Fit to Die: Men and Eating Disorders
Publication Year: 2008
Subject: Eating Disorders Counseling
`This is a book that will be useful to carers, helping them understand the issues that affect male suffers and some of the barriers they will have to break down in order to recover. It will also reassure men affected by an eating disorder that they are not alone, their problems are understood b medical professional and that recovery is possible' - Signpost Anna has established herself as a leading author in the field of eating disorders and combines her personal experiences with an extensive research interest. Her two previous books published by Lucky Duck were winner and special commendation in the NASEN/TES book awards and we expect this publication to be equally well received. It would be a mistake to think that eating and ...
- Front Matter
- Back Matter
- Chapter 1: The Hidden Disorders
- Chapter 2: A History of Men and Eating Disorders
- Chapter 3: Anorexia Nervosa in Men
- Chapter 4: Bulimia Nervosa in Men
- Chapter 5: Compulsive Overeating in Men
- Chapter 6: Muscle Dysmorphia
- Chapter 7: Body Dysmorphic Disorder
- Chapter 8: Men and Their Emotions
- Chapter 9: Men and Depression
- Chapter 10: Eating Disorders and Homosexuality
- Chapter 11: Treatment
- Chapter 12: Healthy Living
- Chapter 13: Healthy Eating
© Anna Paterson 2004
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Published by Lucky Duck
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Fit To Die is Anna Paterson's fourth book, Her first book Anorexic (Westworld International, 2000) was an autobiographical account of her 14 year struggle with anorexia. Her second book Diet Of Despair (Lucky Duck, 2001) was a self-help book for eating disorder sufferers and those who care for them. Her third book Running On Empty (Lucky Duck, 2002) was a novel for young people about eating disorders and friendship. Running On Empty won a Times Educational Supplement NASEN Award in 2002 and Diet Of Despair was also commended by the judging panel.
Anna is now recovered and spends her time trying to help other eating disorder sufferers, who contact her daily. She works to raise awareness about the reality of these illnesses and is regularly asked to speak about her experiences. She lives with her fiancé Simon, who helps her with all aspects of her work including editing her books.
[Page 4]This book is dedicated to Raphael Teff – a very kind and thoughtful man, who is sadly missed.
I would also like to thank Simon for his dedication to this project and his constant support.
In addition, I want to thank The Author's Foundation & the K. Blundell Trust.
I hope that this book has provided some positive ideas about how to move forward with your life. If you are suffering from an eating disorder and have started to think that you would like to try for recovery, it is possible you may be feeling quite overwhelmed. When I was trying to decide whether to attempt recovery, it helped me to make a list of all the pros and cons of my illness. I carefully wrote down all the good and bad points of my eating disorder. How it was affecting my life? What was I losing because of the illness? Did I gain anything by remaining ill?
When I finally had the list complete, I looked down at the few positives I had managed to write about my anorexia and started to realise that these were negative as well. I felt that my anorexia kept me ‘safe’ and ‘protected’ from the world but why did I want to be protected? Living a full life may feel frightening and risky at times but it can also be exciting and fun.
I strongly recommend that you look at how your eating disorder is affecting your life. If you could take two things into a new life, what would you take? Would you take your eating disorder with you? Even if you do not feel that you are ready to attempt recovery, it is important to be honest with yourself about how your eating disorder is damaging your day-to-day living.
If you are already taking steps towards recovery, remember to give yourself plenty of praise for your achievements. Also, try not to be too hard on yourself if you have some setbacks. These are a natural part of recovery. Trying to be perfect is likely to have been one of the reasons why your eating disorder developed in the first place, so do not be afraid of the odd mistake. Everyone makes mistakes – that is part of being a healthy human being. However, if you are having trouble taking further steps forward then do not be afraid to ask for more help. Reaching out for more support shows that you are taking real control of your life.
If you are reading this book because you want to help a loved one who you feel has a problem, there are a few simple steps you can take. Simply offering to be there for them and to listen if they want to talk is likely to be of great benefit. It is natural to feel angry and upset at times but try to be as patient as possible. Remember that the sufferer is controlled by their illness and they feel depressed and frightened by the situation themselves. It is very important to work with the sufferer against the illness as a united team.
