DALLAS — They're fixated by fitness magazines, addicted to abs workouts. They measure what they eat, they know what they weigh, and they might not be the gender you surmise.
"What's happening," Dallas personal trainer Kevin Durio says, "is that guys are just as susceptible to magazine covers as women are."
For a long time, Dallas registered nurse Ruben Castillo bought the magazines. He followed the bulk-up routines; he compared himself to overly built guys at the gym. If he missed a workout, he made sure he fit another in as soon as possible — even right before starting a 12-hour shift.
Eventually, says Castillo, 37, "it affected my self-esteem. I never saw the positive out of it. I realized my body would never be like that. I had to work on the positive points that I can change or make better."
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In a country where way too many people are obese, paying attention to health is a good thing. But in his work at the YMCA in downtown Dallas and in his personal business training law-enforcement officers, Durio sees men who take that concern beyond the edge of mere good health. Some set goals to be outlandishly big and bodybuilder-ripped; others strive for an unrealistic lean look.
"The whole point," Durio says, "is that it's a disorder."
Although it has nicknames — "bigorexia" for men obsessed with being bulkier; "manorexia" for those longing to be leaner — the medical term, at least for the former, is muscle dysmorphia.
Mike McFarland knows all about this. He's a licensed Dallas psychologist who focuses on eating and exercise disorders.
"There's a growing number, or maybe a growing awareness, of people who have these," he says. "It's like a moth to a flame. Everything their life centers around is their body."
A certain degree of boy consciousness is healthy. But Americans, not known for moderation, sometimes take it to the extreme. If one protein shake is good, four are better. If spending three hours in the gym a week is good, then spending two every day is better.
"I know someone who lost his professional job due to his need to work out multiple times during the weekday," McFarland says. "He became a personal trainer because that was in line with the focus on his body. He could be in the gym hanging out at all times, getting accolades from clients about his physique."
Often, these men have regimented programs of eating and exercise that "compromise their ability to focus in a work or social setting," he says. "They may be setting the alarm for 2 a.m. to have a protein shake. Their inflexible regimen gets in the way oftentimes of normally functioning in life."
The obsession often starts when a man is in his late teens or 20s, McFarland says. Recently, though, he's been seeing men several decades older with the same symptoms, and with bodies that don't quite look as if they belong to them. That's when he starts wondering about steroid use.
"A lot of guys in their late 40s and 50s suddenly are having bodies that look more like they're in their 20s and 30s," McFarland says. "It's a slippery slope. You start to get those accolades, and you hit the gym more and hang out with people achieving similar goals. It can be a feedback loop that takes people farther down that path."
The older men, more than the younger, concern Durio, too. "These kids are trying to look cool at the beach, and that's fine," he says. "It becomes an issue when they get older and still have a dysmorphic view of how they should look and be right now."
It's not a normal view of their body, Durio says. Clients will tell him they have 10 pounds to lose, or 20. "I'm like, 'Hang on. No you don't. Cut something off. You won't lose it in fat because you're already there.'"
On the other end, he says, "I'll get clients who like racquetball or squash or tennis but who want to be huge. I'll say, 'You can't be both. Pick one.'"
As a longtime trainer, he can spot someone who has unrealistic expectations.
"We can catch that early, put it into perspective," Durio says. "I get them moving in a different direction."
McFarland uses cognitive behavioral therapy to help clients with exercise or eating issues.
"We challenge perceptions on what's normal and attractive, the health consequences, and seeing how they're compromising their quality of life, whether friendships, emotional relationships, work," he says.
"Success depends. You have a range of results. It's an ongoing struggle. If it becomes a core part of your identity and it's how people respond to you, it's much more difficult to change over time," McFarland says.
Castillo still occasionally compares himself with the bulkier men at the gym, he says, but he's able to step back and talk himself out of trying to emulate someone else.
"It's almost like wishful thinking," he says, "like someone short who wants to be tall. I know it'll never happen, so I can just be comfortable in the body I have and work on things that can be improved."
Dallas psychologist Mike McFarland offers this checklist if you think you might have body-image issues.
■ Frequently checking yourself in the mirror.
■ Asking for reassurance. "Am I big enough? Am I lean enough?"
■ Comparing yourself to others. "Are they bigger, leaner, faster than I am?"
■ Overexercising. Are you exercising more than 90 minutes a day, especially if you're not training for anything?
■ Poor self-esteem. Do you look for ways you come up short?
■ Overfocus on regimen. Do you have to eat certain foods at a certain time? Do you absolutely have to get your workout in?
■ Striving for impossible goals. Are you looking at what's possible for someone with a body type completely unlike yours?