Men Have Eating Disorders Too. Why Don’t They Seek Help?

Public discussions about eating disorders tend to focus on women, and in the past, so have our episodes on the subject. But millions of men also struggle with some form of disordered eating, though they’re far less likely to be diagnosed or to seek treatment. Today we hear stories from three men—in three different stages of life—who have complicated relationships with food.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Dan Pashman?

  My whole extended family and I went to Myrtle Beach, South Carolina this past spring. And I gotta say, I came away feeling like, number one, this is a great family destination. Number two, this is a great place to come all year round. The mini golf alone is probably worth, it's like the mini golf capital of the country. They have the most incredible elaborate mini golf courses. They also have more than 80 championship, full-size golf courses, plus 60 miles of beautiful coastline, all-season sunshine. Of course, you can relax by the beach or the pool. There's also jet skiing, fishing charters, paddle boarding, and of course, food. Oh, man, did we eat well in Myrtle Beach. From fresh local seafood to craft burgers and craft beers to kebabs on the boardwalk. With more than 2,000 restaurants to choose from, from legendary no-frill seafood shacks

• 0:43Dan Pashman?

  to chef-driven dining, Myrtle Beach has it all. Plus, live entertainment at the beach, there's always something epic going on. So, summer may be winding down, but in Myrtle Beach, you're gonna find the coastal vacation of your dreams all year long. Start planning your ultimate beach vacation at visitmyrtlebeach.com. I grew up on Lando Lakes cheese. I still remember going to the supermarket deli counter with my mom and her ordering Lando Lakes American cheese. And now, Lando Lakes cheese and butter are a huge part of my home. There are so many easy weeknight recipes using Lando Lakes cheese and butter that bring delicious restaurant taste right to your table. From chicken parm to weeknight shrimp pad Thai, Lando Lakes has plenty of quick dishes that'll have the whole dinner table talking.

• 1:23Dan Pashman?

  Visit landolakes.com/reцепes/collection for easy weeknight dinners.

• 1:32Dan Pashman?

  Please note, this episode contains discussion of eating disorders and includes a mention of suicide.

• 1:41Speaker 01

  Mashed potatoes and gravy and turkey and three kinds of pie. And man, I just, you know, I went to town. And knowing that I could, you know, throw it all back up later.

• 1:51Speaker 02

  People had told me, my, my parents, "So, you're doing damage to your body." And I, I didn't, never believed them.

• 1:59Speaker 03

  It was really an obsession. It was looking at the scale, and it was a little bit down. I was like, I was like giddy. It was almost addictive.

• 2:10Dan Pashman?

  This is the Sporkful. It's not for foodies, it's for eaters. I'm Dan Pashman. Each week on our show, we obsess about food to learn more about people. Over the past few years, there's been an increase in people seeking help for eating disorders, and the public discussion about this issue usually focuses on women. In the past, so have our episodes on the subject. But we wanted to hear about people who've been overlooked in the discussion, so we put a call out asking men to share their stories. According to the American Psychological Association, boys and men are a third of the population diagnosed with eating disorders. So this affects millions of men in the US. But they're less likely to be diagnosed and less likely to seek treatment. Today, we'll hear stories from three men. They all said they wanted to share their experience so that other men who are struggling don't feel so alone.

• 2:54Dan Pashman?

  And we're asking, how is this different for men? How is it the same? What are the triggers for their disorders and the barriers to treatment? And how do their ideas about masculinity affect their relationships to food? We'll start with Jack Gillies. Jack lives in Mono, Ontario, a small town north of Toronto. He's 16, in 11th grade, and he lives at home with his parents and sister. The whole family's very into athletics. His parents used to do multi-day endurance runs. His sister's a competitive skier. Jack runs, skis, and mountain bikes. And they do a lot of it together. Growing up, Jack says he always had a big appetite. People would tease him about it playfully. But two years ago, when he was 14, those comments began to hit him differently.

• 3:37Speaker 03

  Maybe it was just my own interpretation of their comments, especially the ones that talked about metabolism and how lucky I am to be a teenager with this kind of body right now. I think I interpreted that as someday I won't have that.

• 3:52Dan Pashman?

  Around this time, Jack and his sister decided to go on a plant-based diet, and they convinced their parents to do the same. Now, this was not the first time the family did something like this. When Jack was eight, they cut out processed grains and sugar and moved towards a paleo diet. And when the whole family would go on one of these diets, was there one person in the family who was usually the one deciding or sort of driving that?

• 4:18Speaker 03

  Well, the first thing I'd say is I would, by no circumstance, call them diets. It was lifestyle changes. These weren't short-term things. We would change our eating habits for years and we'd never go back to the way it was before. It was a complete lifestyle shift.

• 4:33Dan Pashman?

  The family's switch to plant-based coincided with Jack getting more competitive about his running. He heard other runners talk about the idea of race weight, getting your body to a lower weight for races to make you a little lighter and quicker, give you an edge. And Jack wanted any advantage he could get.

• 4:48Speaker 03

  How can I become faster? What's going to make me drop a few spots? And unfortunately, it seemed like dropping a few pounds was the solution that made the most sense to me at the time.

• 5:01Dan Pashman?

  At this point, Jack was close to six feet tall, 155 pounds. He decided to get his weight down to 140. That number didn't come from any formula or expert. He just came up with it on his own.

• 5:12Speaker 03

  I just, I started eating less. I wanted to eat more, but it was telling myself to eat less.

