Aziz "Zyzz" Sergeyevich Shavershia, an amatuer bodybuilder who died of an undiagnosed heart condition last year. "Men with muscle dysmorphia experience guilt and shame because they believe that they're not big enough and it's usually unrelated to how big they actually are." He said muscle dysmorphia was so destructive that victims had a high risk of suicide – "even more than guys with depression. So there are lots of problems that aren't known about with these people." A media saturated with male bodies creates an unrealistic perception of what is normal, said Dr Murray. "A lot of the images we see in the media are not attainable unless you want to take steroids or live a life characterised by big sacrifices." Amateur body builder Jacob Martinez, 22, understands what it means to sacrifice in order to achieve his ideal body.

He began weight-lifting as an 18-year-old to get in shape for university games. The transformation he saw in his body and the attention he received was addictive. Soon he was entering amateur body building competitions and in October he competed in the Australian Natural Bodybuilding (ANB) Championships. For 12 months, in preparation, he worked out up to three times a day and removed all salt, sugar, dairy, fruit and flour from his diet. "Nothing tastes as good as looking good feels," Martinez said. "When you're on stage you've got abs, legs, lines, [it's worth it]. I see food I really want to eat but, I see the people eating it and go 'oh, I don't wanna eat it'." The challenge to achieve his body has been more than just physical. "It'll be a while before I compete again," he said. "It's stressful physically, emotionally and in relationships. I didn't realise how much it mentally affected you. I've been moody and grumpy – it affects the people around you and you can't have much of a life coming into it." But, he believes the pain has been worthwhile. "It sort of pays out in the end and everything," he said. "Not a lot of people get to look like what we look like."

Andre Davids, a professional fitness model and bodybuilder, has won multiple bodybuilding competitions and has been in the industry for more than 20 years. But he does not believe that you need to sacrifice your life to get results. "Most people think that to achieve the ultimate physique they have to sacrifice all else," he said. "If that was the case, I wouldn't do it. For me, it's just part of who I am and what I do. Don't get me wrong. I do want to have the best physique that I can have. But, I also want to have a life and be able to enjoy things. So, I use a fortnightly cycle of five days on, four days off and never work out for longer than one hour." But as young men clamour to follow their bodybuilding heroes to potential stardom, not all are able to maintain a healthy life balance. Internet sensation

The amateur bodybuilder-turned-internet-sensation, Azyz 'Zyzz' Sergeyevich Shavershian was a case in point. He transformed himself from "skinny kid" into amateur bodybuilder and attracted a massive Facebook following, but died of an undiagnosed heart condition in Thailand in August last year. "The number of people weight-training is increasing dramatically and I think the pursuit is not necessarily . . . to become the massive freaks," said Davids.

"I think that is perhaps why Zyzz was popular. Nearly everything is about having a more aesthetic physique and I guess for the younger guys it's about appealing to the girls and I think that is more now about having a six pack." But Martinez and Davids argue that there's more to it than just looking good and picking up. "My time management skills are insane," Martinez said. "I've noticed how I'm always on time, I'm organised and I'm more driven now – if you drive for something for 12 months you can transfer that to other factors of your life as well." Davids agrees that the goal should be to cultivate a healthy lifestyle. "For me it's not just about how I look, but how I feel. It's about energy to a large degree and I'm also a big advocate for good nutrition."

But there are plenty prepared to pursue less healthy methods to achieve the aesthetic, and Customs records show a 155 per cent increase on seizures of steroids and growth hormones in the year to July 2010. Quick fix

Dr Murray attributes this rise to the increasing number of men whose self-esteem is directly linked to their body. "When we're dissatisfied with something we often want the quick fix," he said. "Many men come to define themselves through their bodies. Particularly now, in an era where there's greater parity between the sexes. I think a lot of men feel threatened in their masculinity which they emphasise by this aim to have a super muscular body, which makes them feel more like a man." Davids admits that the distinction between a high-achieving athlete and someone driven by body image issues can be blurry: "As much as I try to maintain a perspective, I still want more. Is that viewed as body dysmorphia or someone who has a never-ending desire to improve?" Dr Murray said the line between a desire to improve and an unhealthy problem could be gauged by the motivating factors along with the impact on quality of life. "It's a million-dollar question. Elite sportspeople do need to make immense sacrifices," he said.

"In terms of separating that from a psychological illness such as muscle dysmorphia, these guys will look in the mirror and say I'm not big enough and usually it's not oriented around performance. This is all aesthetic. "So they won't often say I can't bench press enough, they'll say my chest isn't big enough. I think the other thing to note is the level of impairment it causes in your life. "If you're a dedicated sportsperson that's great, but if you're a dedicated sportsperson and you're losing all your relationships because you can't do anything but lift weights that might be crossing the line towards a problem." Anyone suffering from this condition is advised to obtain a GP referral to a psychologist specialising in muscle dysmorphia or eating disorders. *Readers seeking support and information about suicide prevention can contact Lifeline on 13 11 14 or SANE Helpline on 1800 18 SANE (7263) or visit www.beyondblue.org.au.