It's body dysmorphia... twisted self-perception. Same as anorexia. I was anorexic to a terrible degree about 4-5 years ago... Eating 200-400 calories a day, blacking out after going up a flight of stairs, losing control of bodily functions due to electrolyte imbalances, and even though I could see every rib in my back and would bruise on the soles of my feet from walking (no fat to pad them), I would still feel my "rolls of fat" on my abdomen, get angry every time a bite of food would pass my lips, and pat myself on the back when I managed to go a whole day eating nothing more than a protein bar.
Add T3, cocaine, and ephedrine on top of that, and I was one ****ed up individual.
This is why the "adonis" syndrome never really took hold. If I hadn't conquered my demons in the body dysmorphia arena long ago, I'd be dead.