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Researchers have identified a new psychiatric disorder for the gymnasium set: pumped-up people in top physical shape who worry constantly that they "look puny."

Many of the muscle-bound men and women found to have the disorder were so preoccupied with their bodies that they had given up good jobs and intimate relationships to spend hours in a gym. And yet they typically wore baggy sweat shirts and pants even in midsummer to conceal their bodies, refusing to go to the beach or swimming pool. Many reported taking anabolic steroids to build up muscle, constantly weighed themselves and checked in mirrors, suffering great distress if they missed a day of weight-lifting.

"This syndrome looks almost like a reverse form of anorexia nervosa," said Harrison G. Pope of McLean Hospital in Belmont, Mass. He and colleagues from Brown University and Keele University, England, describe their discovery of the disorder, which they call "muscle dysmorphia," in the November-December issue of the journal Psychosomatics.

With anorexia nervosa, a woman diets until she is skinny, yet sees herself as fat. "By contrast, in typical muscle dysmorphia, a muscle-bound bodybuilder will look in the mirror and see himself or herself as out of shape," Pope said.

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