Boys Get Anorexia Too

This is my personal account of what our family experienced when my son was struck down by an acute and almost fatal episode of anorexia. The first half of the book is a self-help guide aimed at parents, carers, teachers, sports coaches, and non specialist medical professionals.

It highlights some of the difficulties for men and boys in getting a diagnosis in the first place and provides lots of practical tips on what to look out for and how to get the appropriate treatment if you suspect that a young man you know may be developing an eating disorder. You can also visit me at www.boyanorexia.com

Author – Jenny Langley

  • Experienced Carer and Trainer providing support in the SouthEast for Families Affected by Eating Disorders and Related Issues
  • Winner 2014 Beat National Volunteer Award for services to Education and Awareness
  • Winner 2016 Royal College of Psychiatrists – Carer Contributor of the Year
Boys Get Anorexia Too - Read More

Eating disorders are usually associated with females, but there are an increasing number of males affected by both anorexia and bulimia. Often there is a link between male eating disorders and athletic prowess, and the quest for physical perfection can result in damaging behaviours associated with diet, supplements and exercise. This website seeks to provide support, comfort, information and some words of advice for anyone concerned about a boy or young man’s eating habits and exercise patterns. Our son developed anorexia at the age of twelve.

He almost starved himself to death and we felt incredibly isolated and lonely. Thankfully he received appropriate treatment just in time and has since fully recovered, but the road to recovery was tough. You can read more about our story on various pages on this website. I have also written a book entitled “Boys Get Anorexia Too” which you might find useful. The first part contains background information on anorexia and practical tips on how to survive with an anorexic boy in your midst as well as how to seek appropriate treatment. The second part of the book is a case study based on our experiences. I have included several other case studies on this website to illustrate the fact that it is not just sporty boys who are vulnerable to anorexia.

The case studies are based on true stories in the UK and the USA.  Anorexia can affect anyone, of any age, from any walk of life. The important message is that you are not alone and anorexia can be beaten. I would urge anyone reading this website who knows of a young man or boy who is restricting his diet and/or over exercising, to encourage that person to seek professional help as a matter of urgency. Growing boys can lose weight incredibly quickly resulting in potentially long term damage to organs. In addition eating disorders are incredibly complex and appropriate treatment is often essential for a sustained recovery.

Finally eating disorders can quickly become a way of life. The earlier the diagnosis and treatment, the more likely is there to be a  quicker and more successful recovery I would also recommend parents, carers and young male sufferers to consider contacting beat (formerly known as the Eating Disorder Association). The team of employees and volunteers are well equipped to provide a great deal of advice and support.

Our Story and Why I Wrote a Book on the Subject?

My name is Jenny Langley and my son nearly died from anorexia when he was just twelve years old. We simply couldn’t understand what had hit us, but when it did hit us it nearly destroyed our family. Thankfully we all survived, but at times we felt rock bottom. This website is designed to give hope and support to any other family going through the experience of boy anorexia.

Boys Don’t Get Eating Disorders! Whilst eating disorders are normally thought to be a female domain, it is logical to assume that men and boys are not totally immune from eating disorders, but how many incidences of male eating disorders have you heard of? Certainly up until my son was afflicted I hadn’t ever heard of any examples. It turned out neither had my GP, any of the teachers at my son’s school, nor any of my friends or work colleagues. So it was a huge shock when my twelve year old son started to disappear before my eyes.

He was a gifted child, in the streamed class at school, a great sportsman and he was very popular with his peers at school. His anorexia developed startlingly quickly, he lost 25% of his body weight in four months, before collapsing and being rushed into hospital. He was dangerously ill, but once his condition had stabilised he was treated as an inpatient at a specialist adolescent treatment centre for four months. The treatment regime was very strict and extremely difficult for a twelve year old boy to cope with.

When Joe finally returned home there were some very difficult moments but the family worked hard together and with the out patient professional team to ensure the anorexia didn’t return. Several years further on, and he is a thriving, healthy and happy young man, who is probably stronger both mentally and physically, having beaten his illness. The relapse rate is high for anorexics, but we are keeping our fingers crossed that this won’t happen to us, and we are looking forward to him having a healthy and happy future. With the approvaI and support of my son and family I decided to write a book  entitled Boys Get Anorexia Too, in which I describe our experiences, and outline the treatment options available. We felt totally alone as parents of an anorexic boy and hope that this book will provide practical guidance, comfort and most importantly hope to families finding themselves in a similar position. In recent years a few books and articles have been published on eating disorders in men and beat now has a men’s section on it’s website.

There are also several American books on male eating disorders, which are very interesting, and at least acknowledge that there has been an explosion in the incidence of eating disorders in the male population over the last few decades. This provided us with some comfort, but didn’t really provide us with any guidance as to the best course of action, being parents in the UK, watching our son starve himself almost to death in front of our eyes. As I have already said eating disorders are usually associated with females but an increasing number of males are known to be affected. Research as well as anecdotal evidence indicates that as many as 20 to 25% of school age adolescents who are affected by an eating disorder are male.

However the number of males diagnosed and seeking treatment is roughly half that. Males and their families can find it hard to believe they may have an eating disorder, if they do seek treatment they may find it hard to get the correct diagnosis and even harder to get the appropriate treatment. Thus there are several problems facing a family whose son starts to display signs of having an eating disorder:How do you diagnose an illness, which most people, including non specialist health care professionals have never heard of?

  • How do you find appropriate treatment for such an illness?
    How do you cope with all the shocked reaction from your peers when you tell them what is wrong with your son?
  • Where do you turn to for moral support if you can’t find a family that has been through a similar experience?

My book seeks to answer all these questions and more. The book is written in two parts. The first part of the book is intended as an educational guide. It describes anorexia, what it is like to live with an anorexic boy, possible triggers, signs to look out for, effects on the family and the fact that boys get other eating disorders too. It also provides practical tips on how to cope with boy anorexia, treatment options, how to return to healthy eating and normal life and the importance of the carer(s) taking care of themselves as well.

The second part is a detailed and harrowing case study based on our experiences. Anorexia crept up on our son and then seemed to take over the whole family. We breathed a sigh of relief once he was taken into a specialist in patient unit, but little did we know how hard the treatment regime would be. A fragile emaciated 12 year old boy thrust into a world of teenage girls with a wide array of behavioural issues ranging from anorexia to self harm and attempted suicide. Unsurprisingly it took Joe a while to settle, but unusually for an anorexic he was determined to get better and despite the odds seeming to be towering against him at times, he did get better.

He learnt a huge amount during his struggle with anorexia and has become much more sensitive to other people’s needs. When I broached the subject of writing this book he responded:

“If one other family benefits from reading about our experiences then it will have been worthwhile”.

I hope my book will provide encouragement to anyone who is involved in caring for or treating a young boy with eating problems. This includes parents, people working in health centres, clinics and hospitals and also youth support groups, teachers, school nurses and sports coaching staff, who are often the first to be aware of concerns about eating disorders in young men.

What is Anorexia?

What is Anorexia and What are the Effects? Many men and boys are affected by anorexia and several studies published over the last few years suggest that males account for up to 25% of cases of anorexia. It is not just a girl’s disease! Anorexia nervosa is the best known of a range of illnesses classified as eating disorders. Anorexia nervosa literally means “loss of appetite for nervous reasons”.

The main diagnostic criteria for anorexia is that there is a weight loss leading to a body weight of at least 15 percent below the normal weight for height or age, although anorexia itself is much more complex than just loss of appetite or weight loss. Certainly those with anorexia will deliberately starve themselves until they are very ill, and in a small number of cases until they die. Anorexics are terrified of gaining weight and if they feel they have eaten even a tiny morsel too much they will exercise obsessively to get rid of the calories.

They are often obsessed with the amount of calories in each type of food. They will often encourage those around them to eat more, whilst continually cutting back on their food intake. Anorexics desperately want to be in control, and the one thing they feel they can control is their food intake. Sadly they soon find that they have lost control and that their anorexia is controlling every aspect of their lives. When he was well on his way to recovery Joe said to me “Mummy, I just wanted to lose a bit of weight for my sport and it just got completely out of control”.

