University of Southern California Dissertations and Theses

A silent disease: men with eating disorders

(USC Thesis Other)

A silent disease: men with eating disorders

PDF

Download a page range

Download transcript

Copy asset link

Request this asset

Transcript (if available)

Content A SILENT DISEASE: MEN WITH EATING DISORDERS by Lawrence James Dechant ________________________________________________________________________ A Thesis Presented to the FACULTY OF THE USC GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree MASTER OF ARTS (BROADCAST JOURNALISM) May 2012 Copyright 2012 Lawrence James Dechant ii Table of Contents Abstract iii Introduction 1 The Patient 3 Treating the Disease 14 Appendix: Levels of Treatment 23 Bibliography 24 iii Abstract The National Association of Anorexia Nervosa and Associated Disorders released a study that said one in ten cases of eating disorders involve males. The website says “many people believe that only white girls are affected by eating disorders, however, in reality, no ethnic, gender or socioeconomic group is immune to the dangers of this disease.” This statement means more than ever for John Simmons, who was diagnosed with an eating disorder in September 2011. Although several factors contribute to the lack of admission by men having disorders, societal pressures and gender stereotypes are the two main issues preventing these men from admitting to having this disease. As these societal pressures lessen and men like Simmons become more inclined to seek treatment, the number of men who are diagnosed with eating disorders may rise. 1 Introduction: Men with Eating Disorders Eating disorders in the United States are now commonplace and have the highest mortality rate of any mental illness, as cited in the American Journal of Psychiatry. In the United States today, 24 million people of all ages and genders suffer from an eating disorder, which include anorexia, bulimia and binge eating disorder, according to The Renfrew Center Foundation for Eating Disorders, the first residential treatment facility established in the U.S. Of these 24 million, 2.4 or 10 percent are male. This number is steadily climbing as the breakdown of gender stereotypes has allowed more men to admit to their disease. However, the diagnosis and recovery are still frequently complicated by a man's reluctance to seek treatment, since society generally regards an eating disorder as a "woman's issue." Men are often less likely to seek treatment for an eating disorder because of the perception that they are “women’s diseases,” according to the American Psychological Association. The fear of being labeled “feminine” or “gay” is also a deterrent for some men struggling with admitting to their disease. Men with eating disorders, like their female counterparts, can fall into any of the categories above. But when a patient with an eating disorder does not meet the strict criteria for either Anorexia or Bulimia Nervosa, yet still has significant concerns about eating and body image, he is placed into the Eating Disorders Not Otherwise Specified Category (EDNOS). This category has been shown in some studies to have the highest death rates of any category of eating disorder, according to the National Association of Anorexia Nervosa and Associated Disorders. EDNOS can result in several health 2 complications like malnutrition, dehydration, gastric rupture due to severe binge eating, and even death. For college sophomore John Simmons, this disorder is all too familiar. After researching men with eating disorders, I wanted to find one who would be willing to tell his story. So, after repeated phone calls to several eating disorder clinics across the nation, I found the Eating Disorder Center of California, where Simmons is a patient. Simmons told me he wanted to help relieve the stigma placed on eating disorder patients, especially men, and explain to them that seeking help for a disease that is often overlooked is crucial to the healing process and most importantly to their survival. At 6 feet, 2 inches tall, Simmons has the demeanor of a young college student with big dreams. His love of music and film are driving motivators that help him get through life and cope with his disease. In order to tell his story fully, he asked that his name not be included and a pseudonym be used instead, so that he could fully disclose everything he was feeling and going through during this difficult time in his life. His story is the story of many young people with undiagnosed eating disorders who are badly in need of treatment. Here are two chapters in the story of John Simmons, a young man with big dreams and a disease he is trying to overcome. It is his hope that others his age will read this, and use his story as a means of self-discovery and recovery. 