Associations Between Muscle Dysmorphia-Related Body Image Concerns, Physical Activity, and Body Composition among Young Asian Adults in Malaysia

Background Muscle dysmorphia (MD) is a body image disturbance characterized by an obsessive drive for muscularity, increasingly observed in non-Western populations. However, limited data exist on its associations with physical activity (PA) and body composition in Asian contexts. This study examined the relationships between MD-related body image concerns, PA levels, and anthropometric/body composition characteristics among young Asian adults in Malaysia. Methods A cross-sectional study involving 513 university students in Malaysia (207 males, 306 females; median age 21 ± 2 years) was conducted. Participants completed validated questionnaires assessing MD-related concerns—Drive for Leanness Scale (DLS), Drive for Muscularity Scale (DMS), MD Disorder Inventory (MDDI), Muscularity-Oriented Eating Test (MOET)—and weight control behaviours. PA was assessed using the IPAQ-SF, and body composition was measured via bioimpedance. Sex differences, correlations, and multiple regression analyses were performed. Results Males reported significantly higher DMS and MDDI scores, greater skeletal muscle, and higher PA levels ( p  < 0.001), while females had higher adiposity measures. PA showed positive associations with all MD-related body image concerns, including DMS (β = 0.149), MDDI (β = 0.188), and MOET (β = 0.107). Regression models also identified BMI, waist-to-height ratio, subcutaneous fat, financial adequacy, and life satisfaction as significant predictors. Participants in higher PA categories consistently reported more severe MD-related concerns. Conclusions Higher PA levels are associated with greater muscularity-driven body image concerns among young Asian adults, particularly males. These findings emphasize the need for culturally sensitive, gender-specific interventions to address maladaptive body image and exercise behaviours among young Asian adults.