But it is much more than just about food. The sufferer is normally deeply unhappy about some aspect of his life, and will have a very low self-esteem. Many sufferers feel that their illness gives them the attention from their loved ones that perhaps they felt they weren’t getting before. Finding out what has made the sufferer unhappy or craving attention can be very difficult and sometimes impossible to work out. There are literally hundreds of reasons why young people suffer from anorexia nervosa. The most important thing to remember is to look forward, not back.

Often the cause is irrelevant to the recovery and most anorexics do eventually recover. What are the effects of self-starvation? A period of sustained weight loss and malnutrition will result in the patient suffering from many symptoms, and damage can be severe. There are many symptoms of anorexia, and not every patient suffers from all of them. I mention some of the more common symptoms below, and you will find that the more you read, the more symptoms you will discover. It may well be worth alerting your son as to what could happen to his body if he continues to lose weight, and be malnourished over a long period of time.

The short-term effects of anorexia are usually apparent fairly early on. In girls, as well as periods stopping, their ovaries and uterus may start to shrink, and in general growth stops. In boys you don’t have such a clear indicator as loss of periods, but ongoing puberty may be arrested or slowed down, and your son may revert to a more childlike state. This is certainly what happened with Joe. As he lost weight he looked younger, he spoke more quietly and became much less physically active. Many anorexics quickly become depressed, may suffer from poor concentration, and lose powers of memory. They may also become irrational, and unreasonable, as a result of subtle changes to the balance of chemicals within the body, and most will suffer from a feeling of low self-esteem. Some develop an unsightly fine downy hair on their back and face called lanugo.

It is one of the body’s ways of keeping warm. Muscles may become weak after a period of malnutrition, and major nerves can become prone to pressure damage. The heart starts to pump less efficiently, and this often leads to an abnormally low pulse rate and blood pressure. This in turn causes dizzy spells, and the sufferer constantly feels cold and tired. A poor diet may also lead to anaemia, which also causes tiredness and the sufferer becomes very pale. A poor diet may also lead to constipation, a feeling of bloatedness, and tummy pains, which can be severe. Joe had episodes when he lay curled up on the ground screaming in agony, having eaten just a few morsels of food. All of these effects reverse quite quickly once normal eating patterns are resolved. The long-term effects of anorexia are not so obvious, but can be of greater concern.

In girls long term loss of periods can lead to infertility, and the abnormally low hormone levels can lead to osteoporosis, resulting in bones that are weak and can fracture very easily. Other hormones such as thyroid and growth hormones can also be affected by long term starvation. The reduced hormone levels have similar effects in boys in terms of infertility, bone density, growth etc. Internal organs are inevitably affected by a lengthy period of starvation, and in particular the heart and kidneys may suffer irreversible damage. Circulation of blood around the body can also be dramatically restricted, following a lengthy period of malnutrition, and in severe cases this can lead to tissue death in the extremities.

Many long-term anorexics have suffered from gangrene, and some have needed below the knee amputations. Unfortunately some anorexics die but thankfully the percentage is quite low. Some can no longer cope with their illness and take their own life, others die from organ failure, but I must stress these are very extreme cases. Many anorexics recover and live perfectly normal lives. Many learn to live with their anorexia.

Other Eating Disorders

Like females, boys and men suffer from a wide range of eating disorders, not just anorexia. The most common are: bulimia (men account for around 15% of cases) binge eating disorder (men account for 60 to 70% of cases) compulsive exercise (also known as bigorexia) EDNOS (eating disorders not otherwise specified) Whilst the different illnesses have different symptoms and effects, many of the approaches to self-help and treatment will be similar to those used for anorexics.

At the end of the day the main aim for anyone suffering from an eating disorder is to re-establish healthy eating patterns, maintain a healthy weight, and to regain self confidence and self esteem. Much of what is written in the self help and treatment options section of my book Boys Get Anorexia Too should be useful for the carer of a boy or man suffering from one of these other eating disorders. There is a chapter in my book which contains a brief description of each illness, what to look out for, and the effects of the illness. I also recommend reading :

  1. Fit to Die by Anna Paterson, published in 2004 by Lucky Duck. In this book the author draws the readers attention to the characteristic and special difficulties for men with eating disorders.
  2. The Invisible Man: A Self help guide for men with eating disorders, compulsive exercise and bigorexia (By John Morgan Publ:Routledge) This book applies the latest research to produce a practical, problem focused self help manual for men with eating disorders and body image problems. John Morgan has used his wealth of experience in the eating disorder arena to produce a book that really understands the issues men face and that provides a very readable guide for men seeking to combat their eating and body image issues.
  3. You might also like to follow Rob’s blog at http://bulimicboy.blogspot.co.uk  He writes candidly about his struggles with bulimia.
Triggers for Boy Anorexia

I have been asked many times “Did you ever find out what caused Joe’s anorexia”. The straightforward answer is no. However we have a few ideas about what could have been contributing factors: He went through a very early puberty. It is no coincidence that many cases of anorexia start in puberty, both in boys and girls. With girls the reason seems more obvious as they look in the mirror and see a more rounded shape developing. Boys tend to be more happy with their developing more muscular physique, but if a boy has a very early puberty, he might not appreciate the changes that are happening to his body and making him different from his peers.

In addition the raging hormones can trigger irrational behaviour in either sex. Joe was and having recovered from his illness, is still, a very talented sportsman. This is his explanation. “ I thought I would be an even better sportsman if I lost a little weight. I felt really good when I lost weight and to start with all my friends commented on how good I looked. The trouble was it got out of control and I found I couldn’t stop losing weight. I just got scared of eating in case I put weight back on”. There are numerous cases of sportsmen restricting their diet for their sport and developing an eating disorder. Consider jockeys, gymnasts, light weight boxers, long distance runners, cyclists and ballet dancers who can all justify restricting their diet to ensure they maintain an “optimum” weight for their sport. Joe is the eldest child of a complex family. He has one sibling, three half siblings and three stepsiblings.

It is likely that he felt he was always the last in the pecking order of all these younger children. For years he may have been craving more of our attention without us realising. He always seemed such a happy boy with a healthy appetite, and who loved his sport. When I read “ The Best Little Girl in the World “ by Steven Levenkron it made me realise how an outwardly happy and well balanced child could actually be feeling very lonely and left out by the demands of other children within the family. Research has shown that pre term babies are more likely to suffer from behavioural difficulties including eating disorders. Joe was born six weeks prematurely so this could have been a contributory factor.

There could have been many other triggers of Joe’s anorexia, but he didn’t bring them to our attention. Of course we agonised about such things as our family structure, was he being overstretched at school, was he being bullied etc? It is important to note that anorexia can appear in any family setting and in any social situation. We are a large complex family, but many small nuclear families, who appear to have no problems, have been affected by a visit from anorexia.

Children from all walks of life are vulnerable. Some typical triggers might include: An overweight child being teased or bullied at school. Comments might be made in jest and in a friendly manner, but then taken to heart. A highly academic child might be bullied by less able children and see food as a way to control his life. A less academic child might see weight loss as the only thing he can achieve positive results with. A child whose parents are constantly dieting might follow suit. A child who has seen an overweight parent or relative suffer a heart attack might seek to prevent this happening to him by cutting back on food. Abuse within the family often leads to an eating disorder.

A death in the family can create a feeling of helplessness and loss of control. A child might find comfort in having control over food. An overprotective or over dominant mother has often been blamed in the past for her child’s eating disorder. A passive or absent father has also been often cited as a reason for a child developing eating problems. Social pressures might cause a child to start dieting and exercising. Within our culture young men who have a slim and athletic build are portrayed as being popular, attractive, healthy and successful in life.

A young boy with puppy fat might feel he has to take drastic measures to achieve this image as soon as possible. As well as the above-mentioned social triggers, eating disorders can also be triggered by chemical or biological factors. Chemical imbalances in the brain can lead to all sorts of behavioural disorders. It is also increasingly believed that there may be a genetic link, and certainly eating disorders seem to run in families. The bottom line is that every case is different. No one type of person gets an eating disorder, and no two people with an eating disorder are exactly alike.