It is also essential to allow the sufferer to take their recovery slowly. Trying to change too much too quickly can force them back to the ‘safety’ of their disorder. A slow recovery is much more likely to be a permanent one.
[Page 108]Finally, I want to end by wishing you lots of luck. From personal experience, I know what it is like to suffer from a chronic eating disorder and feel very grateful that I am now in full recovery. Beating an eating disorder is never easy but it is very worthwhile.
Please feel free to visit my recovery website at http://www.annapaterson.com
My Story[Page 109]
From the age of three, I was mentally and sometimes physically abused by my Grandmother. She treated me badly in many different ways, repeatedly telling me that I was worthless, unloveable, ugly and fat even though I was none of these. She constantly played cruel tricks on me (such as force feeding me and abandoning me in shops) and gradually my self-esteem was destroyed. Many horrific memories remain, including the time when I was seven years old and my Grandmother forced me to walk through the Chamber of Horrors in Madame Tussauds. She told me that I was a revolting person and belonged in this place with all the other disfigured and damaged faces.
I saw my Grandmother every day in an attempt to protect my Mother. My Mother suffered from migraines and I realised that these headaches became worse whenever my Grandmother treated her badly. Quickly I learned that I could stop my Grandmother from being cruel to my Mother if I took all the abuse instead. I was too frightened to ever tell my parents about my Grandmother's ill treatment because she said that she would kill my parents if I spoke out about it, so I stayed quiet.
My Grandmother often told me that I was a failure and said that I would never do well at school. This caused me to work even harder at my studies and I would always complete my homework the night it was set. Even though my Gran didn't live with us, she was often in the kitchen with my Mother when I returned from school and I became afraid of going home. I began to join in all the after-school activities available, including swimming, hockey, computer studies and gymnastics. I was wearing myself out though and by the age of 13, my body was no longer able to cope with all the abuse and hard work and it began to shut down.
I developed glandular fever and after many months of illness was admitted to the children's ward of our local hospital. My Grandmother visited me every day and continued to whisper cruel words to me. At the same time, she told the doctors and nurses that she believed my parents were abusing me. The doctors decided to stop my parents from visiting so frequently and instead encouraged my Gran to visit more often. I became very unhappy and stopped eating, so the doctors prescribed adult doses of anti-depressant drugs.
Almost immediately, these powerful drugs caused me to start hallucinating. The doctors thought I was telling them lies to avoid doing my homework and just increased the dosage of the pills. The hallucinations became more frequent and I couldn't look at a page or blank wall without horrific images appearing before my eyes. A few days later another problem developed and I found that I was losing the [Page 110]ability to read and write. When I looked at a page of writing, the words began to swim and move around so that sentences became meaningless.
It took my parents a number of days to convince the doctors that I was telling the truth about my condition and the pills were stopped but the damage had already been done. After I left hospital, I slowly taught myself to read again with the help of a piece of card that isolated just a few words at a time. Over the next two years
I became used to reading and writing in this way and took all my ‘O’ level classes during this period. It wasn't until I began my ‘A’ level studies that I was able to read and write normally again.
By the time I was 17 we were having serious family problems. To help with her migraines, my Mother had been on tranquilizers since I was six years old. Now, 11 years later, she was taking a massive cocktail of them together with some very strong painkillers. She had disappeared into her own fantasy world and was writing strange poetry and letters to the singer John Denver. My Grandmother told me that my parents' marriage was in trouble and that they were going to get divorced. She said that this was all my fault.
It was then that I decided I had to disappear. I felt worthless and as if all I did was cause problems. I believed that I no longer deserved food and so stopped eating. I didn't feel this was enough punishment though and also began to seriously self-harm. Trapped in an impossible situation, I realised I was developing anorexia.