3 The Patient On September 12, 2011, John Simmons arrived at college ready to begin his sophomore year. After a bad breakup, he was ready to start anew and requested a room change after learning his ex-girlfriend was living in the same building as he was. Little did Simmons know his next-door neighbor would be his ex, and she would serve as a catalyst towards a downward spiral that would affect Simmons’s health and endanger his life. “I was extremely tied to her for my sense of self-confidence and when we broke up and seeing her around, it was extremely painful. It was more than just a breakup because of how closely I was tied to her and dependent on her. I just felt worthless and I felt unlovable,” Simmons said in a recent interview. “I didn’t have the confidence and the tools I have now that would let me be sad and disappointed about the situation and not let it affect my view of myself and of my eating.” Like many men before him, John Simmons, was not just experiencing a loss of a significant relationship in his life, but a loss of self-control -- a loss so great that it thrust him into a life-threatening eating disorder. As the disease took its toll, Simmons, who stands 6 feet 2 inches tall, melted down to 142 pounds. The average weight for a man that tall, aged 20 years or over is 195 pounds, according to the federal Center for Disease Control and Prevention. During that time, Simmons was purging uncontrollably and restricting his food intake in order to cope with the anxiety he was feeling not just about the breakup, but about inner demons he did not know existed. 4 “I was struggling to eat something during the day. My stomach was doing flips all day,” Simmons said. “I was extremely anxious and I was extremely upset. I had been struggling to try and gain some weight. Before then, I was able to maintain my weight although low, but I was able to maintain it. I was trying to gain weight and that was really hard, and when I went to school it was impossible to maintain.” Abby Rubin, a therapist who treated Simmons for five months, said his eating disorder was directly correlated with his extreme anxiety. She said Simmons struggles about being perfect, about his relationships, his family and his future. He worries about being an adult and being independent. “He is very sensitive and he feels everything and that can be very overwhelming,” Rubin said. “His body and mind are very disconnected, and he didn’t know how to talk down to his body.” Simmons said he began restricting his food intake at a young age. Rubin said it was this early restriction that made it hard for Simmons to follow a routine after restricting for so many years. “That was part of it,” Rubin said. “Then the string of events with the girlfriend that made it harder to eat and he was eating an even smaller amount than he was eating before. And when he was confronted with this turmoil, he was purging more. I would guess he wasn’t eating a normal amount to begin with and then he was still restricting and people didn’t notice that.” “I never really tried to gain weight, so it wasn’t really a struggle and I guess the reason I went under the radar was because we just thought my metabolism would 5 increase as I got older and I hit puberty,” Simmons said. “My parents and I kept thinking that I would just fill out and when that didn’t happen we started worrying.” Simmons said he couldn’t pinpoint when his eating disorder began, only when it escalated and affected his health and threatened his life. “I think I have struggled with it for years, it is really difficult. I used to just think I was skinny and I don’t know when it started to become a problem. The earliest times I would want to gain weight and I couldn’t do it was two years ago. It wasn’t a big problem, like it wasn’t life threatening, and I wasn’t in the anorexia range, I was a skinny guy,” Simmons said. “I wouldn’t really eat breakfast. I would probably have two meals and a late night snack. It wasn’t obvious. I was eating a fair amount of times during the day and it wasn’t abnormal and it didn’t look abnormal to people. But, because of my height, I should’ve been eating a lot more than what I was. So, it really takes going to a professional (and) laying out exactly what you eat every day and them telling you where you’re at.” “Being in school, middle school was particularly tough and cliquey,” he said. “I felt like I had to be on top of things to make sure I didn’t say the wrong things, plus I felt that same way at home.” His family life has always been good, he said. Simmons was born in 1992 in Santa Monica, California, and moved to nearby Pacific Palisades were he has lived ever since. He said he had a “normal” childhood, lots of friends, and his parents “were very loving and by most accounts very normal.” However, he said his parents reacted differently when it came to him expressing negative emotions. 