The common features seem to be that people who develop eating disorders suffer from a very low self esteem, and many find it difficult to express their true feelings or explain what is making them unhappy. Of course we will never really know exactly what triggered Joe’s illness, and like most parents of anorexic children we went through many months of agonising over what we could have done better to prevent our son almost starving himself to death. Joe’s key worker made me feel much better when she made two points in our first meeting:

  1. It is much more important to look forward, not back. What caused Joe’s illness may well be totally irrelevant to his recovery and his future. Of course if we discovered, during the course of his therapy, that there was something in his life that was making him unhappy then we could endeavour to change it. In many cases of anorexia the initial triggers remain a complete mystery.
  2. All families are dysfunctional in some way. However simple or complex your family set up, there are always disagreements and periods where some members are less happy than others are. Of course we should examine our family set up, and try to change if necessary, but we shouldn’t assume that there must be something terribly wrong with our family simply because our son had developed anorexia. Family therapy (more of this later) is a very good forum for examining the family set up and discussing if any changes might be beneficial.
What Signs to Look Out For?

Anorexic boys and girls display similar physical and psychological changes as their illness starts to take hold, although boys are more likely to be concerned with their athleticism, whilst girls are much more concerned with their basic body image. One of the key difficulties in diagnosing anorexia in boys is that lots of boys go through extremely skinny phases whilst maintaining a healthy appetite.

If you suspect that your son is suffering from an eating disorder, it is an invaluable exercise to note down any changes to his behaviour however small they might seem at the time. As the weeks go past you may well forget that he didn’t used to have some of these funny habits.

The second key difficulty is that many of the changes in behaviour could easily be caused by the onset of puberty. However as the list starts to grow you will soon sense that something else is having a profound effect on your son.

These are some of the things to look out for:

  1. Has your son lost weight or failed to gain weight for some time?
  2. Is your son exercising more than he used to?
  3. Have you noticed that he is eating less?
  4. Can you find out if he is eating less at school?
  5. Have you noticed your son excluding certain types of food?
  6. Is your son playing with his food, or cutting it up into tiny pieces?
  7. Has your son developed any other rituals around eating?
  8. Does your son comment on other peoples’ shapes and sizes?
  9. Does your son encourage those around him to eat, whilst eating very little himself?
  10. Has your son suddenly become more attentive to his personal hygiene?
  11. Has your son suddenly become much more neat and tidy?
  12. Has your son become more concerned about his schoolwork and/or his position in class?
  13. Has your son started wearing bigger and baggier clothes, or asking for you to buy them?
  14. Have you noticed your son doing repetitive exercises at home?
  15. Has your son developed any other repetitive habits?
  16. Has your son changed his social circle?
  17. Has your son withdrawn from the family?
  18. Has your son developed a temper, or is he displaying dramatic mood swings?
  19. Does he often seem sad and tearful?
  20. Have any aspects of his behaviour become irrational?
  21. Has he developed any superstitions?
  22. Have you noticed any change in his bathroom habits?
  23. Have you noticed any change in his sleep patterns?
  24. Does he get angry if you confront him about his weight and/or eating or exercise habits?
  25. Does your son look pale, and does he complain of constantly being cold or tired?
  26. Is his skin unusually dry?
  27. Has he grown any fine downy hair (not like the increase in normal body hair during puberty)?
  28. Has anyone else in your family, at school, or in your social circle commented on a change in his appearance and/or behaviour?

The above list gives you an idea of the sorts of things to look out for. Different boys will show different changes in appearance and behaviour. Many of the above, when taken on their own could be explained away as normal for a child going through puberty. The key is to look at all the changes together.

Within two months of my becoming concerned about Joe’s health, I could have answered yes to most of the questions listed above. If you are concerned about your son’s weight and/or diet it is worth looking out for some of these other changes in behaviour and: Write them down If you decide to seek professional help you are much more likely to be listened to if you can give a detailed account of how your son’s behaviour has changed.

Top Tips

For  parents and carers who are concerned that a boy in their care is developing anorexia:

  1. Make sure you and your son understand how much an active teenage boy needs to eat in order to grow. Your son may need to consume between 3,000 and 4,000 calories a day if he is particularly active.
  2. Encourage your son to eat a healthy diet including a good balance of carbohydrate, protein, fruit and vegetables, and at least some fats and sugar. However don’t be hard on yourself if he doesn’t respond. Anorexia can take over a child’s previously rational mind incredibly quickly.
  3. Weigh your son as soon as you feel concerned. You need to try and monitor how his weight is changing over a period of time. If he stops gaining weight over a three month period (teenage boys should be gaining between 4 and 6 kg each year, or 1 to 1.5 kg every three months)
    The weight chart shows how quickly Joe’s weight fell from the 75th centile to under the 9th centile. This was caused both by a reduction in his calorie intake and a dramatic increase in his exercise levels.

     

  4. Monitor his exercise routine. A sudden increase in sports training and repetitive exercise can be a major cause for concern. Even if your son appears to be eating well at home, he may be restricting his diet at school. A small decrease in food intake and increase in exercise can lead to weight loss. The chief medical officer recommends children should have at least 60 minutes moderate exercise every day. Several hours of punishing exercise can use up a huge amount of calories in a teenage boy and might even lead to muscle damage.
  5. Watch out for other behavioural changes. Some could be normal changes due to puberty, but dramatic mood swings and the appearance of rituals should ring alarm bells
  6. Write down everything you observe about his weight, exercise and other habits. This may be invaluable in helping a GP or pediatrician to make a speedy diagnosis.
  7. If you can, speak to your son’s teachers or sports coach. They may pick up on things at school that you haven’t observed at home. Other mothers of boys at school might also have picked up on changes in behaviour at school from your son’s friends.
  8. Seek professional help sooner rather than later, and as a matter of urgency if your son’s weight is dropping. An active boy who is restricting his diet can easily lose 1 kg a week and soon become dangerously emaciated. In addition the quicker an eating disorder is identified, the quicker and more complete the recovery is likely to be.
  9. If you decide to take your son to the GP, go prepared, armed with all the facts you have been writing down. It is incredibly difficult for a GP to recognise anorexia in boys so you need to give him all the assistance you can. There is no tangible indicator in boys (girls are likely to stop their periods) and many very healthy teenage boys go through very skinny phases.
  10. The UK government (through the NICE guidelines) has advised GPs that if a parent is worried then his/her fears should be taken very seriously. However many GPs still fail to recognise anorexia in their young patients. If your GP takes a “watch and wait” approach don’t be put off. If your son continues to fail to gain weight keep going back every week, and do not be afraid to ask for a referral to a pediatrician or child psychiatrist.
  11.  A problem shared is a problem halved! beat (The Eating Disorders Association) can provide a huge amount of support. There are telephone helplines and beat can send you a wealth of useful information. There is also a considerable self help network consisting of volunteers who have experience of an eating disorder. You can write to volunteers by post or e-mail, there are phone volunteers and there are many self help groups around the country. Information on any of these can be obtained by calling the helpline on 0845 634 1414, e-mailing help@b-eat.co.uk , or looking on the website www.b-eat.co.uk
  12. Try to learn as much about eating disorders as you can and try to ensure the rest of the family do as well. If your son has an eating disorder you will be much better equipped to help him if you have a good knowledge of his illness. beat can provide lots of helpful information and has a recommended reading list.
  13. Try to keep calm and be consistent with your son over what is acceptable behaviour and what is not within your family setting. This can be extremely difficult when your son is being irrational and shouting at you, but keeping calm can help diffuse an incredibly emotional situation. Being consistent can help provide boundaries for your son who may be feeling very frightened and out of control.
  14. Anorexia is a terrifying experience for any family to go through, but remember:
  15. boys can get anorexia too
  16. anorexia can be beaten
  17. look forward not back
  18. never give up hope

And most importantly, you are not alone.

Reading List
There is so much written about eating disorders in general that when you first look you don’t know where to start. In this section I recommend four general books and then I have listed all the male and boy books I have come across. When my son was ill there was virtually nothing written about anorexia in boys and very little on male eating disorders.
 