• 5:20Speaker 03

  I was trained a lot. I didn't really let myself ever sit down. I had this obsession. I had to just keep going, keep moving, keep burning. Part of me is like, well, it should be happening faster. And another part of me, there was a small part that was saying, well, if I'm not losing weight, maybe it's because I shouldn't be losing weight. And some of that internal conflict made me anxious. And ultimately, I think the side that said, you should be losing more, went over.

• 5:50Dan Pashman?

  What do you think was driving that? Like, why did that side of the internal conflict win out?

• 5:58Speaker 03

  In all honesty, I think an athlete's curse. When we set a goal in different sports, we stick to those goals. And we expect that at some point in your journey, something's going to face you that's going to tell you that you can't achieve it, that you won't get there. And a big part of athletics is you have to push past those barriers. And my athletic mindset really drove me into the fact that this is just an obstacle in my way. I'm going to, I'm going to get to my goal.

• 6:35Dan Pashman?

  That first year with this new approach, Jack did some of the hardest training and best running of his life. He was running a 5K in under 18 minutes. The next year, he did even better, shaving off nearly two more minutes from his time. The thing is, the way race weight is supposed to work, a runner drops a few pounds before a race, then gains it back after. But Jack didn't want to gain the weight back. In fact, he couldn't stop losing it.

• 7:01Speaker 03

  It was really an obsession. It was looking at the scale and thinking to myself, oh, it should come up. But every morning I saw it and it was a little bit down. I was like, I was like giddy. There was, there was almost some part of me that found it exciting. It was, it was weird. It was almost addictive.

• 7:20Dan Pashman?

  What started as something to help his running had become a goal in itself. And on top of that, Jack's times were getting better. And there was another factor. When he lost weight, he liked the way he looked.

• 7:33Speaker 03

  There's this, this idea that the veins should stick out. You should have a six pack. That was, that was my, one of my big obsessions was I had to always have really, really well-defined abdominal muscles. And regardless of what my numerical goal was at first, once I got down to that level, it became something that I was afraid I would lose when I looked in the mirror.

• 7:57Dan Pashman?

  Who did you talk to about this?

• 7:59Speaker 03

  For a while, no one. I, I really kept it in. I tried to hide it from my family. First person I talked to about it was probably my sister. My sister had had similar struggles with food. I think it's, it's fairly common for athletes. So she somewhat understood what I was going through and she recognized that I was doing a lot of the same things that she had used to do. One of the biggest groups that's helped me through this, that's not my family, is a group of girls at school that I've been great friends with. They were one of the only non-family members that I've really mentioned and spoken to this issue about. And part of it's because I've seen a lot of them have had their own struggles with food.

• 8:42Dan Pashman?

  At this point, Jack's family hadn't said anything about the change in his eating or his weight loss. He says they didn't seem to notice it. During Easter 2019, his grandmother made a comment in front of the family that he looked skinny. But the conversation quickly moved on. Jack kept pushing himself to run faster while eating less. He got his weight down to 140. In the fall of 2019, he was in a big regional championship race.

• 9:07Speaker 03

  And I was right up there on the top. I, I could have won. And as I was about 20 feet from the finish line, I went unconscious.

• 9:22Speaker 03

  And I, to me, it felt like maybe 10 seconds had passed. But I remember getting up and trying to crawl and falling and standing up and stumbling and I fell across the line. I'd been down for quite a while longer than I had thought. And I wound up lying in an ambulance for the next hour and a half or so. My heart rate wouldn't come down. Something was wrong and we just weren't sure what it was.

• 9:50Dan Pashman?

  The paramedics working there determined Jack didn't need to go to the hospital. He says having a racer pass out during a race isn't actually that unusual. A few days later, Jack's parents took him to the doctor. Initial tests came back normal. Jack says neither he nor his doctor brought up the idea that he wasn't eating enough. He hadn't told his parents that he was restricting his eating, that he was trying to lose more weight. And he says he didn't even see a connection between his restricting and his passing out. Jack's parents were nervous about him racing again, but they left the decision to him. Less than two weeks after collapsing, he was back running. It was a frigid day in northern Ontario. The course was packed with ice. About halfway through the race...

• 10:32Speaker 03

  My vision started to go spotty and my legs started to go numb. And I remember telling myself for about the next 400 meters, "Oh, well, it's just the cold. This is common. It's the cold. It's, this is what happens when you're running the cold." And I actually, I ended up realizing, as I was going up probably the, the big hill of the course, that this isn't the cold. This is, this is happening again. And I was seeing spots and my vision was spiraling and this, it shouldn't have happened again. And it did.

• 11:04Dan Pashman?

  In December of 2019, after more tests, Jack was diagnosed with anemia. His doctor prescribed iron supplements and said Jack should consider eating meat again, but that there were plant-based foods that could help, too. His parents were worried about the anemia, but weren't aware of the deeper issue. Still, they decided to intervene to try to take some control over what Jack was eating to help bring up his iron levels.

• 11:26Speaker 03

  I was definitely getting a little more pressure, a little more push that you gotta eat more, eat this after dinner, eat, get that next helping. Like, there's definitely a lot, there's a lot of concern and a lot of fear in my family. And for a while, it, I think it did get better.

• 11:47Dan Pashman?

  But that period of improvement quickly turned into more of a day-to-day, up-and-down struggle, especially with the added stress of COVID. Jack did put on some weight. At times, he rediscovered his love of food. But he also started serving himself when the family was eating, so he could have more control over his portions.

• 12:04Speaker 03

  You know, if I could cut back on something, I would cut back on something. And I think there was just this fear of gaining weight again.

• 12:11Dan Pashman?