6 “My parents did not deal with conflict very well so I was constantly being checked when I had an emotion that was on the extreme. If I was energized I was hyper or manic and/or when I was mad I was often violent and depressed. I felt like I had to live in a box and never went extreme in my emotions. Having to be emotionally restrictive was a key factor in my anxiety,” Simmons said. “I was set up to be perfect in any situation, and I was afraid to say the wrong thing and wanted to be perfect in relationships, needing to be perfect in situations for fear of being called manic and abusive. I still have a very difficult time doing anything that adversely affects someone whether it is justified or not; making someone sad or angry and I feel like a monster because of how I was raised.” Simmons said arguments with his parents where he was “loud and very intense,” would often result in his parents labeling him “abusive.” “If I was having an argument with my parents and I was a little pissed off they would say John you are being so abusive and terrible. With that, I learned that I couldn’t be angry and I couldn’t express my full range of emotions. That made me extremely anxious,” he said. “The lid would come off and I would be really really angry and they would say I was being very abusive.” Although Simmons felt his parents were not receptive to his emotions initially, he said they have been very supportive during this time. He also said they have attended several therapy sessions in order to work on dealing with their emotions which he said has “decreased the level of anxiety within the household.” “I am very lucky to have such supportive parents who are willing to work on 7 what they are going through and work with me. I never really had to do that,” he said. “Having a lot of family sessions with my parents, laying out a bunch of things, telling them they never let me get bad and told me I was abusive, every time I raised my voice, I felt very suppressed by that so that contributed to a lot of the anxiety. I depended on a lot of people including my parents, relationships and my self-worth, and I didn’t feel that secure with myself. I had many tumultuous relationships and had to work perfectly in order to be around people. And my parents have been very understanding and have helped me work through all of these issues.” Seven days after Simmons entered Wesleyan University in Connecticut, his downward spiral worsened. He stopped eating and began engaging in what he said was “reckless behavior.” “I was there [at school] for a week and I was losing weight, I was depressed, and going to parties and was being reckless and my friends were worried,” he said. “My best friend called my parents and told them what I was doing. The next day, they came and got me. We went straight home.” Simmons said he was hesitant to leave school at first, but began to grow worried when his clothing became too loose for him to wear. “I was losing a lot of weight and my jeans didn’t fit and that freaked me out,” he said. “And my parents came and got me, and I didn’t want to do it at first because I didn’t feel like there was a way to get better. I thought I had to pull myself up from my bootstraps. It was hard to leave school, but I didn’t fight my parents too much because I was scared myself.” 8 He spent three months at Rogers Memorial Hospital in Wisconsin, one of the few facilities in the country that treats male eating disorders. He entered a residential program and lived in the facilities provided by the hospital to begin treatment. There he began the rehabilitation process focusing on his eating habits as well as trying to discover the root of his eating disorder. “The kind of work that I did was working on being more comfortable speaking up for myself, being more confident, being less dependent on external factors and more dependent on myself,” Simmons said. “That has been the biggest thing. My anxiety a lot of the times stems from needing to please a lot of people and having to make sure I was ‘perfect’ in order to make sure everyone was getting along in my family, my relationships. That stress was really, really tangible and it made eating difficult.” “In the beginning, (at Rogers Memorial) I was so underfed that once I started getting on that schedule I was ravenous and hungry all the time. It was hard for the first week and a half and then I got on the schedule, and I wanted my meal plan increased,” Simmons said. “Once I reached a more normal weight it regulated. It wasn’t that bad being held accountable for stuff. I actually knew it was necessary and I never viewed it as a pain because it was helping me.” For Simmons, his desire to gain weight is what set him apart of his fellow female counterparts, most of who desire to be thin. He did however, relate to the anxiety in his female counterparts and how it affected his body and mind, as well as his thinking about foods. 9 After three months at Rogers Memorial, Simmons returned to Southern California and entered an outpatient program at the Eating Disorder Center of California. “In Simmons’s case, he came in and wanted to gain weight and wanted to eat foods that he was eating before. That was unique. That’s the underlying reason he wasn’t eating the food or purging that was similar to others,” EDCC Dietician Brooke Glazer said. “I think it goes to everybody in general sometimes their stomachs don’t know. By eating by the clock, you’re stomach starts to kick in and feel hungry at those designated times.” After being in rehab for six months, Simmons is still in treatment, but is going to be discharged within the next couple of weeks. Rubin said in order for him to be successful in everyday life Simmons must form a support team consisting of a therapist, dietician and a plan of action. This plan must be something that keeps Simmons busy daily and helps him maintain a structure throughout the day. Simmons is currently a healthy 189 pounds -- a 45-pound weight gain since September of 