This has changed in the past few years and I recommend picking and choosing books that are relevant to your situation. Some of the books sadly do not have a happy ending but may offer some insight into the plight of men and boys struggling with eating disorders. Non Gender Specific Recommended Books Skills Based Learning for Caring for a Loved One With an Eating Disorder: The New Maudsley Method By Janet Treasure, Grainne Smith and Anna Crane, (2007)
 
A new edition came out in July 2016. Skills-based Learning for Caring for a Loved One with an Eating Disorder equips carers with the skills and knowledge needed to support and encourage those suffering from an eating disorder, and to help them to break free from the traps that prevent recovery. Through a coordinated approach, this book offers information alongside detailed techniques and strategies, which aim to improve professionals’ and home carers’ ability to build continuity and consistency of support for their loved ones. The authors use evidence-based research and personal experience, as well as practical support skills, to advise the reader on a number of difficult areas in caring for someone with an eating disorder.
 
These include:
 
  • working towards positive change through good communications skills
  • developing problem solving skills
  • building resilience
  • managing difficult behaviour.

This book is essential reading for both professionals and families involved in the care and support of anyone with an eating disorder. It will enable the reader to use the skills, information and insight gained to help change eating disorder symptoms.

Getting Better Bite by Bite: A Survival Kit for Sufferers of Bulimia Nervosa and Binge Eating Disorders by Ulrike Schmidt (Author), Janet Treasure (Contributor), June Alexander (Contributor) (2015)

Getting Better Bite by Bite is an essential, authoritative and evidence-based self-help programme that has been used by bulimia sufferers for over 20 years. This new edition maintains the essence of the original book, while updating its content for today’s readers, drawing on the latest knowledge of the biology and psychology of bulimia and its treatment. The book provides step-by-step guidance for change based on solid research. The use of everyday language, stimulating contemporary case study story-telling and evocative illustrations in Bite by Bite provide encouragement, hope and new perspectives for all readers. This handy-sized book fills a need for easy-to-understand information about Bulimia Nervosa, a serious and prevalent eating disorder. Ulrike Schmidt and Janet Treasure are world-renowned researchers and authorities on eating disorders, and June Alexander, a former sufferer of anorexia and bulimia, is a respected writer and internationally-known eating disorder awareness advocate. Getting Better Bite by Bite is a valuable resource – for sufferers, for their families, and for the health professionals and carers treating them. Anorexia and other Eating Disorders: how to help your child eat well and be well: Practical solutions, compassionate communication tools and emotional support for parents of children and teenagers by Eva Musby (2014) Parents are best placed to help their teenager or young child beat an eating disorder, yet most struggle to know what to do and how to do it. In Anorexia and Other Eating Disorders, Eva Musby draws on her family’s successful use of evidence-based treatment to empower you to support your child through recovery.

  • Learn practical and effective mealtime skills
  • Help your child to eat well and be free of fears and compulsions
  • Know what to say and what not to say in highly charged situations
  • Recognise the treatments that work and the ones that don’t
  • Develop your own emotional resources

However difficult your situation, this book gives you the tools you need to care for your child, your family and yourself. Using compassionate presence, Nonviolent Communication, mindfulness and acceptance, Eva Musby plots out a path towards well-being. With a wealth of guidance and practical examples, Anorexia and Other Eating Disorders is an invaluable guide to coping with and overcoming an eating disorder in the family.

Help Your Teenager Beat an Eating Disorder by James Lock (Author), Daniel Le Grange (Author) (2015)

Tens of thousands of parents have turned to this compassionate resource for support and practical advice grounded in cutting-edge scientific knowledge. Numerous vivid stories show how to recognize and address anorexia nervosa, bulimia nervosa, and other devastating eating disorders that wreak havoc on teens and their families. James Lock and Daniel Le Grange present strong evidence that parents–who have often been told to take a back seat in eating disorder treatment–can and must play a key role in recovery. Whether pursuing family-based treatment or other options, parents learn specific, doable steps for monitoring their teen’s eating and exercise habits, managing mealtimes, ending weight-related power struggles, and collaborating successfully with health care providers. Featuring the latest research and resources, the second edition now addresses additional disorders recognized in DSM-5 (including binge-eating disorder).

Books about Men and Boys (most recent first) Anorexia:

A Son’s Battle, A Mother’s War by Debbie Roche (2016) Anorexia: A Son’s Battle, A Mother’s War aims to expose the indicative and sometimes secretive characteristics of anorexia nervosa through the perspective of a mother. Referring to difficult lived experiences of caring for a teenage son with anorexia nervosa, this book is both powerful and emotional. Furthermore, it makes reference to the medical definitions of eating disorders, provides an historical context as well as highlighting useful practices to aid effective support and recovery.

The Boy Who Loved Apples: A mother’s battle with her son’s anorexia by Amanda Webster (2014)

Brave, honest and ultimately uplifting, The Boy Who Loved Apples is a compelling and beautifully written account of life with an eating disorder, and a gritty, moving testament to a mother’s love.When it became clear that Amanda Webster’s eleven-year-old son Riche was not just a little too skinny but dangerously ill, people were often surprised. Do boys get anorexia? they would ask. How did he get it?That was the question Amanda asked herself, too. She had trained as a doctor; she knew that every disease has a cause. And if her son had an eating disorder, she wondered what the cause could possibly be but something she and her husband Kevin had done—or failed to do? Quick to blame both Kevin and herself, worried about how her two other kids were coping, Amanda also found herself at odds with a medical establishment that barely understood Riche’s illness, far less how to treat it. And as she embarked on the long, agonising process of saving her son’s life she found herself battling not just Riche’s demons but her own.

Man Up to Eating Disorders by Andrew Wallen (2014)

Men get eating disorders too, and are often left out in the dark when it comes to resources, language about what the disease looks like, how guys talk about it, and more. This book is to help guys come together, create their own tribe, and talk recovery in their own language. Straight, gay, black, white, Asian, Hispanic, whatever your background – if it’s anorexia, bulimia, binge eating, compulsive exercise, steroid abuse or some combination of any or all of the above; we are all part of the same brotherhood. We are all dealing with the same core issues of belonging, perfectionism, control, identity, independence, and insecurity. We need to be welcomed by others – to feel the embrace of the tribe and move forward with our lives together. This book, my brothers, is for you. It’s now your job to spread the word. Strengthen your tribe.

There are three sections to Man Up to Eating Disorders, starting with the development of my emotional eating experience, into my first forays into body loathing and dieting, to my period of anorexia in late high school, and how the “thin ideal” stretched my eating disorder into exercise bulimia. My life’s journey into love, marriage and fatherhood are covered including the near death of my son and the zenith of my binge eating behavior. Eventually rock bottom hits, and recovery starts. Section two covers my experience in therapy, learning how to manage my binge drives, to accept myself as I am, and learn the roots of my low self-esteem come from my childhood. Working with a dietitian, I gain perspective on enjoying food rather than abusing it. My relationship with myself and my family improves, and a decision to specialize in working with others like myself is made. Section three speaks from my perspective as a therapist treating eating disorders in men, and has many client excerpts about what helped them in their journey into recovery and what sustains them now.

Understanding Anorexia Nervosa in Males: An Integrative Approach by Tom Woolridge (2014)

Because anorexia nervosa has historically been viewed as a disorder that impacts women and girls, there has been little focus on the conceptualization and treatment of males suffering from this complex disorder. Understanding Anorexia Nervosa in Males provides a structure for understanding the male side of the equation combined with practical resources to guide clinical intervention. Presented using an integrative framework that draws on recent research and organizes information from multiple domains into a unified understanding of the interconnected issues at hand, this informative new text provides a comprehensive approach to understanding and treating a widely unrecognized population.

Please eat… A mother’s struggle to free her teenage son from anorexia by Bev Mattocks (2013)

Bright, popular and a star on the rugby pitch, 15 year old Ben had everything he could want. But then food-loving Ben began to systematically starve himself. At the same time his urge to exercise became extreme. In a matter of months Ben lost one quarter of his bodyweight as he plunged into anorexia nervosa, an illness that threatened to destroy him. “Please eat… A mother’s struggle to free her teenage son from anorexia” is his mother’s heart-breaking yet inspirational account of how she watched helplessly as her son transformed into someone she didn’t recognise, physically and mentally. It also describes how, with the help of his parents and therapist, and through his own determination, Ben slowly began to recover and re-build his life. Also :

Anorexia Boy Recovery: A mother’s blog about her teenage son’s recovery from anorexia, 2 book box set (parts 1 & 2, 2011 & 2012) by Bev Mattocks

In 2009 Bev Mattocks’ rugby-playing 15-year old son, Ben, developed anorexia. Two years later, in January 2011, Bev made the decision to write a blog based on their experiences in order to help other parents of young people with eating disorders. The blog, ‘AnorexiaBoyRecovery’ – now read by followers all over the globe – looks back on the development of Ben’s eating disorder and examines the signs and symptoms. It goes on to chronicle how Ben finally responded to treatment and describes the various ups and downs along the way. In ‘Anorexia Boy Recovery Part I – 2011’ (based on the 2011 blog posts) Bev Mattocks describes how, in 2009, her family gradually realised that their 15 year old rugby-playing son, Ben, was developing anorexia.

