Psychologist Mark Griffiths speculates that the roots of macrophilia may lie in sexual arousal in childhood and early adolescence that is accidentally associated with giants. Macrophiles often enjoy feeling small and being abused, degraded, dominated, or eaten, and they often view the much taller being as powerful and dominating.

Generally, the interest differs between macrophiles, and depends on gender and sexual orientation. Although macrophilia literally translates to simply a 'lover of large,' in the context of a sexual fantasy, it is used to denote attraction to beings larger than themselves.