For the next four years my weight slowly dropped. I managed to keep my illness under control while my life was relatively calm but as soon as there was any extra stress, that dormant monster anorexia reared its head again. I left college at 19 because 1 was bullied by a ‘friend’ and instead started work in a solicitors' office. The first three months were fine but in time my boss began to treat me badly. My Gran's treatment had led me to believe that I deserved to be abused by anyone and he soon realised he could sexually harass and humiliate me. This behaviour continued for over two years.
By the age of 21 I was very ill. Two days after my twenty-first birthday, my parents told me that I was ruining their lives and making them both ill. The guilt I felt was tremendous but I simply couldn't eat, even for them. I felt totally controlled by an anorexic ‘voice’ in my head that sounded just like my Grandmother. It told me 1 was fat and ugly and had to starve myself. It yelled loudly every time I ate, repeatedly telling me I was a very bad person. I was now completely obsessed with food and did everything possible to avoid eating. Unable to force myself to eat, I grew extremely weak and had to give up my job as a legal secretary.
My parents took me to our family doctor who was horrified by my weight loss and immediately sent me to see a psychiatrist at our local hospital. She diagnosed [Page 111]anorexia nervosa and I felt as if my deepest darkest secret had been discovered. I felt ashamed and very alone. I had to agree to see a psychiatric nurse once a week but the shame I felt left me unable to share my true thoughts and feelings with her. Misled by my confusing answers to her questions, the nurse disagreed with the original diagnosis and started to treat me for the illness M.E. (chronic fatigue syndrome).
Relieved that the nurse no longer believed that I was suffering from anorexia, I fell even deeper into the illness becoming more withdrawn every day. Just after Christmas I felt so desperate and alone that I attempted suicide. Halfway through the attempt, I realised that my Mother would return home to find my dead body and I just couldn't hurt her in that way. I felt that 1 had already caused her enough pain by what 1 believed to be my ‘selfish’ behaviour. 1 put away the knife and bandaged my bleeding wrist.
Later that year, my Father retired from his job and we all moved to Cornwall to try and escape from my Grandmother. I managed to avoid doctors for three months but eventually we had to join the local health centre. The doctor 1 saw was horrified by my condition. During my physical examination, the nurse had discovered that I was trying to cheat the scales and they realised that my weight was now at a life-threatening level.
After just three months in my new home, 1 was confronted by two doctors who wanted to admit me to hospital. I tried to beg them to allow me to stay at home but my Mother said that she could no longer cope and I was admitted to my first psychiatric hospital. I was put on complete bed rest because my weight was so low that the doctors were scared that I could have a heart attack at any time. I should have been safe in the hospital but my Grandmother still managed to reach me there. She sent me letters telling me that my parents did not love me and asking why I didn't just let myself die? Instead of showing the doctors this evidence of her abuse, just as my Gran had instructed, I carefully tore up the letters and hid them at the bottom of my waste bin.
After a month, I had gained six pounds and managed to convince the doctors to discharge me. I began weekly therapy that increased to daily therapy as my weight slowly began to fall again. I had left hospital determined that the anorexia would never win again but after a few weeks at home, it had regained control and the ‘voice’ was louder than ever. I was once again lying and cheating so that I could lose weight. I hated myself every time I pretended I'd eaten or hidden some food but I felt 1 had to obey that ‘voice’. My parents tried to force me to eat more but this just led me to become even more cunning and secretive.
One horrific day, two years after my release from hospital, 1 managed to totally block the drainage system in our Cornish home. 1 can still remember the complete [Page 112]terror I felt when I heard my Father's words: “She's really done it this time! Idon't want to call her my daughter any longer!” My Mother was equally angry and said that she didn't believe my Father would ever forgive me. I vowed never to hide food or cheat the scales again but anorexia is a very powerful illness and that whispering ‘voice’ in my head soon took back control.
Three years after the first hospital admission, my weight had dropped to its lowest ever. I was seeing a psychiatric nurse every day and he was measuring out tiny portions of food for me to eat but my body could no longer process solid food. Even though I was eating, I was losing more weight every day. I tried to fool the doctors into believing I was heavier than I really was but eventually my tricks were discovered and I found myself back in hospital again. This time I was admitted to an eating disorders unit 200 miles from my home, where I was told that 1 was now just hours away from death.