It talks about the family’s struggle to get their son’s illness diagnosed and their long and distressing wait for treatment culminating in a shocking turn of events which led to a much earlier assessment. The book describes how, with the help of his parents and UK-based treatment team, Ben eventually began to recover, but not before facing further uphill struggles and battles. In ‘Anorexia Boy Recovery Part II – 2012’ (based on the 2012 blog posts) Bev continues to describe her teenage son’s recovery from anorexia.

Although at the beginning of 2012 Ben was well on the road to recovery, he wasn’t fully recovered. There were still underlying issues that needed addressing, issues which, no doubt, other families also face during the later stages of their son’s or daughter’s anorexia. As a result, 2012 was a year when Ben’s recovery was still very much a work in progress. 2012 was a year of ups and downs, of challenges and of glitches. Ben’s mood and motivation went up and down like a rollercoaster as he reached a number of frustrating plateaux and stumbling blocks. Yet 2012 was also a year of tremendous successes and emotional highs. It was the year that Ben sat his A-levels, won his place at his first choice of university and prepared to leave home.

That, in itself, is a long tale which may prove useful for other parents wondering whether or not their child is ready for university or college. Crucially, 2012 was a year when the family could see the light shining brightly at the end of the tunnel, a light that had seemed so dim and unattainable in past years. Bev says that sometimes the light seemed so close they could almost touch it. Yet at other times it seemed to be moving further and further away.

Dying to Be Perfect: A Mother’s Story of Her Son’s Battle with Anorexia by Susan Barry (2013)

Calling upon the same inner strength and faith that got her through her son TJ’s tragic death at age 22, Susan Barry decided to share their story. Complete with photographs, poems and journals from TJ’s personal lockbox, the result is a gift to the families and friends of those suffering the terrible toll of anorexia nervosa—and to all who seek insight into a disorder that is widely misunderstood, difficult to treat, and too often fatal. Dying to Be Perfect details TJ’s journey from bright, active high school student to a young man who is isolated, desperate, and consumed by the disorder he has battled for nearly a decade.

Fighting alongside him every step of the way is his brave and tenacious mother, who tries one strategy after another for curing TJ—everything from bargaining and tough love, to forcible commitment. In addition to her deft and sensitive recounting of his story, Barry has included solid advice to desperate parents, insight for those treating this disorder, and writings from others whose lives he touched. In this unforgettable book, TJ lives on and offers a beacon of hope for anorexia sufferers and their loved ones Shattered Image: My Triumph Over Body Dysmorphic Disorder by Brian Cuban (2013) Brian Cuban is a successful lawyer, activist and TV host is living with an enemy that haunted him for over 30 years – his own reflection in the mirror.

Through a series of very personal, witty and poignant anecdotes, the younger brother of Dallas Mavericks owner Mark Cuban opens up about his personal battle with a mental disorder known as Body Dysmorphic Disorder (BDD) in which the sufferer is preoccupied with a distorted sense of self-image and is often afflicted with eating disorders, depression and addiction. In the book, Cuban illustrates the ongoing nightmare of (BDD) that has permeated his thoughts since childhood, taking the reader through the painful journey of childhood bullying over his weight, rejection and the behaviors that slowly developed as a young adult which took him into the abyss of depression, alcoholism, drug addiction, steroid abuse and eating disorders, nearly causing him to take his own life at the age of 44.

Destroying the Monster: Lessons Learned on the Path to Recovery by Vic Avon (2013)

Sometimes all a person needs is a little bit of guidance to find his or her way through the darkness. Vic Avon tells his story in order to help people affected by eating disorders find the strength and wisdom needed to recover from the disease. Destroying the Monster: Lessons Learned on the Path to Recovery is the follow up book to Vic Avon’s very personal My Monster Within: My Story. This book details the author’s struggles and triumphs throughout the recovery process while providing the reader with valuable lessons, not only to help in his or her own recovery, but also in life as a whole. It has been written in a way to shatter the mold of typical “cookie-cutter” eating disorder recovery books as Vic discusses personal stories and important tips/strategies.

Destroying the Monster focuses on topics such as dealing with the shame of having an eating disorder (especially as a man), returning to places where trauma occurred, moving on and accepting the past, facing challenges, and finding lessons and motivation in the strangest of places. Vic shows that it’s possible to live the life you were meant to live because “It’s never too late to start your life over.” Destroying the Monster shows that it is possible to Turn Struggle Into Strength!

No Labels – Men in Relationship with Anorexia by Derek Botha (2013)

In NO LABELS: Men in Relationship with Anorexia, Derek Botha argues that traditional understandings of and approaches to diagnosis and treatment for anorexia nervosa are unacceptable, inappropriate and laden with labelling ways, and thus exacerbate these men’s struggles, leaving them dishonoured, disabled, powerless and even more distressed. He presents alternative ways of understanding the nature of their social positionings as well as a more appropriate therapy for them, namely narrative therapy. NO LABELS: Men in Relationship with Anorexia contributes to meaningful dialogue amongst mental health academics, practitioners, students and all who have an interest in seeking fresh understandings of these men and their complex positionings

Starved by Michael Somers (2013)

The day high-school senior Nathan Thomas throws up at school without needing to use his fingers is the day he knows his eating disorder is completely out of his control. The night his mother finds him collapsed in the living room is the night he nearly dies from his starvation. He is rushed to the hospital and admitted to an adolescent eating disorders unit. He weighs 112 pounds. Nathan rebels by pretending to go along with the program at first, until his parents refuse to help in his recovery. With only his treatment team and fellow patients to rely on, Nathan comes to terms with the boy who lost himself and the young man who gains himself back, one pound at a time.

Current Findings on Males with Eating Disorders by Leigh Cohn (Editor), Raymond Lemberg (Editor) (2013)

The subgroup of males with eating disorders has been understudied, and this book presents the most comprehensive look at this topic since Arnold Andersen edited the text Males with Eating Disorders in 1990. This monograph represents both original research and reviews of other studies based on a special issue of Eating Disorders: The Journal of Treatment and Prevention, with additional added chapters. Representing international contributions from researchers and clinicians in nine countries, this cross-section includes chapters on etiology, sociocultural and gender issues, symptom presentation, assessment, medical and psychological concerns, treatment, recovery, and prevention.

Second Son: Transitioning Toward My Destiny, Love and Life by Ryan Sallans (2013)

Second Son is a unique lens on life and love, intimately exploring the transition experience of Ryan Sallans – born Kimberly Ann Sallans. Ride alongside Ryan’s transition from a child to a body-obsessed young woman with an eating disorder; from female to male, daughter to son, and finally a beloved partner to a cherished fiance’.

Ryan candidly shares his struggle to find love and acceptance; a struggle that transcends through every layer of society. He nearly died from an extreme case of anorexia as an insecure female college student. The only thing that saved him was his inner spirit begging for a chance to live. Second Son chronicles Ryan s battle with his family, his romantic partner, and his body. It is an unblinking focus on self-empowerment tracing Ryan’s evolution into manhood as he underwent gender reassignment surgeries. It took twenty-nine years for Ryan to find himself. Second Son is an intimate and honest autobiography that will educate and empower anyone journeying to find their own destiny, love, and life.

