As the scale between small and tall is not generally found in real human life, almost all macrophilic behaviour is sexual fantasy.

‘The literal translation of macrophilia means a “lover of large” but in this context it does not refer to those in the fat admiration community (i.e., people who are sexually attracted to very fat women) but specifically refers to individuals who are sexually attracted to people much taller than themselves (i.e., it is the height rather than width that is crucial). Alternatively, macrophiles may fantasize about their sexual partner growing to an abnormal height while the macrophiles themselves remain unchanged. Such fantasies may include the macrophiles themselves shrinking in front of a normal sized person (male or female). ‘Macrophilia is be an increasingly popular sexual paraphilia in which individuals derive sexual arousal from a fascination with giants and/or a sexual fantasy involving giants.