Looking in the bathroom mirror for the first time since my illness had begun, I saw how I really looked. I was a walking skeleton, with my skin stretched tight over bones. My face had become a skull and when I smiled, it looked like I was wearing a horror mask. For that brief period of time I could understand why everyone was so worried.
The hospital saved my life and I stayed there for six months, working hard at therapy sessions each day. I wasn't completely honest with the doctors though, as the anorexic ‘voice’ in my head was still very powerful. I had learned so much therapy over the years that I was just repeating it back to them without feeling anything. My occupational therapist did realise what I was doing though and decided to play me the REM song “Everybody Hurts”. As I heard the lyrics about holding on and never giving up, I broke down for the first time and started to talk very vaguely about my Grandmother's abuse. When 1 was discharged from the hospital a few months later, I was physically better but mentally and emotionally I was still very ill.
For the next five years, I lived at home with my parents. The confidence I had developed in hospital slowly began to disappear. I had been able to talk and joke with anyone in the hospital but once I was home, I started to hide in my anorexic shell again. Gradually my weight dropped once more, although I managed to maintain it at a level just high enough to keep me out of hospital. I started my own needlework business but this just gave me another safe reason to stay hidden at home. I led a very isolated life, seeing only my therapists. The few times I went out were with my parents and we lived a very controlled, timetabled existence. I was an adult woman, living the life of a child.
At the age of 29 I felt that my life would never change. I believed that 1 would always have anorexia and although it stopped me from doing so much, I could see no other options. The loneliness eventually became too much to bear and I joined [Page 113]a pen pal club. Through this group I met Simon, who I soon learned also suffered from low self-esteem. For the first time in my life, I felt able to tell someone about the abuse and my anorexia. This was the real start of my recovery because Simon was able to show me that I was not the terrible person my Grandmother had always told me I was. Slowly I began to realise that I did not need to punish myself by starvation and self-harming. I learned to trust Simon's view of my body rather than my own distorted anorexic view.
Simon was the first person to show me unconditional love and after a few months, we became engaged. With Simon's help, my recovery continued and I am now living a fulfilled happy and healthy life. Recovery is not easy or quick and the fact that Simon was willing to stand by me however long this took gave me the courage I needed to keep making progress.
I decided to share my experiences in the hope that I could help other sufferers beat their eating disorders. I wrote my autobiography Anorexic and soon found that many people began writing to me to share their own experiences. I began to realise just how huge a problem eating disorders really were and how little practical information and advice there was available. This is was why I wrote Diet Of Despair, a self-help book for sufferers and their families. I have since also written Running On Empty, a novel for young people about eating disorders and friendship. Through my books, I hope that I will be able to help sufferers and their friends and families to fight these killer diseases.
- Abuse – To mistreat a person either mentally, physically or sexually.
- Aerobic Exercise – Increases oxygen production by raising the heart rate, for example jogging, swimming etc.
- Amphetamines – A drug that is used as a stimulant and which, at first, causes a person to feel very wide awake.
- Appetite suppressants – Medications that stop a person from feeling hungry.
- Assertiveness – An ability to put forward your point of view and opinion.
- Bigarexia – Where a sufferer believes that they are much smaller than they actually are. Sufferers generally tend to focus on the size of their muscles in particular.
- Bingeing – When a person eats large quantities of food in a short space of time.
- Body Dysmorphic Disorder – An illness where the sufferer believes that parts of their body are extremely ugly.
- Body Mass Index (BMI) – A method for indicating the weight status of adults and measures weight in relation to height.
- Bulimarexia – An illness that combines the symptoms of both anorexia and bulimia.
- Calorie – A unit of energy obtained from food.
- Cognitive Behavioural Therapy – A form of therapy that uses positive thoughts to reverse negative thoughts and feelings.