2011. He has also been prescribed “heavier medications,” that help him deal with his anxiety, but he said he is trying to avoid heavier medications and take only those he needs to thrive. “I am nourished within my body, mind, and soul. It went so much deeper. I feel really good, that is a big difference with me,” he said. “I love it, I feel so much safer and my brain works better. It has been a really positive experience for me.” Simmons said that although he feels better than six months ago, he still struggles with many issues that have affected his eating. He said when these issues arise he realizes 10 that his need to be perfect and not make people feel bad can’t always be avoided and are a necessary part of life. “I am confident in my soul and I acknowledge my humanness on a day by day level,” he said. “I may feel bad for hurting someone’s feelings or telling me I’m a bad musician and it is that ability to make mistakes and be okay with it that has helped me grow and begin to overcome this disease.” Confidence and less anxiety are the two critical issues Simmons struggled with during treatment and he said they are the two issues he has learned to foster and accept. “I am a lot more confident, a lot less anxious, but most importantly those things are still there and everybody has those days they don’t feel so hot. The difference is, I am able to take it day by day and if I am feeling that way I can still eat my food,” he said. “And of course, those times come less now but even when they do I have a larger overall confidence in my ability. It comes from confidence, if you have the confidence you don’t have to let it affect your eating. I feel confident all the time on like a deeper level. I feel that I am worthwhile. I’ve shared so much of who I am in very intimate settings with a lot of people and shown who I am with no restrictions, and have been accepted. And if someone isn’t appreciating me, I can take it because these people I have shown my whole side to appreciate me.” After his discharge from the EDCC, Simmons said he will continue treatment from an outside team, will attend alumni therapy sessions at the EDCC, and he will engage in activities he loves. 11 “I do everything. I’m into music like electronic music, indie rock. I play guitar and piano and sing and compose,” Simmons said. “I have a sketch comedy group that does YouTube videos, act in plays, musicals. I am trying to figure it out and I would love to do something artistic in the music field or movie business and I want to figure out what I am best at.” Simmons’s path to recovery has been a long one, but he said he doesn’t regret his decision to seek treatment. If anyone is suffering from an eating disorder whether they are male or female, he said it is important to seek treatment. “It is important if things are getting dangerous. If people are worried about you and there is some actual worry about your state of being you need to go to inpatient rehab,” he said. “In a perfect world the highest rate of recovery is going from the highest level of care to the lowest level of care and having smooth transitions. You can have so much support-wise and so much more time to work on the underlying issues. It is a disease. It’s a very deep-rooted thing sometimes, if it truly is an eating disorder. It is hard to beat any disease if you are on your own, there’s a lot of stigma about eating disorders. In our society, you are supposed to pull yourself up by your bootstraps, like why can’t you eat a fucking cheeseburger? It is something that has to be worked on every day.” Simmons said a main reason for him coming to terms with his eating disorder and wanting to tell his story, was because he wanted to make sure people suffering with eating disorders know there is help out there. He said he cautions anyone who thinks they are on the verge of an eating disorder to evaluate their situation and seek treatment. 12 “For someone who does think that they are struggling with something weight related, or if you are a very skinny person and you feel like you have a high metabolism and you think you are picky or don’t eat a lot you should get that checked out with an eating disorder specialist, because a lot of the time your doctor doesn’t know based on your body mass index (BMI),” Simmons said. “I was in the right range of BMI and I was never told something was wrong by one of my physicians and it took an eating disorder specialist at that point, and even then, it still didn’t make sense to me that I had an eating disorder. Go to one of those people and have it checked out.” Simmons is now studying film at Wesleyan University but is currently on medical leave until the fall. Until he returns to school, he said he is looking for internship opportunities and continuing taking music lessons, a favorite pastime of his. He said he takes his disease day by day and hopes one day to reach full recovery. Until then, he will work towards recovery and said he has learned valuable lessons along the way. The most important lesson he said he learned was to be confident and know that his life is a life worth living. “I’ve learned truly that I do not need to be perfect, and I acknowledge my human nature and sometimes I make people feel bad and am not always in the perfect situation, and that has alleviated all of the pressure,” Simmons said. “Because I have found this, eating has become easier. Those two things are what I meant by a deeper level. Spiritually, I am confident in my soul, I acknowledge my humanness on a day-by-day level. I may feel bad for hurting someone’s feelings or telling me I’m a bad musician and 13 it is that ability to make mistakes and be okay with it that has set me free. I am freer now, I am eating now, and most importantly I am really happy.” 