I was 5-foot-8 and 112 pounds. My cheeks sunk in, like the fish face I used to make when I was little. My arms were like thin, dead tree branches. My ribs emerged from my torso like a parrot's cage, convex and wiry. By the time I landed myself in the emergency room, I no longer looked like your average all-American 20-something college student. An intravenous needle punctured a slender vein in my hand, replenishing my famished body. At my bedside, my nervous mother held on to my other hand so tightly that it ached from lack of circulation. Unsure of what was wrong with me, not one doctor suggested or even asked me about a potential eating disorder.
It was the fall of 1995, and I certainly hadn't heard anyone talk about a man with an eating disorder. I'd known plenty of women sufferers, some of whom were close high-school friends. They confided in me about their self-destructive rituals, and I, being the empathetic guy that I was, helped them get the treatment they needed from a counselor specializing in eating disorders in our small suburb outside Boston.
But no one had ever talked with me about treating an eating disorder. After a two-hour run around Boston and Cambridge, I had urinated blood into my college dorm's bathroom toilet, and the sight of it threw me into a panic. My knees had buckled, and I'd collapsed to the floor. Lying in the ER, my bony body exposed in the flimsy hospital gown, it never occurred to me that I could've inflicted this incident, this illness, upon myself, just as my girlfriends had in high school.
I wasn't about to go there. It was scary enough trying to hide my emerging homosexual orientation from everyone around me, especially my hypermasculine, often-angry, sports-obsessed father. What would it do for my cover to admit that I might possibly have a girls' disease? But there'd be no need to consider such a notion; no one brought the idea up, so I assumed there was nothing "real" afflicting me.
Instead I went on dozens of outpatient doctor visits, my mother (and sometimes my nurse sister) by my side. We saw one specialist after another: urologists, internists, and nephrologists. I tolerated one annoying, often-invasive, sometimes-painful test after another: cystoscopy, intravenous pyelogram (IVP), ultrasound, MRI, and, worst of all, kidney biopsy. All of them shattered every single theory uttered. It wasn't trauma, kidney stones, the rare Alport syndrome, or even cancer.
Surely, my mom, sister, and I knew something was very wrong with me -- there had to be a reason that each urinalysis showed blood. I wonder now if we knew on some subconscious level that I was doing it to myself.
It began in the dreary winter of early 1995, with a single, exhausting one-mile run, followed by a radical change in my diet from high-fat to low. Over the course of a few months, I added miles while cutting more and more fat from my diet until intaking anything more than zero grams a day was unacceptable. Running at least a dozen miles at a time, day in and day out, I began to quickly waste away.
And yet, not one of the many specialists that I visited wanted to recognize that I was clearly struggling with an eating disorder. Eventually, when all else failed, I was diagnosed with "runners' hematuria" -- blood in the urine -- from running too many miles.
"It happens to marathoners all the time," one doctor said dismissively. "It makes perfect sense." I don't remember him telling me that what also made sense was to stop running so many miles on such an empty stomach.
But that was nearly 20 years ago. This would never happen in this day and age, right?
One of my close guy friends, who, ironically, witnessed me torment myself with anorexia, bulimia (I abused laxatives too), and excessive running in college, faced severe, mysterious, and life-threatening symptoms starting in 2007. He dropped 50 pounds in a few months. He suffered from extreme fatigue, loss of appetite, constipation, insomnia, chills, depression, acid reflux, and anxiety, among other things. He saw dozens of doctors and specialists, from naturopaths to gastroenterologists to endocrinologists. He, like me, endured one invasive test after another. Doctors encouraged him to cut things out of his diet. They said food was the possible source of the symptoms, so dairy, meat, wheat, and corn were eliminated, until he was left with scarcely anything left to eat at all. His health deteriorated. Doctors came up with nothing.
Desperate to uncover some answers on his own, he headed to an alternative medical clinic in Florida. There he was discouraged from eating anything substantial, cutting out even more than the doctors already had. He was put on an all-vegan diet and was instructed to perform wheatgrass enemas. At his weakest, in 2010, he was 6-foot-1 and weighed an astounding 105 pounds. No doctor, no nurse, no specialist, and no alternative healer discussed an eating disorder. Frustrated and feeling helpless, he brought up the possibility of an eating disorder to a psychiatrist, who dismissed his inquiry because he didn't fit the diagnosis in the manual.
Had anything changed in our medical, mental-health, or other healing professions in the 15 years that had passed between me and my friend presenting eating disorders? Our experiences with doctors and specialists were alarmingly similar. Has enough changed in our mainstream media to raise awareness not only within the medical communities but in the community at large to give men, their friends, and their families the tools to detect warning signs that they could be suffering from a life-threatening disorder?
To be fair, I've heard more in the last year about men suffering from eating disorders than ever before. For instance, I've heard reports on the news about men in sports struggling with eating and body-image issues. The Huffington Post has published a number of essays about men suffering from eating disorders. I know that Eating Disorder Hope has worked to share recovery stories about men to raise a level of consciousness with men sufferers. I've also learned about a new nonprofit in the United Kingdom called Men Get Eating Disorders Too, aiming to educate the masses about the epidemic.
Thankfully, my friend finally found a psychologist who was willing and able to help treat his eating-disorder issues. I'm just relieved it wasn't too late for him.
But what about others? We still don't talk about it enough. We're scared. We're ashamed. That's why I've written My Thinning Years: Starving the Gay Within. I wanted to share my story to try to help others. Some may say that I shouldn't have written such a vivid, detailed account of my affliction. It was important for me, however, to give men, their friends and family, and potential caregivers the chance to identify and relate to something that they read in my story. Not all of us fit into a clean diagnosis that is written neatly in black and white. Too many are going undiagnosed or misdiagnosed or, worse, encouraged to do things that complicate matters.
I was trying to starve the gay within, but symptoms and manifestations are individual and will vary endlessly. Sufferers will have different reasons and root causes -- different factors, from genetic to familial, environmental, and societal. People need to know that men can suffer from eating disorders too. We have to continue to discuss, conduct research, and encourage men to share their stories. If nothing else, we have to start asking men about eating disorders too, so that they will have the opportunity to be diagnosed accurately and led onto the path of recovery.
Need help? In the U.S., call the National Eating Disorder Association hotline at 1-800-931-2237.