Alfonso Moretti is a successful personal trainer, helping his clients stay on a track through healthy exercise routines. But, this fitness expert drifted off course early in his career, after becoming obsessed with building big muscles.
"It takes over your life, so every decision you make becomes about the workout and how your body looks," said Moretti. "I used to track and weigh every single ounce of food that went in my body, I used to wake up a 3 o'clock in the morning to drink protein shakes, I never missed a workout, ever, ever, ever."
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This all-consuming desire to bulk up is called muscle dysmorphia; also known as "bigorexia," and the number of men susceptible to this disorder is growing.
"About 45 percent of men are dissatisfied with their body image. 1 in 10 people who are diagnosed with an eating disorder is a man," explained Dr. Michele Kerulis, Director of Sports & Health Psychology at Adler School of Professional Psychology.
Kerulis says men of all ages are falling victim, and the emotional effects can be severe.
"This obsession can start quickly or it can begin over a period of time," she said. "We see psychological abnormalities including irritability, angry outbursts, which sometimes people would call a 'roid rage,' we see depression sometimes mania."
For Moretti, the desire to be big started young.
"I can remember as young as 13, 14 looking at some of these muscle magazines, and I was conditioned to think that's what a man looked like so big shoulders, big legs, just big muscles with veins everywhere," he recalled.
Moretti's routine was not only emotionally debilitating, the extreme workouts caused physical damage, which, for him, was a wake-up call.
"I finally came to a revelation, only after 11 or 12 years because I had neck surgery. I had major neck surgery. I had ruptured a disc in my neck, and it basically paralyzed me on the right side of my body," said Moretti.
Dr. Selene Parekh, an Associate Professor at Duke University, says physical injuries caused by "bigorexia" can range from muscle strains and stress fractures to organ failure.
"So individuals who have 'bigorexia,' a lot of them tend to use supplements and if you, you overdose on these supplements, without having a balanced diet you can develop kidney and liver failure, and as that happens you may need a liver or kidney transplant or your could eventually die," said Parekh.
Now Moretti encourages healthy body image and realistic workouts, urging other men not to go down the path he did.
"I look back now and I see those pictures and I'm like, 'wow,' like I would never want to look like that guy," he said.
Kerulis says your can combat this behavioral disorder through cognitive treatment and a healthy exercise regimen, with the help of a medical doctor, nutritionist and psychologist.