14 Treating the Disease The National Association of Anorexia Nervosa and Associated Disorders released a study that said one in ten cases of eating disorders involve males. The non-profit group says on its Website that while “many people believe that only white girls are affected by eating disorders … in reality, no ethnic, gender or socioeconomic group is immune to the dangers of this disease.” Although John Simmons’ eating disorder is common among eating disorder patients both male and female, but it does not have a name, since the disordered persons meet only some of the criteria for anorexia, bulimia or binge eating. Instead, the updated Diagnostic and Statistical Manual of Mental Disorders (DSM-V), to be published in May of next year by the American Psychiatric Association, will list cases such a Simmons’ as Eating Disorder Not Otherwise Specified, or EDNOS. “It is pretty common,” Simmons’ therapist Abby Rubin said. “With Anorexia Nervosa, while he [Simmons] was restricting food and underweight, he was purging involuntarily, and he doesn’t have a fear of gaining weight, so that is why he didn’t fit under the conventional categories.” Simmons began treatment at Rogers Memorial Hospital a facility in southeastern Wisconsin, near Milwaukee, that was the first provider in the nation to offer treatment for men and boys with eating disorders. Simmons underwent a series of treatments, including being “re-fed,” or training the body to re-feed itself by providing structured meals and snacks at the same time every 15 day. In eating disorder cases, re-feeding is difficult because the body has become accustomed to thriving on minimal food intake. “The first thing, getting re-fed, really helped,” Simmons said. “There is a really interesting thing when you’re at that low level of weight, it doesn’t just affect your body, it affects your brain. You are so underweight and just getting re-fed helps with your anxiety. It helps your brain and your brainpower, which people don’t really understand. People that are going through recovery and are doing the same work, there’s a commonality among them: they are underweight, they are slow, speak slowly, they are tired, it’s because their brain is tired too. When they get re-fed they are faster thinking, their brain has been fed and it helps with your mental faculties. Getting re-fed, having structure, and being on your own helped a lot.” For Simmons, the biggest challenge was having someone hold him accountable for his eating. “The first thing was, you had to do it,” he said. “The biggest thing was meal support which was you had three meals, three snacks every day and you had to finish it. Having that structure was 70-80 percent of what helped me every day, because it was really hard to hold yourself accountable when you are struggling when you are outside on your own.” Simmons said two staff members watched him eat everything on his plate, every day, a daunting task for someone who has extreme anxiety about food, he said. For Simmons, regimented eating or “re-feeding” himself was only part of the rehabilitation 16 process. He said it was his extreme anxiety about life’s woes and his constant desire to “people please,” that all contributed to his eating disorder. After three months, Simmons left Rogers and entered a program at the Eating Disorder Center of California (EDCC) in Malibu, Calif., where he underwent 6 ½ hours a day of therapy and group sessions, as well as continuing the “re-feeding” process, or training the body to re-feed itself by providing structured meals and snacks at the same time every day. “We look at each client in a case by case basis and we have basic meal plans which is just an average plan based on the number of calories needed in a day,” EDCC Dietician Brooke Glazer said. “This plan includes three meals, three snacks a day. In Simmons’s case, the base meal plan was way to small for him to maintain his weight and gain his weight. So we had to modify our basic meal plan to accommodate his weight gain.” Glazer said the patients, including Simmons, had to wake up each morning at the same time, eat breakfast, lunch and dinner at the same time, as well as two snacks in between lunch and dinner. She said the reasoning behind this regiment is because a structure is the most important component to recovery for an eating disorder patient. When dieticians provide meal plans to their clients, calories are never mentioned, Glazer said. “We don’t talk calories here so he was given a meal plan of how much food he should eat instead of how much weight he should gain,” she said. “We want our clients to 17 gain weight of course, but our focus is to work on the behavior and of having an