Social physique anxiety (SPA) and body dysmorphic disorder (BDD) have the body as a common denominator. These constructs both involve concerns with either others or one's own perceptions about the body or specific physical features; SPA involves concern about the evaluation of others while BDD involves concern over self-perceptions. This chapter provides definitions and information on diagnostic and statistical elements of SPA, BDD, and muscle dysmorphia (MD) which is a particular type of BDD. Psychological, physiological, and environmental factors implicated in the experience of these constructs are outlined as well as potential co-morbidities. Despite the wide range of physical and psychological benefits derived from exercise and physical activity, evidence suggests that these involvements can have negative effects for some individuals with SPA and MD. Consulting, counseling, and pharmacological strategies for addressing SPA and MD are outlined including commentary on cognitive behavior therapy (CBT), antidepressants (e.g., selective serotonin reuptake inhibitors), and a combination thereof.In this chapter we first provide commentary on the theoretical background of the mechanisms that play an essential role in development of SPA and MD among exercisers and physically active individuals. Main topics and associated concepts are introduced in vignettes to illustrate experiences of SPA and MD, and how they relate to exercise and physical activity. We then describe variables that have been linked to SPA and MD, including potential causes, moderators, mediators, and other correlates. Finally, we provide theoretically grounded recommendations for the professionals working with the physically active individuals who 2 portray symptoms of SPA and/or MD and provide suggested readings for further exploration in the area.
Anna's Experiences: Social Physique AnxietyAnna, a 25-year old high-school teacher, felt that she was an attractive woman except, perhaps, for a few "extra" pounds. She decided that joining the fitness center to more regularly engage in exercise would put her on the path to losing those extra pounds. Anna had second thoughts, when it came time to start her membership. She started worrying that everyone in the gym would stare at her heft and that she would make a fool of herself because of her lack of knowledge on how to operate the machines. Even the thought of going to the gym started causing her to break out in a sweat, get flush, and have a racing heart. Sally, Anna's best friend, realized the distress Anna was experiencing and offered to come along to support her during her workouts. Although she still felt uneasy and anxious, she was able to get over her fears enough to attend her very first session at the gym. She still, however, felt as though she was "on display"and that everyone was critiquing her size and shape. Even so, her motivation and social support allowed her to make three workouts per week until she had finally lost 10lbs. Sally recognized Anna's progress by saying: "You look amazing! I...