  This time, however, Jack was finally able to open up to his parents about the fact that he'd been restricting his eating.

• 12:18Speaker 03

  I think they felt bad. At first, I know they felt a little guilty because they were worried that they had caused it, which they hadn't. And I think, to a degree, there was a bit of a sense that, you know, they had to do something to fix it. I think we all came to the realization that I just needed support and that if they just supported me through all of it, that I could, I could get myself out of this.

• 12:44Dan Pashman?

  Jack says in recent months, that support from his family has been helping.

• 12:48Speaker 03

  Right now, I feel like I'm, I'm climbing the ladder. I'm certainly nowhere near at a spot where I could say that I am fully past this. I'd say most days, I have at least a moment or two where I question what I'm eating and I might have a moment of anxiety. It's been really trying to walk myself through being okay with food, eating for fulfillment and for enjoyment.

• 13:14Dan Pashman?

  Have you talked to any of your male friends about this?

• 13:19Speaker 03

  Uh, not so. I'm not even sure why I took a second to answer that. It's, it's a simple no. I haven't spoken to almost any male figure about this. I, I've had trouble speaking to my own dad about this. The day before we had this, this conversation, um, recording this, he asked me in the car, well, what are you going to talk about? Um, and cause he knew the issue was there. He knew, I'd say the overall gist of it. But in the moment, I don't know why I just, I couldn't explain it to him. And what he knows is far more than what any other male figure in my life knows. My struggle with this is that it just really, it really isolated me. And that's something that I hope can end.

• 14:07Dan Pashman?

  As of now, Jack hasn't told his doctor about this issue and hasn't sought any professional treatment.

• 14:13Speaker 03

  It's a hard thing because I really wish I could help, ask for help sometimes. Um, and to a degree, I think I found a compromise where I can ask for help and in people's support and for some people's advice. But I still want to do this myself because I need that independence that I got myself into this. I need to be able to get myself out.

• 14:35Dan Pashman?

  I mean, I'm not an eating disorders expert, but this sounds like, what I would suspect a lot of people think, but especially I think is probably more common for boys and men, that to ask for help would be a sign of weakness.

• 14:52Speaker 03

  Yeah, I think you nailed it right on the head. I think that's something that anyone who's had to experience it at some point in their life definitely knows that feeling.

• 15:02Dan Pashman?

  If you had broke, if you broke your leg, even if you felt that it was your own fault, you would never say, I got myself into this, I'm going to get myself out of it. I'm going to set my own bone and put on my own cast and do my own x-rays.

• 15:12Speaker 03

  I certainly hope now that wouldn't end very well.

• 15:15Dan Pashman?

  But the approach that you're trying to take with your issues around food may be the sort of eating disorder equivalent of that.

• 15:23Speaker 03

  For sure. I, I totally agree. It shouldn't be a separate issue from a leg. And yet it just, it often feels like there's something different about it.

• 15:32Dan Pashman?

  Right. So what do you think would have to happen to persuade you to seek some sort of treatment or professional help?

• 15:43Speaker 03

  If I was to take a worse turn again, I think I would seek help. Now that I have formed a better support system with family and friends, I think I might have the confidence now, if things were to get bad again, I would ask for help.

• 16:02Dan Pashman?

  I'm not going to tell you what to do, but I do think, generally speaking, that, and maybe this is something that comes with age, but I think that, you know, you get to a point where you realize that asking for help isn't an indication of weakness or failure, that we all need to ask for help sometimes in our lives.

• 16:24Speaker 03

  I'd say going through this experience has helped me realize that majorly, and that's part of the reason I'm almost grateful I've gone through this.

• 16:46Dan Pashman?

  Later in the show, we'll talk with two more men who struggled with eating disorders, both older than Jack and at different points in their journeys. But first, I wanted to talk with an expert. Dr. Roberto Alavardia is a clinical psychologist and lecturer at Harvard Medical School. He's spent 25 years studying and treating men and boys with eating disorders. That includes anorexia, which is a restrictive eating disorder, and bulimia, which involves binging and purging.

• 17:12Speaker 04

  For a lot of men that I've worked with over the years, they feel a lot of shame. So they're struggling with having an eating disorder, and then they feel really bad about the fact that they're struggling, that they have an eating disorder, because they feel that somehow it's an assault on being a man and their masculinity.

• 17:28Dan Pashman?

  So the biggest way this is different for men, they're much less likely to get help. Dr. Olivardi says part of that is the perception that men just don't get eating disorders. And part is that we have very different ideas about how boys and men are supposed to eat.

• 17:43Speaker 04

  With men that you'll often see, you know, behaviors like binge eating behavior, for example, that might go unnoticed or unrecognized because of, you know, we think of men eating a lot. And so a lot of times when men are binging, it sort of just looks like, oh, he just has a really big appetite when he could have a really problematic, you know, behavior.

• 18:04Dan Pashman?

  There is this idea that eating a lot is masculine.

• 18:09Speaker 04

  Absolutely.

• 18:10Dan Pashman?

  That there's something, there's something manly about sitting down in front of a gigantic plate of food and eating all of it.

• 18:16Speaker 04

  There's something, right, manly about eating a lot. And there's something that's feminizing in some ways about watching what you eat.

• 18:26Dan Pashman?

  These ideas not only make it harder for men to seek treatment, they also make it less likely that doctors will raise red flags when a male patient's weight fluctuates wildly. But in other ways, eating disorders for men and women are strikingly similar, now more than ever. While there's still more pressure on women to look a certain way, Dr. Olivardi has seen a change in body image expectations for men in recent decades, along with the rise of a more traditionally masculine version of diet culture.