Eating Disorders: A Female And Male Issue: A Deeper Look Into The Affliction Of Eating Disorders by Gayle Schneider (2012)

Females make up the greater percentage of those affected by eating disorders; however, males are not immune to the disorder. Males can also fall victim to Anorexia Nervosa and Bulimia Nervosa and Compulsive Overeating. Eating disorders are not caused by a single known cause. In fact, the majority of those individuals struggling with this disorder have developed it after numerous factors paved the way. These issues surrounding weight, diet and body image can prove highly dangerous to the physical and mental health of an individual. Because poor body image is at the core of those struggling with eating disorders, it is no surprise that this disorder is associated with depression. The treatments success is proportional to the timing of problem diagnosis. The more time that elapses where harmful habits have developed and become routine, the greater the difficulty to break the unhealthy patterns. Eating disorders are responsible for tremendous damage to both the body and mind, thus the greater the amount of time it is left untreated the greater the danger. If you feel that you or a loved one may be struggling with an eating disorder, it is imperative to seek immediate attention. This book will give the reader further insight into this female and male issue. From what an eating disorder is to where it stems from, pregnancy concerns and treatment; this book will not only inform but offer helpful insight for professional help.

Becoming John: Anorexia’s Not Just For Girls’ by John Evans (2011)

“This is the only thing I’m good at, the only thing that makes me stand out.” “Being an anorexic means that I am someone.” In “Becoming John: Anorexia’s Not Just For Girls”, John Evans uses his in-patient diary and detailed life story to unravel the events and circumstances that saw him turn to Anorexia Nervosa for the acceptance and safety that he had failed to find anywhere else. Anyone touched by Eating Disorders in any way will find valuable insights within John’s story, as well as snatches of hope in the way that John has begun to turn his life around. Anorexia doesn’t care if you’re male or female. All it needs is your mind and all it wants is your soul.

Eating Disorders in Males: Muscularity and Fragility: the Two-faced Ianus of Male Identity (Eating Disorders in the 21st Century) by Emilia Manzato ,Tatiana Zanetti ,Malvina Gualandi ,Renata Strumia (2011)

Eating disorders in males are a complex phenomenon. Eating disorders are less common in males than in females, occurring generally 10 times more frequently in women than in men. In spite of similar symptoms in men and women, men are less likely to be primarily diagnosed as suffering from an eating disorder and they risk to be under-diagnosed. This new and unique book reviews research on the epidemiology, clinical features, risk factors, weight and shape concerns, body dissatisfaction and a particular male anxiety on muscle mass on the topic of eating disorders in males.

My Monster Within: My Story by Vic Avon (2010)

“My Monster Within” provides an autobiographical account of one man’s life before, during, and in recovery from Anorexia Nervosa. This is an inside glimpse into a world that few people know about or understand. It is written as an attempt to review the author’s life and to figure out how he became the person he is. The author illustrates the severity of his illness and the triumphs and tragedies along the way. The horrors of the disease are discussed in detail as the reader is brought on an emotional roller coaster ride that ends with hope and positiveness.

The Hungry i: A workbook for partners of men with eating disorders. by Barbara Kent Lawrence (2010)

The Hungry i: A work book for partners of men with eating disorders combines the results of scholarly research with practical exercises to help people understand the history, causes and realities of eating disorders in men, a topic about which too little is known. The book offers ways in which partners of men with eating disorders can help not only their partners but also themselves. According to Dr. Ira Sacker, co-author of Dying to be Thin, , “The Hungry i is a true breakthrough in the understanding of male eating disorders! and a user-friendly work of scholarly art that is truly needed.”

Fat Boy Thin Man by Michael Prager (2010)

Fat from an early age, the author had an obese adolescence that last into his 30s. Despite having lost more than 130 pounds three times, he weighed 365 in October 1991, when he began accepting that he might be a food addict, and undertaking the practices and treatments designed for alcoholics. “Fat Boy Thin Man” relates what it was like to grow up fat, what it was like to experience reliable improvement in his health and lifestyle, and what about his experience relates to others. The second line of his book assures readers he isn’t a guru; he shares what was shared with him by others. “Fat Boy Thin Man” will delight readers who enjoy humorous, engaging, real-life stories of redemption. But it will also serve readers who suffer, or whose loved ones suffer, with obesity that they have tried and failed to resolve repeatedly.

Counselling for Eating Disorders in Men: Person-Centred Dialogues (Living Therapy) 1st Edition by Richard Bryant-Jefferies (2010)

According to the Eating Disorders Association there is a general lack of recognition of eating disorders in men, making it more difficult for male patients to access specialist services, although clients with problems connected with over-eating, under-eating, and poor eating form a significant proportion of counsellors’ lists. This book focuses on men whose eating patterns have generated side-effects on other aspects of their lives such as work, health and family. By adopting the unique approach of the Living Therapy Series, using fictitious dialogue to illustrate the person-centred approach, the reader is able to experience directly the diverse and challenging issues surrounding patients. This is difficult to achieve with conventional text books. Counselling for Eating Disorders in Men provides vital insight for trainees and experienced counsellors, as well as men suffering from eating disorders, their friends and families. It will also be of interest to members of support organisations.

The Invisible Man by John Morgan (2008)

A Self help guide for men with eating disorders, compulsive exercise and bigorexia This book applies the latest research to produce a practical, problem focused self help manual for men with eating disorders and body image problems. John Morgan has used his wealth of experience in the eating disorder arena to produce a book that really understands the issues men face and that provides a very readable guide for men seeking to combat their eating and body image issues.

Skinny Boy: A Young Man’s Battle and Triumph Over Anorexia by Gary Grahl (2007) with a related website www.skinnyboybook.com

Challenging the assumption that anorexia is an exclusively female affliction, this compelling memoir is the first to describe how a young man overcame this often fatal disorder. Handsome and popular, Gary had baseball abilities that had attracted the attention of the big leagues, until a shaming inner-voice convinced him that he needed to be thinner, leading to an out-of-control compulsion to exercise and starve himself, causing multiple hospitalizations. Providing strategies for tackling the recovery process and examples of changes in the thinking needed to take those steps, this important narrative comes at a time when eating disorders are at an all-time high in America, afflicting more than 8 million men. Demonstrating how anyone can win the internal battle between mind and body, this much-needed biography offers therapists, sufferers, and their families with powerful tools to help them triumph over this life and death battle.

Fit to Die by Anna Paterson (2004)

Anna has established herself as a leading author in the field of eating disorders and combines her personal experiences with an extensive research interest. It would be a mistake to think that eating and body image problems are experienced only by women. Anna draws the readers’ attention to the characteristic and special difficulties for men, including: ” athletics, body building and eating ” depression and self-esteem ” eating disorders and homosexuality. Like all her books she offers a comprehensive overview and contributes information, advice and hope. This is a book for those affected and those who want to help them.

Hiding Under the Table by Dennis Henning (2004)

$300.00 a day food habit, 300 laxatives a day, prostitution: These are a few of the ways Dennis Henning numbed himself to deal with his “silent killer”, an eating disorder. This is the raw, uncompromising account of a man who suffered from an eating disorder, and how for years the medical establishment would not take his anguish seriously because he was a male. This is his true and unfiltered story, from the evolution of his crushing addictions to how he finally recognized that he had to take responsibility for his own recovery.

The Adonis Complex: How to Identify, Treat and Prevent Body Obsession in Men and Boys by Harrison G. Pope, Katharine A. Phillips, Roberto Olivardia (2000)

A Health Crisis That Strikes Men Of All Ages Trying everything from compulsive weight lifting to steroids, more and more boys and men are taking the quest for physical perfection beyond the bounds of normal behavior. The Adonis Complex — the groundbreaking book that first gave a name to this phenomenon and sparked nationwide interest in the subject — identifies for the first time the symptoms and warning signs of this dangerous problem, including:

  • An obsession with exercise, sometimes to the exclusion of all other activities
  • Binge eating, anorexia nervosa, and bulimia
  • The abuse of steroids, muscle-building supplements, and diet aids

But perhaps more important, it offers readers an explanation of the underlying causes of the Adonis complex, together with hands-on advice for those who have experienced body obsessions themselves, or who see these problems in a boy or man they love.

Making Weight: Men’s Conflicts with Food, Weight, Shape and Appearance by Andersen, Cohn and Holbrook (2000)

This book is written by three of the leading experts on eating disorders in males in the US. It describes the explosion in the numbers of men with eating disorders, body image conflicts, compulsive exercise and obesity. This book examines why men have become affected by such issues and what to do about it. The book  gives a scientific narrative based account of male body image problems but doesn’t really offer any practical tips for sufferers or their families.