eating regiment.” Glazer said another part of treatment is teaching their clients there is no such thing as “good or bad foods.” “We don’t need to tell people to eat healthy, we just say eat the foods that you like to eat in moderation and make sure they were balanced,” she said. “Oftentimes, people label foods as good or bad and the perception of those foods often change. So like a pizza might become charged as good or bad. So the perception of the food changes and then your perception of yourself often changes as well. When you label pizza as bad you start to feel bad about yourself for eating pizza. We hear it a lot in society. People say I was so bad today I ate all these bad foods, and I am bad, and that’s not the case.” Glazer said Simmons had a hard time initially adjusting to some of the foods, because of his anxiety and his pickiness. She said the meals never restricted certain foods, but made sure it was a balanced meal with all of the necessary food groups represented and the correct portion sizes. If clients don’t like a meal, the health drink Ensure is used to supplement a snack and/or a meal. If Ensure is used to replace a meal, Glazer said the number of cans a client must drink is dependent on the calories needed for that day to complete that meal. “With Simmons and many of our patients, we use Ensure to help supplement a snack. If he was having a problem at times its helpful to use Ensure to supplement for meals. Each of his meals here included an Ensure, because of his size,” she said. 18 Simmons’ therapist, Abby Rubin, said subsequent family therapy sessions were a necessary component to helping Simmons recover. “He went through a lot of tough family work, which was crucial because they learned as a family to communicate,” she said. “They all put in a lot of work and I think that hard work is paying off.” Aside from family group sessions, Simmons also underwent food and group support. He attended different therapy groups including process group, which allowed him to share daily struggles, trials and tribulations. He attended group sessions called Food and Feelings, where he discussed with fellow patients about meals and how it impacts their daily lives. He also attended Cognitive Behavioral Therapy Groups where they tried to challenge negative eating disorder thoughts. And finally he attended one of his favorite groups called Body and Soul, a group designed to get the patient to realize the other aspects of themselves and not their body. Rubin said Simmons and other patients work to try and find out what kind of role the eating disorder plays into their lives. “If they don’t figure out the role, it backfires and tries to destroy their life. John had to learn about coping skills and how to deal with them,” she said. “This is a common theme that everyone feels individualized and a lot of times he had anxiety about being perfect. He is very anxious about growing up and being an adult and being in charge of his own life, which is not super uncommon.” For men, the road towards admitting to an eating disorder is often grim. Carolyn Costin, the founder and executive director of The Monte Nido Treatment Center and its 19 affiliates, including the EDCC, said it is hard for men to admit to an eating disorder because of societal stereotypes. “It has long been thought of as a female only disorder and men are less likely to seek therapy anyway,” Costin said. “Men are afraid of being seen as feminine or gay and also doctors routinely miss an eating disorder diagnosis in males.” The difficulty of admitting to an eating disorder was prevalent for Simmons as well. He said eating disorders have become widely accepted in society primarily when they involve women. “It surprises people that men have eating disorders because men aren’t supposed to have eating disorders and people think there aren’t societal pressures placed on men,” he said. “We do have pressures. Pressures to be buff and have a six-pack (ribbed abdominal muscles) and it doesn’t account for other eating disorders for men and women. That is the biggest message I want to get out there, that one, it does affect men and women, and two, it isn’t limited to body image with men and women. There is still stuff about pressures at home to be perfect, depression, self-sabotage. The hardest thing is that you are not always aware how it is correlated.” He said the treatment allows the patient to connect the behavior with the underlying emotional issues, which is “cutting the eating disorder at the root. That’s why people go (back) multiple times because they often cut it at the base, and they (still) have some of those underlying issues and the disorder comes back.” Treatment for males and females is oftentimes the same, but Costin said men’s eating disorders can be unique. 