• 18:54Speaker 04

  In the late 90s, you know, early 2000s, you know, when I would ask men in the intake, men I work with who have eating issues, I say, you know, do you take diet pills? Do you take laxatives? And they'll say, no, I would, you know, like, that's almost like too girly. And I'll then say, do you take any health supplements? And they'll say, oh, yeah, I take this thermogenic fat burner, blah, blah, blah. And I said, that's a diet pill. I mean, it has all the ingredients of everything that's in these diet pills, but the packaging is thermogenic, anabolic, you know, it has like a muscle in it, but it's, it's all the same ingredients. And in the 80s, it was about just being big. Steroids started to become a much bigger problem. I would say that there became a shift, though,

• 19:39Speaker 04

  where looking too big started to be associated with kind of... Dumb or insecure, but I remember in particular when the movie Fight Club came out. Then I started hearing in patients, I want to look cut, I want to look lean. I also want to have my muscle striations and definitions and six pack and those kinds of things. There's a lot more attention on body and social media absolutely put gasoline, you know, into that flame. Because studies show that teenage boys are just as susceptible to body dissatisfaction and being impacted by photographs on social media as girls are.

• 20:18Dan Pashman?

  And I feel like a lot of the messaging today, which is sort of like, your body is a machine. You must optimize it by filling it with the right fuel.

• 20:25Speaker 04

  Yes.

• 20:26Dan Pashman?

  Almost feeds into that, but by treating like your body as this separate thing, to have the nuts and bolts tightened as opposed to like you, you know, as opposed to a part of you.

• 20:36Speaker 04

  Absolutely. So you'll often hear words like pure, clean, optimal. But when I ask people, you know, when's the first time you noticed, you know, something kind of happening? And it usually for a lot of people says, you know, say, oh, I went on a diet. I went keto, I went paleo, I went vegan, you know, I want to cut out sugar. And sometimes it starts out, again, very, and it's not like nobody ever goes into this saying, I'm going to have an eating disorder and it just kind of really gets out of control.

• 21:08Dan Pashman?

  Dr. Olivardi is quick to add that, of course, there are folks who would benefit from healthier eating. And many people go on these diets and don't end up on that slippery slope. Diets are one of the most common triggers for eating disorders. But that's not the only factor. He says the people who are most susceptible often have certain personality traits. So for people with anorexia who restrict what they eat.

• 21:30Speaker 04

  You'll see perfectionism is very high in this group of men who have eating disorders.

• 21:35Dan Pashman?

  While people with bulimia tend to fit a different profile.

• 21:38Speaker 04

  There's an addictive nature to bulimia. It's not uncommon to see men with bulimia who also have a history of substance abuse issues.

• 21:46Dan Pashman?

  Why that connection in particular?

• 21:47Speaker 04

  So bulimia is an impulsive eating disorder versus anorexia is more compulsive, someone who's almost like thinking so much, you know, about things. With bulimia, it's associated with more impulsivity, which is why you see attention deficit hyperactivity disorder, which is more impulsivity. Substance abuse is also related to impulsivity. So even in genetic studies, as we're sort of mapping genes and things like that, we see this overlap of binge eating, addictive behaviors, ADHD, that they all sort of aggregate in the same kind of way, the same sort of personalities. But purging also creates a euphoric feeling in the brain.

• 22:28Dan Pashman?

  What is the role of sports, athletics, in triggering or leading to eating disorders for men?

• 22:38Speaker 04

  So there are a lot of men, I've seen it actually go in both directions. So I've worked with lots of men who have, who had eating disorders and gravitated to a sport that they knew would sort of, in some ways, cultivate that eating disorder. Wrestling, where you have to make weight and you have to be super careful. And then I've also seen it where men who don't have eating disorders, and this is true for women as well, that, you know, that go into a sport and if they have a high degree of perfectionism and high achievement orientation and high competitive spirit, that they want to compete and sometimes they feel they're in this culture that basically says, hey, you gotta do this and you might have to purge, or you might have to take laxatives, or you

• 23:21Speaker 04

  might need to restrict for a couple of days, and then it sort of develops. But overall, like, I don't want to demonize athletics. I mean, sports and athletics is very healthy and a wonderful thing in so many, you know, respects. And even with the patients that I've worked with, who, it doesn't mean they have to get out of the sport necessarily, but they have to work harder at regulating that and making sure they don't fall into that hole.

• 23:50Dan Pashman?

  Coming up, we hear from two men who spent years battling eating disorders and who now face them in very different ways. Stick around.

• 24:10Speaker 05

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• 25:40Dan Pashman?

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• 26:17Dan Pashman?

  For a long time, I did not understand the point of vests. Like, why not just have a jacket? That covers your arms, too. But something clicked for me. I think I got gifted a vest, and now I am obsessed with vests. And it just adds that little bit of toastiness. And I got this new Quince Packable Puffer Vest. I love that you can just squish it up and shove it in the bottom of your bag. That way, you have it with you all day. If it gets a little chilly, break out the vest. I also got a Quince Down Quilted Vest. It is so soft and cozy. They make them for men and women. And as with everything you get at Quince, they focus on high-quality staples made with premium materials like 100% Mongolian cashmere, 14-karat gold, and Italian leather. These are all timeless, versatile pieces that feel special to unwrap and become everyday favorites long after the holidays.

• 27:01Dan Pashman?

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• 27:26Dan Pashman?

