Men have body dysmorphia too. That's why some use this drug.

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That's a great question. So the research actually shows a high correlation of social media usage and body dissatisfaction because of sort of all the different influencers and whatnot. And there are some that are just outright harmful in terms of encouraging steroid use and things that are very unhelpful. But the reality is, is that a lot of us can't do some of those sort of exercises and whatnot.

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Men have body dysmorphia too. That's why some use this drug.

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Like when Mark Wahlberg posts his workout plan.

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Men have body dysmorphia too. That's why some use this drug.

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These are the guys who, despite being in good shape, they might wear long sleeve shirts on a 90 degree day because they think their arms look too puny or too scrawny.

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Men have body dysmorphia too. That's why some use this drug.

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That's good for you. You're being paid 20 million bucks or whatever a movie. I would do that if I was being paid 20 million bucks for a movie. But the average person is not going to wake up at four in the morning, do that, and then do it again at like 2 p.m.

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Men have body dysmorphia too. That's why some use this drug.

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And I guess the part that interests me is when people internalize that is, oh, because this person's doing this and they're getting all these likes and attention, I should be doing that. Coming up. I'm seeing this in boys as young as 12, you know, 11.

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Men have body dysmorphia too. That's why some use this drug.

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Oh, yeah. Yeah. I've worked with boys as young as 13, 14 who have done anabolic steroids.

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Men have body dysmorphia too. That's why some use this drug.

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Yeah, what's fascinating is, so in the research, when we looked at advertising, we found that in the late 70s, early 80s, there was a real uptick of advertising that featured unclothed men, bare-chested men. We saw this certainly in Hollywood, where the movie stars of the 70s and 60s were wearing

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Men have body dysmorphia too. That's why some use this drug.

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You know, being dwarfed by your Stallone and Schwarzenegger and Jean-Claude Van Damme, like all those 80s stars, which, you know, their acting is their acting, but their bodies were their commodity. I mean, that was the thing that, you know, drew people to the box office, you know, seeing these hyper muscular bodies. Muscle magazines were exploding, you know, in the early 80s.

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Men have body dysmorphia too. That's why some use this drug.

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Steroid use started to trickle out of just elite bodybuilding circles into more sort of the mainstream. And then incidentally, the rise of eating disorders amongst men really started to skyrocket.

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Men have body dysmorphia too. That's why some use this drug.

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Yeah. Then it started to shift where I remember in the 90s when a patient of mine said, oh, I just saw this movie called Fight Club with Brad Pitt.

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Men have body dysmorphia too. That's why some use this drug.

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Yep. And I was like, oh, I had never heard of the movie. It just came out. And he goes, Brad Pitt and these other guys are just cut. They're lean. They're not massive, but they are cut. And I started to see that shift even in my patients where they weren't so much about being the biggest person, but being the fittest person.

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Men have body dysmorphia too. That's why some use this drug.

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And when I'm talking boys, I mean, I'm seeing this in boys as young as 12, you know, 11.

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Men have body dysmorphia too. That's why some use this drug.

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Oh, yeah. Yeah. I've worked with boys as young as 13, 14 who have done anabolic steroids. So I see the variety and I still work with men that want to be big and then some that they're not looking to be big, but they want very, very, very little body fat.

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Men have body dysmorphia too. That's why some use this drug.

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Yeah, my co-authors and I sort of nicknamed that politely roided steroid.

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Men have body dysmorphia too. That's why some use this drug.

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So they're doing steroids enough that it's having a certain effect. And some steroids also might grow muscle by burning fat too. But then I also see patients who have had a lot of medical problems because of the use of steroids, liver damage and kidney issues and cardiovascular issues, as well as psychological issues like psychosis and depression and things like that. So it

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Men have body dysmorphia too. That's why some use this drug.

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it really can do a number on your body.

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Men have body dysmorphia too. That's why some use this drug.

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So one of the things that we sort of looked at, and even in a lot of sociological research, is that a lot of times in either periods of time or in certain communities where there's, you know, more gender equality... Yeah. Yeah. culturally men to sort of assert themselves in like, okay, well, am I the soldier? Am I the breadwinner?

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Men have body dysmorphia too. That's why some use this drug.

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Am I like all the roles that were sort of attached to being quote unquote masculine started to be shared, you know, more. And that was inherently more threatening in some ways. Whereas for, you The idea of feminism is I could be the stay-at-home mom, I could be the CEO, and all of that could be fine and no one should be threatened by that.

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Men have body dysmorphia too. That's why some use this drug.

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Even if that was not the actual case, that's the experience. Yeah. We called it sort of like the threatened masculinity theory. And I think that's what we're seeing now. But I have patients who might struggle, let's say, with social anxiety and they feel so desperate because they're like, I want people to see me as a threat.

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Men have body dysmorphia too. That's why some use this drug.

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I want people to see me as dangerous because internally I feel so inferior. Well, there's power in that. There's power in other people being afraid of you. A hundred percent. And so there's a sense of asserting dominance too. There's a sense of physically taking up space.

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Men have body dysmorphia too. That's why some use this drug.

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And I see that a lot just with a lot of young men that I work with who really struggle with that ideology around like, oh, I don't want someone sort of taking away my manhood.

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Men have body dysmorphia too. That's why some use this drug.

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Yeah. So this brings up one of my favorite studies that I did inspired by research in the feminist body image literature. In 1980, there was a famous study of the Barbie doll that found that the Barbie doll was a real life human female. Her dimensions would be completely unrealistic. Yeah. I remember. So we were like, well, what's the analogy to boys and men that we can look at this?

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Men have body dysmorphia too. That's why some use this drug.

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their dimensions would be unrealistic without the use of steroids. Now, what was striking in that study is we looked at, this was in the late 90s, whereas the Star Wars movies were digitally remastered and put back out in the movie theaters. Oh, I remember. Yeah, I saw them in theaters.

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Men have body dysmorphia too. That's why some use this drug.

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Yeah, and they re-released the action figure lines. And we got a 1970s action figure of Luke Skywalker and the 1998 action figure. And it's totally different. I mean, the new Luke Skywalker action figure had his robe open, his very defined pectoral muscles, smaller waist. more defined legs.