Bitter Ice: A Memoir of Love, Food, and Obsession by Barbara Kent Lawrence (1999)

With sensitivity and compassion, Lawrence chronicles her husband’s life-threatening eating disorder from the time when he was an accomplished 6’1″ college athlete, through hospitalization and therapy when he weighed just over one hundred pounds, to the final days of their marriage twenty-seven years later. Through Lawrence’s startling prose, we bear witness to her husband’s obsessive exercising; masochistic starvation methods; and addiction to saunas, laxatives, and ice baths-and the chilling effect his behavior had on the life they had so carefully tried to build. Taught from childhood that her husband would naturally be her provider, Lawrence finds herself unable to break free from his controlling ways, even when they bring their family to the brink of self-destruction. Forced to examine her own complicity in her husband’s illness, and ultimately come to terms with her own childhood demons, Lawrence must make choices that are both painful and dramatic in order to reclaim her life.

Males with Eating Disorders by Arnold Andersen (1990).

As far as I know the first comprehensive book examining male eating disorders. It has been reprinted several times A very technical book encouraging more research on eating disorders but nonetheless at least it acknowledged the illness in the male population and that more help was needed to help this sub group.

Reviews:

‘The book is immensely reassuring to any parent who has experienced at first hand the problems that a young boy already caught up in the maelstrom of adolescence can both experience and cause when anorexia arrives. Any parent or carer concerned about a boy who may be developing or has already developed an eating disorder will find this book useful and supportive even when it is talking about the most difficult problems that affect sufferers and their families’
 Signpost

`This is a detailed observational account of severe Anorexia Nervosa in a boy, and the effect on his family. It documents their emotional and torturous journey through treatment back to full health. The descriptions of the disorder are written without jargon and with great accuracy. The book is packed with practical tips on how to manage everyday situations. This is truly a book that adolescents, their families, and clinicians should read’
Dr David Firth, Consultant Child and Adolescent Psychiatrist

`’Boys don’t get anorexia’ is a phrase that any parent who is concerned about a son who is losing too much weight or exercising excessively will hear at some time or other. Well, boys DO get eating disorders and in this very personal and insightful book, Jenny Langley looks at what it means to have a son who does in fact have anorexia. Jenny writes about the way in which the disorder crept up on her family and then seemed to take over the household. The slow painful climb of [her] son back to recovery is recounted in uncomfortable detail. Ultimately however this is a story of hope. Joe does recover eventually and although life is by no means the same as before, it does return to a new normality’
From the foreword by Steve Bloomfield, Eating Disorders Association

A clearly described account of adolescent behaviour patterns which can lead to anorexia, written for worried parents, but useful to anyone working either with a boy diagnosed as anorexic, or a member of his family… It offers both sensible and sensitive information as to what to expect, suggests courses of action, and provides lists of resources’
Therapy Today

 

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Case Studies

Case Study: Joe’s Story
Joe is born six weeks early, but is healthy, and leaves the hospital two weeks later. He grows into a happy boy with a healthy appetite. He loves being outside and plays sport at every opportunity. Just before his twelfth birthday Joe has a growth spurt and starts to become even more serious about his sport. His muscles quickly become clearly defined and Joe’s friends at school praise him over his new found physique. Even his mum has to admit he looks in fine shape. Joe feels on top of the world.
 
He is the best footballer and cross-country runner in his year group and he intends to stay that way. Unfortunately Joe’s euphoria is short lived. Each day Joe finds he wants to exercise a little more and eat a little less. This soon has a dramatic effect on his weight. Joe loses a quarter of his body weight in four months, falling from 42kg (6 stone 8 lbs) to just 31.4kg (4 stone 13 lbs). When he reaches 37kg his mum takes him to the doctor for the first time but is told not to fuss. Joe has several more visits to the doctor before being finally referred on to a specialist.
 
It is a painfully slow process. Meanwhile Joe’s behaviour changes. He becomes distant from his friends. He can’t concentrate at school. He becomes angry and aggressive if anyone challenges him about his weight or his diet. He gradually becomes superstitious and his days are filled with rituals. He becomes severely emaciated, and his skin is dry and scaly. The whole family is being affected by Joe’s behaviour. Just as the specialists finally agree that Joe is suffering from anorexia, Joe collapses and is rushed into hospital with a suspected heart attack. He is on a drip for three days before being admitted to a residential adolescent unit.
 
The treatment regime is very strict and extremely difficult for a twelve year old boy to cope with. A fragile emaciated young boy thrust into a world of teenage girls with a wide array of behavioural issues ranging from anorexia to self harm and attempted suicide. Unsurprisingly it takes Joe a while to settle, but unusually for an anorexic he is determined to get better. Even though his mind is distorted by his illness he can see that if he doesn’t beat it, he will never play competitive sport again. He complies with the treatment regime, and, despite the odds seeming to be towering against him at times, he does get better. When Joe finally returns home there are some very difficult moments but the family works hard together, and, with the out patient professional team to ensure the anorexia doesn’t return.
 
For the first six months back at home Joe struggles to maintain his weight within an acceptable range, as he gets used to having to consume the huge quantities of food that an active teenage boy needs, to grow. His weight fluctuates a little, but never falls enough to cause real concern. Within a year Joe is signed off by the psychiatrist and is relieved to hear he has no more therapy sessions to attend. He continues to be fit, healthy and happy and no longer has to think about what he is eating. There is also a very similar story to Joe’s featured on the BBC News Health website.
 
It was written in August 2003 and features a 13 year old boy who wanted to get fit for the rugby season. The doctors were mystified when George became ill and lost weight. Like Joe, George did manage to get the appropriate treatment just in time and has now made a full recovery.
Case Study: Edward’s Story
Edward was born in the early sixties. At eight years old Edward thought he was ugly and overweight. At eleven years old he was making himself sick to avoid school. He struggled with food throughout his teenage years and was very thin but his mother accepted that he was a fussy eater and thought that perhaps he had a food allergy.
 
On the occasions that she did take Edward to the doctor, she was told that there appeared to be nothing wrong with him and that she should let him eat what he liked. In his later teens when he complained of pains in his limbs and joints they were dismissed as growing pains. Edward struggled at school but in his late teens found that the logic of computer programming suited him. In his early twenties he held down a demanding job for two years but he continued to starve himself and was exercising fanatically.
 
Despite the fact that he was over 6ft tall his weight plummeted to 7 stone 7lbs. Inevitably he suffered a nervous breakdown but this proved to be a turning point. He changed GPs and at the age of 24 he was finally diagnosed as having anorexia. He embarked on a treatment programme which included anti-depressants and therapy. He also joined the Young Quakers. Edward wanted to get better but it took several years to find a treatment programme that suited him. Once he did he was the only man on the programme but this didn’t unduly concern him. He inspired confidence in the other patients. He also became passionate about writing both poetry and prose and was always bursting with new ideas.
 
Sadly Edward died in his early thirties of a brain haemorrhage following surgery. Whilst it is unlikely that the brain haemorrhage was linked to his anorexia, the operation could have had a different outcome if Edward had not been so seriously debilitated by his illness. This was a young man who really wanted to beat his anorexia and live a fulfilling life. He had so much to say and so much to write about, but his anorexia was so deeply embedded in his psyche by the time he was diagnosed, that it was always going to be incredibly difficult for Edward to beat it. This story illustrates the importance of early diagnosis and treatment. If Edward’s doctors had taken his childhood ailments more seriously he would have had a much better chance of being diagnosed much earlier and his treatment regime might have had a speedier and more successful outcome.
Case Study: David’s Story

David loved to dance and by the age of eleven he was enjoying modern, jazz, ballet and tap. Of course he had to wear a clingy lycra leotard for several of his dance classes which didn’t bother him at all until some of the girls in his class started commenting that his tummy was starting to stick out. In addition his teachers seemed to be constantly commenting on David’s posture and telling him to pull his tummy in. One day after a dance class David announced to his mum that he felt fat. His mum was horrified. David was anything but fat. He was fit and healthy and a great dancer. David told his mum about the comments from the girls and the teachers.

He felt under pressure to do something about his growing physique. His mum was well aware of the dangers of teenagers becoming wrapped up in body image and so ensured she kept a close eye on her son’s eating and exercise habits. She constantly reinforced the message that it was really important to have a balanced diet and not to become obsessive over exercise. For a while David repeatedly commented on his “fatness”. He started to avoid certain foods, although this never became a really big issue.