  Welcome back to The Sporkful. I'm Dan Pashman. Last week on the show, I talked with Chef Roy Choi. He was one of the first chefs to start cooking out of a food truck. His Kogi Korean Beef Taco Truck was a sensation in L.A. when he debuted it in 2008. It later inspired the movie Chef, starring Jon Favreau. But for years, Roy struggled, sleeping on the streets, doing hard drugs, feeling aimless. He finally pulled himself out of a rut when he says Emeril Lagasse came to him in a vision. He climbed the ladder as a chef in high-end restaurants. But when his friend offered him the chance to try to cook the food he cared about, Roy couldn't pass it up.

• 27:59Speaker 06

  We went to the store, got ingredients. I started opening up my third eye. And I just started like, okay, what is this Korean barbecue taco? Then I started, all these memories and energies of growing up started to flow through me. Started to feel all the tacos I've eaten throughout my life, all the family homes that I had been welcomed into, all the lowrider clubs that I had been a part of, all the Korean restaurants that I had eaten at. All the food from my mother and my family and my aunties. You know, all these things just started flowing into this tornado. And then I went to the market and it just kind of started picking ingredients, you know, without even thinking. I was out of my brain. It was all coming like through my spirit.

• 28:44Speaker 06

  Started filling up the basket and we didn't go to a professional kitchen. We went back to his apartment and then I just started prepping these things.

• 28:51Dan Pashman?

  In that moment, Roy realized that he had a gift that had been passed down to him through generations of his family. This was a great conversation. If you're already a Roy Choi fan, I think this will give you a deeper understanding of his backstory. If you're not, I think you're going to really be moved by the conversation. So make sure you check out my conversation with Roy Choi, available now wherever you got this one.

• 29:11Dan Pashman?

  Now, back to our look at how eating disorders affect men. Galen Muscat is 27. He's from the small town of Sandwich, New Hampshire, not to be confused with Sandwich, Massachusetts. Did you still grow up with police officers driving around in cars labeled Sandwich Police?

• 29:26Speaker 02

  Yes, yes, exactly.

• 29:30Speaker 02

  Always a highlight.

• 29:32Dan Pashman?

  But I digress. Like Jack, who we heard from earlier, Galen is an athlete, a runner and a skier. In 10th grade, he went to an intensive ski camp led by a former Olympian from Russia.

• 29:43Speaker 02

  The first, the first week we were there over in Vermont, um, doing roller skiing, she took out a pair of calipers to, to measure body fat.

• 29:54Dan Pashman?

  And she's like literally pinching around your body and measuring different places?

• 29:58Speaker 02

  Yep, exactly. She did like on the chest. She did the upper thigh. She did our, our side.

• 30:06Dan Pashman?

  That moment by itself didn't change much for Galen, but he didn't forget it. Three years later, in college, he developed terrible stomach pains. He went to the doctor and got diagnosed with a severe gluten intolerance. He'd have to go gluten free. For a person who always got a lot of pleasure from food.

• 30:22Speaker 02

  It completely altered my sense of myself, um, changed my relationship with the kitchen. Suddenly I had to be careful.

• 30:31Dan Pashman?

  Galen had transferred to Amherst College, so when he started his sophomore year, he was at a new school, didn't know anyone. He says he had also been struggling with depression for years. On top of all that, he was dealing with the stress of this new diagnosis, trying to figure out what he could eat. He felt embarrassed about having to explain it to others.

• 30:49Speaker 02

  That really started to affect me. So it became easier for me to just sort of avoid that altogether. Not only by starting to sit alone in the dining hall, but also sometimes avoiding meals altogether.

• 31:06Dan Pashman?

  Cutting gluten was medically necessary, but Galen began restricting his diet even further.

• 31:11Speaker 02

  First, it was grains, no brown rice, nothing. It was just easier, or so I thought. And I started to lose a little weight. My brother told me at one point, kind of good natured, like, I said, "How do you drink your coffee?" And he said, "Oh, I don't put sugar in it anymore. I'm trying this thing of no added sugar." Growing up, my brother and I were opposite in the sense that if you gave me a task, I would do it until I got it perfectly. A drawing, I would crumple it up and start over if I went outside the lines. I took my brother's challenge like, huh, I'm gonna try this. And I successfully removed things from my diet, sugar, grain, et cetera.

• 31:55Speaker 02

  So by that point in March, I was doing that with various things, egg yolks, olive oil, milk, you name it. I felt like I was doing something good. Part of me, some weird, twisted part at that time, really started to take pleasure in feeling really different and isolated and alone.

• 32:22Dan Pashman?

  At the start of that semester, Galen weighed 166 pounds. When his dad picked him up at the end of the semester, he weighed 114. In four and a half months, he had lost 52 pounds.

• 32:35Speaker 02

  Yeah, my dad picked me up and he was speechless. Didn't talk to me for two and a half, two and a half hours, the whole drive home. And I would learn later in a family therapy session that when he got out of the car in our driveway and saw my mom, he said, "When you see Galen, try not to cry."

• 33:05Dan Pashman?

  Over the summer, Galen was diagnosed with anemia and took a medical leave from school. When he returned, his depression and anxiety persisted. He told his brother he was suicidal. Just a week into the school year, Galen's parents picked him up to bring him home. They knew he needed treatment for an eating disorder, but insurance wouldn't cover inpatient treatment because they said he weighed too much to qualify.

• 33:29Speaker 02

  That, that was shocking, because I was still at that point 45 pounds below what I, my ideal weight should have been.

• 33:37Dan Pashman?