- Comfort food – Food that people turn to for comfort when they are feeling low, such as chocolate pudding.
- Constipation – This is when someone has trouble passing waste products (faeces).
- Counsellor – A trained professional who deals with mental and emotional problems. They use a combination of empathy, unconditional positive support and congruence (emotional honesty).
- CPN – An abbreviation for Community Psychiatric Nurse.
- Dehydration – A lack of water in the tissues of the body, often caused by vomiting or laxative abuse. [Page 115]
- Depression – A mental state of great sadness.
- Diabetes – A disease where there is too much sugar in the blood due to a lack of insulin.
- Dietician – An expert in diet and nutrition.
- Distortion – A misrepresented and warped view.
- Diuretics – Otherwise known as water pills, these medicines increase the production of urine.
- Dysfunctional – Not working properly.
- Ectomorph – People with an ectomorphic body tend to be underweight. This is the typical ‘model’ build. They often have trouble putting on any weight, however much they seem to eat.
- ED – An abbreviation for ‘Eating Disorder’.
- ED-NOS – An abbreviation for ‘Eating Disorder Not Otherwise Specified’.
- Electrolytes – Otherwise known as ‘salts’, these are chemicals such as potassium, sodium, magnesium and chloride which are necessary to keep the heart rate constant.
- Emetics – A medicine used to make people vomit.
- Endomorph – An endormorphic body is quite sturdy and not too tall.
- Endorphins – A chemical produced naturally in the brain during exercise, which brings about a feeling of well-being and happiness.
- Exposure therapy – A type of therapy whereby a sufferer slowly confronts their fears in a controlled environment.
- Fasting – When a person goes without food for a number of hours or days (otherwise known as ‘starving’).
- Genetics – The study of which characteristics we inherit from our parents.
- Gonadatropin – A hormone that controls testosterone production.
- Gynaecomastia – Affects men and is a slight enlargement of the breasts during puberty.
- In-patient – When a patient is admitted for a stay in hospital.
- Insomnia – Sleeplessness and restlessness at night. [Page 116]
- Insulin – A hormone produced by the pancreas that controls the amount of sugar in the blood.
- Internalise – To turn your feelings inwards.
- Lanugo – A fine covering of dark hair that grows on the body of an anorexic.
- Laxative – A medicine which causes the bowels to empty more often.
- Liposuction – A surgical procedure in which pockets of excess fat are drained away.
- Menstruation – The discharge of blood once a month (otherwise known as a ‘period’) when an egg is unfertilized.
- Mesomorph – People with a mesomorphic body type tend to keep their weight very level. They are usually quite tall and angular in shape. They are generally more muscular than endomorphs. They can gain or lose weight quickly but usually keep their weight stable. Even at a young age, mesomorphs generally look slightly older.
- Metabolic rate – The speed at which the body burns up food.
- Metabolism – The way that the body uses food to keep itself functioning.
- Obesity – A condition where the sufferer is at least 20% above the recommended weight for their height.
- Obsessive-compulsive – A condition in which the sufferer feels compelled to repeat rituals and live by strict rules in the belief that it will keep them ‘safe’.
- Oedema – A condition where fluid collects in the body tissue, especially around the ankles.
- Osteoporosis – An illness caused by a loss of bone mass, which usually develops in middle age. Bones become brittle and are at risk of breaking.
- Out-patient – When a patient has treatment on a daily or weekly basis at a hospital or clinic but does not stay overnight.
- Passive-aggressive – Expressing anger through indirect means.
- Pituitary – A gland in the brain which releases hormones and works with the hypothalamus.
- Pounds – A measurement of weight, which can be written as ‘lbs’.
- Psychiatrist – A medically qualified doctor who specializes in the treatment of mental and emotional problems. [Page 117]
- Psychologist – A person who, although not a medical doctor, is specifically trained in the treatment of mental and emotional problems.
- Puberty – When a young person's body begins to change in preparation for adulthood.
- Purging – When a person takes laxatives in large quantities to empty the body of all waste products.
