CHICAGO — Rob hated to run. But he hated to stop even more.
That’s when his disparaging inner voice would emerge. If he didn’t keep going, it said, he was going to get fat. He would never have the shredded abs that taunted him from every fitness magazine. He would be just a regular guy.
So on he ran. And when even six hours a day of exercise weren’t enough to quiet the voice, he started skipping meals too.
Anorexia, bulimia and other eating disorders have been viewed as women’s problems. Researchers say only 10 percent of those who are treated for the conditions are men. But some experts say that number is misleading. A study published last year estimated that men make up 40 percent of teens who have eating disorders. An earlier Harvard survey estimated that men account for 25 percent of adults with anorexia and bulimia.
THE ACTION FIGURE IDEAL
Niquie Dworkin, a therapist on Chicago’s North Side, said men have been tormented by the same kind of unattainable body images that have long plagued women and girls.
“Action figures used to look normal,” she said. “Now they’re superhuman with really cut abs and really big shoulders. Even little boys are being exposed to images of men that are not realistic.”
Experts say eating disorders present different symptoms in men and women. One big contrast is that men focus on muscularity, not thinness, and they tend to manage their weight by working out to incredible extremes.
That’s what happened with Rob, 24, of Elgin, Ill., who asked that his last name not be used. His trouble began at age 14, not long after bullying schoolmates mocked him for supposedly being fat. Vowing to gain the same kind of lean, athletic physique one of his tormentors had, he started doing 100 pushups a night. He then moved to the weight room, and when he entered high school, the cross-country team.
His parents were delighted. The other runners were laid-back, friendly and supportive, and Rob’s grades improved after he joined the team. He cut junk food from his diet and worked out with a vengeance. Not even a downpour could keep him from training.
“All the way around, it seemed like a really good thing,” Rob’s mother recalled.
THE HUNGER THAT SATISFIES
Almost imperceptibly, his routines grew longer. A coach at a summer running camp preached maximum effort - when you’re not running, another guy is, and he’s going to beat you - and Rob took it to heart. By the time he was a senior,he made excuses to leave practice early so he could work out even harder alone.
Strange thing, though: Rob didn’t care that much about winning races or setting records. He didn’t really even like running. Thinking about the hours of exercise that awaited him after school filled him with dread. But he absorbed the pain, and after noticing an odd relief in hunger, he began skipping meals too.
Daniel Le Grange, director of the eating disorders program at the University of Chicago Medical Center, said it’s common for people who have the disorders to express a desire for control and self-affirmation. But any contentment that emerges from starvation and hellish exercise doesn’t last long, he said.
THE PRICE OF RESTRAINT
Rob’s intense exercise led to stress fractures, and he decided not to join the cross-country team when he went to college in fall 2006. He rose at 6 a.m. for a quick breakfast before heading to the gym for a four-hour workout, including 90 minutes on an elliptical machine and an hour of weights. In the afternoon, after skipping lunch, he walked for two hours before doing repeats on the library steps. He picked at his dinner before rewarding himself for his suffering with a giant piece of pie.
When Rob healed enough to run, his routines grew ever more punishing, his body ever lighter - sometimes dipping below 100 pounds on his 5-foot-7 frame.
In November 2011, Rob sustained another leg fracture, the result of what doctors said was a lack of calcium in his bones. Though he was ordered to rest for a month, he became so frenzied from inactivity that he grabbed his crutches and did laps around his parents’ kitchen table.
It turned out to be his moment of clarity. He called the eating disorders recovery center at Alexian Brothers Behavioral Health Hospital in Hoffman Estates, Ill., and had himself admitted.
A FINAL REWARD
Therapy and reflection eventually convinced Rob that he needed to change. He yielded to the program and spent a few weeks putting on weight before transferring to Rogers Memorial Hospital near Milwaukee, home to a rare men-only eating disorders program.
His task there was to excavate the psychological turmoil that lay beneath his behavior - the desire for control, the need to feel special, even the fear of becoming an adult - and reset his mind and body to healthful habits.
In his three months at Rogers, Rob said, he learned to take a more realistic view of himself and gain more control over his eating and exercise habits. He put on about 45 pounds in treatment and now follows a diet worked up by a nutritionist, dining at appointed times even if he isn’t hungry (his long periods of starvation scrambled the neural circuitry that governs hunger - a common side effect of an eating disorder).
He works out cautiously, lifting weights with his father lest he get carried away. On a recent Sunday morning he went for a slow walk around the block, the only form of cardiovascular exercise he allows himself.
“Sometimes there’s the urge to hurry up,” he said, strolling past well-watered lawns and vibrant flower beds. “It’s a little battle. I usually win.”
ActiveStyle, Pages 24 on 07/30/2012