  Galen's parents fought the insurance company, and they got him admitted for outpatient treatment. The program included therapy, art classes, and writing workshops. Galen graduated from the program after four months. He says in some ways it was a frustrating experience because he's someone who likes to accomplish things without help from others. But it led him to a realization.

• 33:58Speaker 02

  There were a lot of times, whether that was sitting around a table, where being faced with other people's predicaments gave me that shred, like a little shred of self-compassion that I was so lacking that first term at Amherst. And it helped me see something that has today guided me, which is, in a weird way, maybe a fear of being in that position again. It was frightening to see, to see that things could get worse, because I really didn't think they could until I went there.

• 34:36Dan Pashman?

  Still, after leaving treatment, Galen's struggles continued. And this is something we've heard on this show from others who've struggled with eating disorders. There are so many ups and downs. Just when you think you're finally headed in the right direction, the bottom falls out again. Galen sought various forms of help, whether that meant going to family therapy, or his parents helping him maintain healthier eating habits. There were times he enjoyed eating again, put on some weight. Times he felt like he was back at square one. This ebb and flow went on for five years. In April of 2019, he started seeing a dietitian, but still couldn't stop exercising compulsively.

• 35:13Speaker 02

  I was around 125. And I would go for 10 mile run or so almost every day. And I was out on a run. It was May. It was beautiful. I was running along the Charles River and I felt something explode in my groin. And I thought, oh, no.

• 35:31Dan Pashman?

  For two months, doctors told Galen it was a lightly torn muscle, but it just kept getting worse.

• 35:37Speaker 02

  And suddenly my, my back started to hurt. I would go to work and I would sit and I would get these awful spasms throughout my lower body. I was walking home one day and I got my, my right leg went numb.

• 35:47Dan Pashman?

  After three months in pain, Galen got an MRI. He found out he was walking around with a stress fracture in his pelvis. He had lost critical bone mass in his spine and developed osteoporosis, all at age 25. For Galen, this diagnosis was rock bottom.

• 36:05Speaker 02

  People had told me, my, my parents, so you're doing damage to your body. And I never believed them.

• 36:12Dan Pashman?

  Today, it's unclear how much Galen's bones will be able to heal long term, how much of the damage is permanent. But after months on crutches and physical therapy, he is now able to walk without pain. He's gained some weight back and he's developing a better relationship with food.

• 36:28Speaker 02

  Yeah, I'm back to 160 pounds. Enjoy some chocolate every night and walking again. Not sure if I'll ever run, but I'm just grateful to be able to walk and pick up some pastries at a gluten free bakery.

• 36:47Dan Pashman?

  Galen's dietitian told him the injury, because it slowed him down, might actually have saved his life. Galen continues to work with her, along with a therapist, and says they've been crucial to his recovery.

• 37:00Speaker 02

  It's always felt like they saw something that I couldn't see. There's no judgment. It's like you're, you're allowed to be, you're allowed to make a mistake. And to see that it's okay not to be perfect just because we're, I mean, striving for perfection all the time in work, in cooking, you name it. Um, the message is be perfect and to have two hours every week where I'm told otherwise.

• 37:33Speaker 02

  Has really just helped me see like, yeah, you did injure yourself, but that's not your fault.

• 37:50Dan Pashman?

  You sent me a couple of photos, some from before your eating disorder, some from right in the middle of it, and some more recent. Why did you want to share those?

• 38:01Speaker 02

  Um, I, I guess because I'm, I'm sort of proud.

• 38:11Speaker 02

  And I didn't let myself feel pride for a really long time. I mean, I didn't feel like I had anything to be proud of.

• 38:19Speaker 02

  But I also shared because I wanted to show that it's possible to recover from one of these.

• 38:32Dan Pashman?

  So Galen has identified his eating disorder, he's getting treatment for it. And even if the road is long and winding, he feels now that there is a road to recovery. But not all people with eating disorders seek or receive help. Like Arnold Atienza, who's been dealing with food and eating issues for over 40 years. Arnold's 57. He was born in the Philippines. He grew up in Cleveland, one of five kids.

• 38:57Speaker 01

  No, there'd be like seven people sitting around the table and my mom would just like cook all this food, put it in the middle of the table, and when it was gone, dinner was over. So I think at a relatively young age, I became aware of like that that food was like a limited resource. My mother's nickname for me, it's a Filipino nickname, it's Tabachoey, which really kind of translates into like chubby or fatty. And in Asia, that is not, it's not a big deal. But as a kid, you kind of internalize that, you know, that becomes kind of your identity.

• 39:36Dan Pashman?

  When he was 13, Arnold joined the wrestling team. Now, in wrestling, you only compete against other people in your weight class. So weight becomes central to your place on the team. It's a huge focus. I can remember being at lunch in high school one time, and one of the guys I was sitting with was on the wrestling team, and he didn't eat a bite. He just kept spitting into an empty Snapple bottle. He was trying to get every ounce of liquid out of his body so he could make weight for a match. Arnold still remembers the first time he heard his teammates talk about their methods for cutting weight.

• 40:06Speaker 01

  This is Black Friday. You know, the morning after Thanksgiving, we're all rolling in into practice. And this kid Sam, he's just talking animatedly about his Thanksgiving dinner. He goes, you know, there were mashed potatoes and gravy and turkey and three kinds of pie. And man, I just, you know, I went to town. And knowing that I could, you know, throw it all back up later and, you know, that turkey hits you, man. And I think I passed out.

• 40:31Dan Pashman?

  In other words, this guy Sam ate a ton of food, planning to purge. But then he fell asleep after the meal. And by the time he woke up, the food was digested. As he put it to Arnold.