20 “Men’s underlying issues are sometimes different and need to be addressed as such. Males do not have the same medical complications such as amenorrhea (the absence of a menstrual cycle),” she said. “Treatment is more difficult if they do not have other men in treatment to relate to and men often feel left out of certain kinds of body image discussions that females have while in treatment. Men approach problems in a different way, and so, different approaches work best for males.” Costin said more men tend to have binge eating disorders where one usually consumes unusually large amounts of food. “There are so many other men out there I have learned from talking to the ones that have come in, that can relate to having an eating disorder,” Rubin said. “It is brave to come to treatment, and I haven’t met a male who has come in and regretted it. Yes, it’s really scary, but necessary. I think that just being human we go through a lot of struggles and it does not matter male or female. We have our own struggles and ways of coping and you picked it up. It doesn’t matter. You started to do it and it’s not about gender.” Rubin said societal stereotypes are not the only things keeping men from seeking treatment. “Society, and lack of facilities also contribute to the lack of men seeking treatment,” she said. “They may be afraid of ridicule or anxious to come into treatment and commit to something that is unknown. They put their jobs and lives on hold. It’s scary.” 21 At the EDCC, the team believes full recovery for patients is possible but only with the right tools and support. “If they have these components, they can get there and have a normal relationship with food and their body,” Rubin said. Costin said recovery is a step-by-step process; it takes time, and requires a treatment team that can help identify specific symptoms that need to be addressed and help the patient uncover the underlying issues. “I think he has come really far and faced really difficult things with his family,” Rubin said “He has a road ahead of him, but I feel he can really do this with the right support. He has a lot more tools in his toolbox, is able to cope with things and can tolerate people and not be so hard on himself. He is learning he is a cool guy and he didn’t know that before.” Rubin said in order for Simmons to not relapse he will need to follow a strict schedule. “I think that structure is going to be very important for him. Waking up at the same time every day, going to bed and eating the same thing every day,” she said. “If he doesn’t have that structure he is going to miss stuff and panic. It is extremely important after discharging to see a therapist and dietician once a week and a psychiatrist per request. It is also important to attend family groups and alumni groups.” Rubin said it could take two years or more for an eating-disorder patient to fully recover. “Some studies say it can take five to seven years to recover,” she said. “There are different amounts of times based on each patient” 22 The EDCC currently has four men in its treatment program, and Costin said they do not treat males at the residential level due to the lack of housing facilities for men. Simmons said the low numbers of males enrolled could be traced to eating disorders being identified only with someone who is not having enough food intake or has a preoccupation with eating. “If you don’t have any of those traditional symptoms, the eating disorder is a lot trickier to identify. And I think that’s why the stats are so low for men,” he said. Rubin has been treating eating disorder patients for more than five years. And in that time, she has seen only three men. Simmons was the only male in treatment at the EDCC during the majority of his treatment there. 23 Appendix: Levels of Treatment The rehabilitation process for an eating disorder patient consists of contacting a residential eating disorder facility and getting an initial consultation. Then the patient is placed into one of the specific levels of treatment based on level of severity of the disease. The highest level is Inpatient Treatment, where the patient is in a hospital setting and receiving constant medical attention by doctors and nurses. The next treatment level is Residential where a nurse is present part of the time; a doctor visits once a week, along with a therapist. The overall experience is less intense medically. Then there is Partial Hospitalization where patients come to a facility on average six days a week seeking treatment for 6 ½ hours a day. There is also Intensive Outpatient Therapy that is five days a week for 3 ½ hours a day of treatment. And finally, the Intensive Outpatient Program (IOP) that requires a patient to attend treatment four times a week. The patient is then discharged to an outside treatment team consisting of a dietician, therapist and psychiatrist --- all working together to ensure the patient fully recovers and can function healthily for the remainder of his or her life. 24 Bibliography Costin, Carolyn. Personal Interview. 16. Feb. 2012. “Eating Disorder Statistics.” American Psychological Association. Web. 20 March 2012. <http://www.anad.org/get-information/about-eating-disorders/eating-disorders- statistics/>. Glazer, Brooke. Personal Interview. 20 March 2012. “Males and Eating Disorders.” National Association of Anorexia Nervosa and Associated Disorders, Inc. Web. 20 March 2012. <http://www.anad.org/getinformation/ males-eating-disorders/>. Rubin, Abby. Personal Interview. 20 March 2012. Simmons, John. Personal Interview. 29 Feb. 2012. Sullivan, Patrick F. “Vol. 152 (7).” American Journal of Psychiatry July 1995: 1073- 1074. Print.