His mum was slightly more concerned about David’s increasing focus on body image. He talked about developing a six pack and started doing repetitive exercise, particularly sit-ups. David’s mum continued to reinforce the message that it was really important to have a balanced diet and not to become obsessive over exercise. If David didn’t eat enough he wouldn’t have the energy to dance and if he over-exercised he might suffer an injury which would stop him dancing. Gradually David became more accepting of his developing frame. It certainly wasn’t interfering with his ability to dance well and he learned to ignore the comments, which after all, were actually few and far between. Four years on David is still enjoying dancing with a group of young people that have been together for a long time.

He could have succumbed to the intense pressure often put on young dancers to restrict his diet and maintain an artificially low weight, but he didn’t. This story has a powerful message. David was under undue pressure to lose weight at the age of eleven, but with the support of his family he stayed healthy. It could have been a different story and it is a sad fact that young dancers, both boys and girls are vulnerable to developing eating disorders. The Eating Disorders Association is working together with Dance UK to increase the awareness of the risks facing young dancers of developing eating disorders.

Case Study: Tom's Story
Tom can’t remember a time when weight was not an issue. As a young boy he was often taunted, teased or simply left out by his peers in the playground because he was slightly overweight. As the years passed by the weight piled on and by the time he was 14 years old he weighed 16 stone. Tom’s mum urged the GP to help and at last Tom was referred to see a specialist at the local hospital. It was Tom’s worst nightmare coming true. He had to tell the doctor all about his daily food and drink intake and then he was weighed. The nightmare became a reality when the doctor said to Tom “you are overweight”. Tom’s head started to scream out thousands of words.
 
Tom’s parents were really supportive and encouraged Tom to go to the gym and eat a more healthy diet. Tom felt he was doing well and losing weight but was devastated, when on his next trip to the doctor his weight had not changed. Tom was sent to a dietician and they worked out a diet plan together. With a much increased exercise regime and the new diet Tom found losing weight wasn’t so hard after all. Tom’s family and doctor were euphoric when, several months later, Tom reached the average weight for his age and height. However there was a problem. Tom’s mood was very low and, despite his weight loss, every time he looked in the mirror he still saw nothing but fat.
 
Tom became obsessed about his weight, diet and exercise. He continued to lose weight at an alarming rate and his family watched helplessly as he reduced his food intake to almost nothing and insisted on going to the gym almost every day. Tom quickly became very fragile and his mum insisted that they go back to the doctor. He recognised that Tom had developed an eating disorder and referred Tom to see a child psychiatrist, but this would not be until after Christmas. Tom was petrified that Christmas would make him fat and so he desperately tried to avoid anything fatty and returned to the gym as soon as he could after Christmas, where he did the hardest workout he had ever done. In a short period of time Tom had gone from being unhealthily overweight to dangerously anorexic.
 
Tom found his visits to the child psychiatrist nerve wracking and he felt like a freak. He continued to lose weight and at one point was losing 3 pounds a week His weight fell to 8 stone. Tom has seen some other therapists since but thus far he has not really been able to fight his anorexia for more than short periods of time. His mind is split in two – anorexia and reality – and he and his family are praying that reality comes out on top. Tom’s message to parents is that it is really important that if your son/daughter has any signs of an eating disorder, they should seek treatment as soon as possible. As Tom and his family have found out, the longer you leave it, the harder it is to fight the illness.
 
Tom has become an Ambassador for the youth section of the Eating Disorder Association. Rather than suffering in silence this means that Tom gets his voice heard. His views on treatment and his experience of suffering from an eating disorder can be used to improve professional services and challenge the stereotypes of young people with eating disorders in the media. Despite his illness he is managing to make a very positive contribution through this role.
Case Study: Edward’s Story
Rob blogs about his experience as Bulimic Boy. Visit his site at http://bulimicboy.blogspot.co.uk. Rob is in his mid-30s and has bulimia. He’s suffered from a dysfunctional relationship with food since his early 20s. A third of his life. Not a third of his life wasted, but still a lot of wasted energy trying to control his eating and dealing with its consequences. Until he left university Rob didn’t have much of a relationship with food at all. It was fuel. He ate when hungry. He liked some things and not others. But all in all he paid food little attention. Then one day he looked down while showering and thought he looked a bit fat. The next day he took one sandwich to work instead of two. He made his breakfasts a little smaller. And his dinners. He started cycling a couple of extra miles each way on his commute (already a 17-mile round trip). He went running almost every lunchtime instead of twice a week. These changes happened over a couple of months and at first Rob convinced himself that he was being healthy: watching what he ate and taking plenty of exercise. Then he started binging and any illusions that this was ‘normal’ were shattered. While his housemates went out on a Saturday night, Rob would stay in, bake a cake and eat it all before they got home. He had an overwhelming urge to eat and he had to satisfy it.
 
He still gets that urge almost every day. It’s like going into a trance. Thoughts of consequences are banished (although Rob knows very well what those consequences are) and if he gives in he eats until he’s so full that he has to stop. In the twelve years since this began, Rob’s life has probably looked more-or-less normal to all but the very few people who know about his condition. He’s studied for and got a PhD, worked as a lecturer and now as a project manager for a charity, got married, bought and renovated a house. All things that anyone might do. Rob doesn’t vomit to purge after his binges; he over-exercises. In particular, he cycles. But because he’s always loved cycling and has always cycled a lot, nobody thinks it strange that he rides 27 miles to get to work when it would be two miles if he went straight there.
 
Over-exercising keeps Rob fit and he’s physically healthy, but his eating disorder is mentally very debilitating. He’s battled depression on and off for all the time he’s had bulimia. He feels ashamed at his lack of self-control and at the things he’s sometimes done: stealing food from friends and eating out of bins. He feels guilty because he’s often withdrawn and so doesn’t show his wife the love she deserves, even though she couldn’t be any more supportive and understanding. His self-esteem is rock bottom because he feels that he’s constantly letting himself down. He feels hopeless because the cycle of binge and purge seems endless. He has no self-confidence because he feels like a failure, even though he’s achieved many things that he set out to achieve. Life is very often a struggle, despite appearances. But Rob is now trying harder than he’s ever tried, because he was presented with an opportunity in an unexpected guise. He was knocked off his bike and broke his collar bone, meaning no cycling for two months.
 
This was his nightmare come true: being injured badly enough that he couldn’t exercise. But he also recognised it as a golden opportunity: a chance to address the destructive eating behaviours that he’d persisted with for more than a decade. Rob’s collar bone has healed and he’s back on his bike now. His eating disorder hasn’t been so easily cured, but Rob feels for the first time that he can beat it. He’s realised that the cure, if that’s what it is, has to come from within. He has to want to get better. Want it enough that he’s willing to suffer when the urge to binge strikes, which means suffering most days. Want it enough to cling to the knowledge that if he doesn’t give in, he’ll feel immeasurably better the next day than if he does. Rob had cognitive behavioural therapy (CBT) for his bulimia about eight years ago, but he now realises that at the time he didn’t really want to get better. Or at least not all of him did. Some part of him was comfortable with bulimia; with the certainty of the binge and purge routine and the crutch it provided. But after twelve years that comfort has gone. Bulimia is nothing but a millstone now.
 
There’s no part of Rob that sees it as positive. So every day he’s searching for the willpower to eat normally, exercise but not over exercise, and resist the urge to binge. Rob’s been to his GP and is awaiting referral for another course of CBT. This time he hopes that he will make the most of it. And he’s started blogging about his experience of being a man with an eating disorder. Partly this is therapy: Rob finds that getting his thoughts and feelings out helps him to make sense of them. And partly it’s in the hope that someone in a similar situation might read what he’s written and find something helpful in it. If even that tiny positive could come from his experience, Rob would feel that all that energy used on bulimia over the last twelve years might not have been completely wasted. He knows it’ll be a long road and that he hasn’t binged for the last time yet, but at least he feels hope now. For him, that in itself is a crucial step on the path to recovery. Rob blogs about his experience as Bulimic Boy.
 
Visit his site at http://bulimicboy.blogspot.co.uk.
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