• 40:42Speaker 01

  You know, I come to a couple hours later in a panic, and my baby bump was gone. I go try to throw it all up, and, you know, two peas come out, and that was it. And Will just kind of laughed, and he goes, I'm gonna go run extra. And, you know, that's when it hit me. It's like, oh, wait, what?

• 40:59Dan Pashman?

  This pattern of binging and then purging is a hallmark of bulimia. But 13-year-old Arnold just thought of it as a great solution, a way to be able to eat all the food he loves while also competing as a wrestler.

• 41:11Speaker 01

  You don't want to let the team down. If you can't make weight and there's nobody else at that weight, you know, your team forfeits. And if I've got the school depending on me, you know, you do what you need to do to make weight.

• 41:23Dan Pashman?

  So Arnold started purging during the wrestling season. Throughout high school, his weight fluctuated dramatically from 119 when he was wrestling to 150 in the offseason. Once he left high school and stopped wrestling, Arnold did stop purging. He says now he's come to understand that he does better when he has a purpose and structure that give him healthier things to focus on. He graduated college and went to law school, but he dropped out, started working in bars and restaurants and began drinking too much, got into drugs, got addicted to both. He struggled with that addiction until he was 40, when he got sober. But sobriety left a kind of hole in his life.

• 42:00Speaker 01

  Don't smoke, can't drink, can't use. You know, it's like, my thing was, what do I have left?

• 42:08Dan Pashman?

  Arnold turned to food. He started eating a lot and gaining weight. But he also tried to find other healthier ways to fill the void. He went back to school for social work, got into yoga, kept attending AA meetings. During this phase, he also got married. When he was 51, his wife got a job in Singapore, so they moved there, but he wasn't able to work because of visa restrictions. That left him with a lot of time on his hands. He started exploring and eating his way through the city.

• 42:37Speaker 01

  The whole culture was kind of like food obsessed, and I just fit right in. And so that's when the eating to fill the void thing starts up again, but that's not what it feels like. That's not what it looks like. It feels like, oh, I'm in this culture and I gotta take advantage of, you know, these and I've never had that before, oh, what is this?

• 42:58Dan Pashman?

  Arnold's eating led to health issues, including gout, which made it difficult to walk. Gout is a complex form of arthritis. It's often connected with a high sugar diet and obesity.

• 43:07Speaker 01

  And so I went to the doctor and, you know, they ran all the tests and is like, well, you know, the gout is really the least of your problems. And I'm like, wait, what?

• 43:20Dan Pashman?

  Arnold had a whole host of issues related to his weight. The doctor said he had to start taking a bunch of prescriptions. But if Arnold lost 10% of his body weight, he could go off some of the meds.

• 43:30Speaker 01

  And so I like, I panicked and I knew what was going to get the weight off. Like, yeah. And so that's when the purging started up again.

• 43:40Dan Pashman?

  And do you remember the first time that you threw up after not having done it for so long?

• 43:46Speaker 01

  Oh, I'm sure it was that night. I'm like, you know, if it's there, why wait to use it?

• 43:53Dan Pashman?

  And how did you feel that first time doing it again after so long?

• 43:59Speaker 01

  Um, it's like getting back together with hot ex-girlfriend that you know is crazy. She's just got a hold of you. That's kind of what it felt like, like I was having an affair.

• 44:18Dan Pashman?

  The first month, Arnold lost 20 pounds. He got off some of the prescriptions, but he wanted to keep slimming down. He kept purging, lost another 10% of his body weight the next month, but he waited before going back to the doctor so it wouldn't look like he had lost so much so quickly. The doctor took Arnold off more of the meds. Even though Arnold knew, deep down, it was a dangerous way to get there.

• 44:40Speaker 01

  It worked. That's the insidious thing about this.

• 44:45Dan Pashman?

  Dr. Olivardia, the expert we heard from earlier, says this is often part of the struggle for people with eating disorders. In one way or another, the behavior gets rewarded. In Arnold's case, it's getting off his meds. Maybe for others, it's that they get more compliments on how they look, more romantic interest. But for Arnold, just like in high school, what started with a specific purpose kept growing. And the whole time, he was hiding it from his wife.

• 45:09Speaker 01

  I just remember in Paris, you know, we're in Paris, for God's sakes. We just had just amazing food. And of course, I overdid it because I knew I was going to purge that night. But you know, my wife was all jacked up and jet lagged and she just wouldn't fricking fall asleep, man. And that's not how you should be enjoying Paris with your wife, you know, psychically willing her to fall asleep so you can purge.

• 45:46Dan Pashman?

  Two years after that first doctor's visit, Arnold and his wife moved back to the States and things got somewhat better for him. He got back into yoga and other exercise. He felt like he had more to keep him busy. In the beginning of 2020, they were supposed to move to Beijing, but then COVID hit. The stress of the move being canceled and the pandemic all took a toll. Arnold's yoga studio closed and it got harder for him to maintain his healthier habits.

• 46:10Speaker 01

  I don't have the same outlets that I had and I'm stressed out, so I'm eating. And again.

• 46:20Speaker 01

  My, my old crazy ex-girlfriend is, is there waiting.

• 46:25Dan Pashman?

  In the spring of 2020, Arnold starts purging again. But after a few months, he turns to intermittent fasting. For him, that means on weekdays, he eats just one meal a day, dinner with his wife. On weekends, he'll have lunch and dinner. He hasn't purged in months. That's where he's at right now.

• 46:44Speaker 01

  It seems to be a sustainable, socially acceptable way to manage my weight. So that's, that's been working for me.