- Restrict – When a person is limiting their diet and avoiding certain foods.
- Reverse anorexia – See ‘Bigarexia’.
- Rituals – A series of repeated behaviour patterns.
- Section – When a doctor has to legally force a patient to accept treatment.
- Self-esteem – Your own opinion of yourself.
- Serotonin – An important substance for normal nerve and brain functioning. It is often associated with levels of happiness.
- ‘Six-pack’ stomach – Where a man's stomach is ridged so as to resemble a six-pack of beer.
- Starvation – The condition caused when a person doesn't eat enough food.
- Testosterone – A male hormone.
- Vegetarian – A person who does not eat meat.
- Vomiting – When someone is physically sick and brings up food they have recently eaten.
- 28 grammes = 1 oz
- 454 grammes = 1 lb
- 600 millilitres = 1 pint 16 oz= 1 lb
- 14 lbs = 1 stone
List of Useful Addresses[Page 118]Eating Disorder Associations (Worldwide)Eating Disorders Association
National Association of Anorexia Nervosa and Associated Disorders (ANAD)
- First Floor, Wensum House
- 103 Prince of Wales Road
- Norwich NR1 1DW
- Telephone Helpline: 0845 634 1414 (8.30am − 8.30pm Weekdays)
- Youth Helpline: 0845 634 7650 (4.00pm-6.30pm Weekdays)
- E-mail: firstname.lastname@example.org
- Website: http://www.edauk.com
British Columbia Eating Disorders Association
- P O Box 7
- Highland Park
- IL 60035
- Hotline: 847-831-3438
- Fax: 847-433-4632
- E-mail: email@example.com
- Website: http://www.anad.org
Eating Disorders Association
- 526 Michigan Street
- Victoria, BC
- Canada V8V 1S2
- Tel: 250.383.2755
- Fax: 250.383.5518
- Website: http://www.preventingdisorderedeating.org
The Eating Disorders Association
- P O Box 80 142
- Green Bay
- Auckland 7
- New Zealand [Page 119]
- Tel: 09 818 9561; 09 627 8493; 09 523 3531; 09 523 1308
- E-mail: firstname.lastname@example.org
- Website: http://www.everybody.co.nz/support/eating.html
- 53 Railway Terrace
- Queensland 4064
- Tel: (07) 3876 2500
Therapy and Counselling OrganisationsThe Institute of Family Therapy
- For after hours help – Lifeline: 131114
- Children's Helpline: 1800 551800
- Parents Helpline: 1300 301 300
- Website: http://www.uq.net.au/eda/documents/start.html
United Kingdom Council for Psychotherapy
- 24–32 Stephenson Way
- London NW1 2HX
- Tel: 020 7391 9150
- Fax: 020 7391 9169
- Website: http://www.ift.org.uk/
[Page 120]United Kingdom Register of Counsellors
- 167–169 Great Portland Street
- London W1W 5PF
- Tel: 020 7436 3002
- Fax: 020 7436 3013
- E-mail: email@example.com
- Website: http://www.psychotherapy.org.uk
Other Useful OrganisationsChildline
- P O Box 1050
- CV21 5HZ
- Tel: 0870 443 5232
- Fax: 0870 443 5161
- E-mail: firstname.lastname@example.org
- Website: http://www.bac.co.uk
- Freepost 1111
- London N1 0BR
- Tel: 0800 1111 (Open 24 hours a day, 7 days a week)
- Website: http://www.childline.org.uk/
Victim Support (England and Wales)
- Tel: 0845 790 9090 or 0114 245 6789 (help 24 hours a day)
- E-mail: email@example.com
- Website: http://www.samaritans.org.uk
- Cranmer House
- 39 Brixton Road
- SW9 6DZ
- Tel: 0845 30 30 900
- (Low-call rate: 9.00 am − 9.00 pm weekdays, 9.00 am to 7.00 pm weekends)
- Tel: 020 7735 9166
- Fax: 020 7582 5712
- E-mail: firstname.lastname@example.org
- Website: http://www.victimsupport.org.uk