Abstract (if available)

Abstract The National Association of Anorexia Nervosa and Associated Disorders released a study that said one in ten cases of eating disorders involve males. The website says “many people believe that only white girls are affected by eating disorders, however, in reality, no ethnic, gender or socioeconomic group is immune to the dangers of this disease.” ❧ This statement means more than ever for John Simmons, who was diagnosed with an eating disorder in September 2011. Although several factors contribute to the lack of admission by men having disorders, societal pressures and gender stereotypes are the two main issues preventing these men from admitting to having this disease. As these societal pressures lessen and men like Simmons become more inclined to seek treatment, the number of men who are diagnosed with eating disorders may rise.

Linked assets

University of Southern California Dissertations and Theses

Conceptually similar

PDF

Beyond the bipolar disorder dilemma

PDF

Rare diseases

PDF

Heels, microphones, and unlikely heroines: comparing the female broadcast journalist in the fiction of Sparkle Hayter and Kelly Lange

PDF

Trauma in the field: a reporter's view

PDF

The YouTube phenomenon: YouTube stars eliminating stereotypes in new media

PDF

California horsemen

PDF

Ethanol: the billion-dollar harvest

PDF

Speaking up in Boyle Heights

PDF

Dance in the Diaspora

PDF

Cal-Earth comes

PDF

Helping students find a way home: one case at a time

PDF

Male reports of abuse in romantic relationships on the rise

PDF

Jumpers, dribbles and curry: Indo-Pak basketball

PDF

The lovesick journalist: the image of the female journalist in Danielle Steel’s novels

PDF

Bohemian paradise lost

PDF

Adversary for a strange hero: depictions of journalists in Showtime's Dexter with comparisons to Jeff Lindsay's novel Darkly dreaming Dexter

PDF

Training for the Olympic trials

PDF

Learning to fall

PDF

Robot, my companion: children with autism take part in robotic experiments

PDF

Cultural differences

Asset Metadata

Creator Dechant, Lawrence James (author)

Core Title A silent disease: men with eating disorders

School Annenberg School for Communication

Degree Master of Arts

Degree Program Journalism (Broadcast Journalism)

Publication Date 05/03/2012

Defense Date 05/03/2012

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag disease,disorders,eating disorder otherwise not specified,eating disorders,EDNOS,men,OAI-PMH Harvest

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Pryor, Lawrence (committee chair), Muller, Judy (committee member), Nelson, Bryce (committee member)

Creator Email dechant@usc.edu,dechantlarry@hotmail.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c3-26910

Unique identifier UC11288381

Identifier usctheses-c3-26910 (legacy record id)

Legacy Identifier etd-DechantLaw-735-0.pdf

Dmrecord 26910

Document Type Thesis

Rights Dechant, Lawrence James

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA