Table Of ContentBoys Get
Anorexia Too
Coping with male eating
disorders in the family
Jenny Langley
© Jenny Langley 2006
First published 2006
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Contents
Foreword
v
Author’s Note
vii
Preface
ix
Part One : About Anorexia in Boys
1
1.
What is anorexia and what are the effects?
2
2.
Boys don’t get anorexia, do they?
4
3.
Triggers for boy anorexia
5
4.
What to look out for
8
5.
Living with an anorexic boy
10
6.
Effects on the family
22
7.
Self-help
27
8.
Treatment options
31
9.
Therapy, therapy, therapy
43
10. Healthy eating
49
11. Caring for the carer
56
12. Returning to normal life
61
13. Do boys get other eating disorders?
65
Suggested Reading List
71
List of Useful Organisations
74
Part Two : Joe’s Story
75
14. Setting the scene – happy chaos
76
15. Decline and fall
82
16. The diagnosis – watch out for Rex
97
17. The treatment – heaven or hell?
107
18. Recovering too quickly? Watch out for Rex
131
19. Coming home – will Rex come too?
165
20. Moving on – Rex has gone!
172
v
Foreword
‘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, hopefully from an uninformed friend or relative rather than a
health professional.
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.
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. At Eating Disorders Association we know from callers to both our
adult and youth helplines that males can find it hard to believe that they may
have an eating disorder. Getting it diagnosed may be a struggle and finding
appropriate treatment can be very problematic.
It is reassuring that with the approval of her son, Jenny has decided to write
about the development of anorexia in boys and has taken the trouble to
investigate and write about the wider issues in a way that will be helpful to
parents and carers who are concerned about a young boy.
Any parent with an eating disorder in the family will know 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. Jenny writes about
the way in which the disorder crept up on her family and then seemed to take
over the household. Many parents will be relieved to know that they are not
the only ones to experience this powerful and generally negative mix of
emotions that surrounds and engulfs everyone nearby. Recent research
indicates that boys affected by eating disorders are much more likely to blame
themselves for their problems than girls do, complicating the already difficult
process of recovery.
Jenny was lucky that the team involved with Joe’s treatment involved her at
every stage of the therapy. Although Jenny and the team often had very different
views on Joe’s progress, and at times the relationship was very strained, she
and her family were never totally excluded. Many parents have found that
talking to their doctor and even psychologists and psychiatrists is often not
straightforward and many health professionals who struggle with these most
complex of disorders hide behind a smokescreen of ‘confidentiality’ adding to
vi
parents’ confusion and concern. Open communication and talking therapy
is the key to recovery from eating disorders and except for those few cases
where some form of abuse is at the heart of the problem, parents should be
informed and involved with the whole treatment process.
Nevertheless, it is important to differentiate between the confidentiality of
the consulting room and straightforward information about the progress of
treatment. The relationship between patient and therapist can be slow to
develop and difficult to unravel so it is entirely appropriate for the conversations
during therapy to be confidential in every sense of the word. However, being
prepared to discuss whether therapy is going as well as expected or is proving
more difficult without needing to go into detail is the sort of information that
should routinely be shared with parents or carers.
Many people find that pressured and confused health professionals can use
the age of a patient (the NHS recognises 16 years old as an appropriate age
for people to be treated as adults) to choose not to communicate with parents
and carers who nevertheless are expected to care for the sufferer when they
come home, either at weekends or at the end of the therapy. The Government
Mental Health National Service Framework clearly states that patients must
have a care plan that is drawn up with the involvement of the carer and
the National Institute of Clinical Excellence (NICE) guidelines specifically
recommend that all family members should be included in the treatment of
children and adolescents with eating disorders.
Sadly, many carers find themselves having to fight to be included in the
therapeutic process instead of being there by invitation from the professionals.
This leads to even greater stress and disharmony in the family. Many parents
and carers will find the practical tips Jenny provides on how best to approach
medical professionals initially, and how to stay involved as treatment
progresses, very useful.
As many parents have discovered, the problems do not disappear when the
hospital takes over and the slow painful climb of Jenny’s 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.
Steve Bloomfield
Head of Communications
Eating Disorders Association
vii
Author’s Note
It is common knowledge that eating disorders, and in particular anorexia,
are a girl thing, and we have all read articles containing startling facts
such as:
One in 20 women will suffer from an eating disorder in their lifetime.
In Britain, anorexia and bulimia have reached catastrophic levels.
Maureen Rice, Observer Sunday July 29, 2001
Of course it is also logical to assume that men and boys are not totally
immune, 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 12-
year-old son started to disappear before my eyes. He was a gifted child, in the
streamed class at school, and a great sportsman representing the school at
football, his main passion, as well as cross-country, athletics, rugby, cricket
and swimming, 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. Six months on and after three
and a half months in a residential adolescent unit, I am pleased to say that
he was well on the way to recovery. Two years further on and he is a thriving,
healthy and happy 15-year-old, 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.
The reason for writing this book, in which I describe our experiences and
outline the treatment options available, is that we felt totally alone as parents
of an anorexic boy. The eating disorder societies were very helpful and
sympathetic but could not put me in contact with other families who had
experienced boy anorexia. The professionals assured me that boy anorexia is
not unheard of, and especially in the younger age group the balance between
boys and girls is more even, but as far as I know there is no literature on
this specific subject. I managed to locate a couple of American books on
male eating disorders, which have been written in the last couple of years.
They were very interesting, and at least acknowledged that there has been
an explosion in the incidence of eating disorders in the male population over
the last few decades. This provided me with some comfort, but didn’t really
provide me with any guidance as to the best course of action, being a mother
viii
in the UK, watching her son starve himself almost to death in front of her eyes.
I would like to think that this book will give hope and practical guidance to
any family going through a similar experience.
Anorexia is a terrifying experience for any family to go through, but remember:
Boys can get anorexia too.
Anorexia can be beaten.
Look forward not back.
Never give up hope.
And most importantly, you are not alone.
•
•
•
•
ix
Preface
Tuesday 12 March 2002
Joe started moving around his room at 5.30 am. Since his weight had dropped
below 36 kg I knew he hadn’t been sleeping very well. I am a light sleeper
myself and was on a high state of alert to any sounds in the night from my
eldest son. His weight had dropped from 42 kg to 32 kg in just four months,
and he was in a constant state of agitation and anxiety. We were still awaiting
the results from endless blood tests, and had yet to rule out a seemingly
endless list of terrible diseases that could be the root cause. I had lain awake
night after night considering illnesses ranging from leukemia, and stomach
cancer, to thyroid problems, and glandular fever. But in my heart of hearts I
knew my son was suffering from an acute case of anorexia, and as every day
passed it was taking a firmer grip.
At 6.30 am, after an hour of intense repetitive exercise (mainly press-ups and
sit-ups) in his bedroom, Joe went downstairs. He liked to have breakfast on
his own, as he had become extremely self-conscious about eating in front
of other people, even within our family. I knew that if I tried to force him to
eat with us, or even to suggest he should eat a little more, he would become
deeply upset and eat nothing.
Getting from his bedroom to the kitchen involved a whole array of rituals.
Joe had become deeply superstitious and believed that some terrible fate
would overcome him if he did not do each and every one of his rituals,
which seemed to be increasing as each day passed. First Joe stopped at the
boundary between his bedroom and the hall. He stared, for a few seconds, at
the metal strip separating the two carpets, and then carefully stepped over
it, as if stepping on it might cause an explosion. Each step on the staircase
was like an individual challenge, with Joe placing first his right foot quickly
followed by his left foot on each individual step. Halfway down the stairs Joe
did fifty to sixty pull-ups as he could reach up to the banister on the landing
above. He then did another set of pull-ups when he walked past the stairs in
the hallway on the way to the kitchen. Once in the kitchen Joe would touch
all the surfaces on the way to the fridge. Breakfast for Joe used to be one or
two large bowls of cereal, but now it was the same everyday, a Muller Light
yoghurt. I had tried filling the fridge with high fat yoghurts, but then Joe would
have no breakfast at all. As for all his meals, Joe ate a little less each day.