• 46:55Dan Pashman?

  Are you hungry during the week?

• 46:57Speaker 01

  Oh, all, all, all the time. You know, if it's there all the time, you don't even notice it. Like if you live in the monkey house, you don't notice the stench. So it's always a part of my, you know, conscious being.

• 47:12Dan Pashman?

  Dr. Olivardia says that intermittent fasting can be an effective way to manage weight for some people, but for those with histories of eating disorders, it can be a trigger for binge eating. He says you should consult with your doctor before adopting this practice. Have you ever talked to your wife about your purging?

• 47:31Speaker 01

  No.

• 47:34Dan Pashman?

  Why not?

• 47:38Speaker 01

  Because if I talk to her about it, it might, I might have to like give it more attention than I want to give it. There might have to be like, you know, doctors and whatever brought into this. And it's shameful, Dan, to say you're a middle-aged bulimic is not, is not the, yeah, it's, I, I, I just, I don't want to do it, man.

• 48:05Dan Pashman?

  Do you think, is your wife gonna hear this?

• 48:09Speaker 01

  I think so. I think she needs to. Maybe that's part of the reason I wanted to, to come on here is. I, I, you know, I was telling myself the main reason I wanted to do it is to share my story with other guys out there that have a problem with disordered eating. But maybe it's a way for me to confront it and to talk about it and to, you know, bring it out into the light where it needs to be. You know, again, I'm afraid, I think what I'm, I'm just afraid that she'll, she'll look at me differently, that she'll, you know what I mean? Like, ah, this is not what I signed up for. This is not the guy that I married. And I know that's crazy. I know that she loves me and that she will love me unconditionally.

• 48:53Speaker 01

  But again, there's that nagging, you know, doubt in my mind. And that's just, I think that's the disease going, don't talk about it.

• 49:11Dan Pashman?

  Before we wrap up, I tell Arnold about Jack, the teenager we heard from earlier in the show. Arnold's been dealing with disordered eating on and off for nearly 45 years. What would he say to Jack?

• 49:23Speaker 01

  Dude, you are perfect, exactly the way you are, where you are right now. You don't have to fix anything. You don't have to change anything. You don't have to be anything. You just are exactly who you're meant to be in this moment.

• 49:46Dan Pashman?

  So if Jack, or Arnold, or any other boy or man were to get professional treatment for an eating disorder, what would that look like? Here again is Dr. Roberto Olivardia.

• 49:57Speaker 04

  If a boy or man goes into a program, an eating disorder program, there's no question that they'll be in the minority in terms of gender, that the majority of people will be women. Sometimes they might be the only male in the program. But there's this universality of this sort of experience that men who go to these programs who are very hesitant and worry about, oh, like, how's it gonna be? They say within a couple of days, they feel comfortable and they feel understood and they feel like there's something very freeing about it. You know, I, I've never worked with someone who goes into it and, and comes out of it thinking, oh, my God, that was the worst experience.

• 50:37Speaker 04

  It was, it's hard, just like rehab, you know, and sobriety is very hard, but it's totally worth it.

• 50:44Dan Pashman?

  For people grappling with disordered eating, Dr. Olivardia has this message.

• 50:49Speaker 04

  Please, please get help. People who struggle with eating disorders longer tend to have a worse prognosis, but that doesn't mean they can't recover. I once worked with a 72-year-old man who struggled with eating disorders for, since he was 12 years old, and he recovered at 72 and lived, I think, 13 more years, and he said those were the best 13 years of his life.

• 51:23Dan Pashman?

  We first aired this episode in 2021, and I have some updates. Galen has continued to see a nutritionist. He's working on intuitive eating, and his bone density has improved. He's now a licensed elementary school teacher. Jack is now a student at McMaster University in Ontario, and he's part of the EMS team there. In the summer, he works as a wildland firefighter. He told us in an email, quote, "Getting help was one of the most important decisions I ever made. And when I look back at where I was, struggling alone with my thoughts, I don't for a moment regret experiencing this disorder, because it taught me that I needed to find myself. And now, using that experience, I can be there for others." My thanks to Jack, Galen, and Arnold for sharing their stories with us. And special thanks to Dr. Roberto Olivardia, clinical psychologist and lecturer in the Department of Psychiatry

• 52:08Dan Pashman?

  at Harvard Medical School for his help with this episode. If you or someone you know is struggling, please reach out to the National Eating Disorders Association at ned.org. Next week on the show, we look into the mystery of the Hydrox cookie. Many people think it's a copycat of the Oreo, but in fact, Hydrox came first, then it disappeared. So what happened? We find out next week. While we wait for that one, check out last week's episode with chef Roy Choi. He was one of the first chefs to start cooking out of a food truck. Now he's earned national acclaim. But he spent a lot of years struggling before that. We talk about all that and more. That episode's up now. And hey, did you know you can listen to The Sporkful on the SiriusXM app? Yes, the SiriusXM app, it has all your favorite podcasts,

• 52:50Dan Pashman?

  plus over 200 ad-free music channels curated by genre and era, plus live sports coverage. Does your podcasting app have that? And there's interviews with A-list stars and so much more. It's everything you want in a podcast app and music app all rolled into one. And right now, Sporkful listeners can get three months free of the SiriusXM app by going to siriusxm.com/sporkful. This episode was produced by me along with managing producer

• 53:14Speaker 05

  Emma Morgenstern.

• 53:15Dan Pashman?

  And senior producer Andres O'Hara. Our editor is Tracy Samuelson. The show is mixed by Jared O'Connell. And our intern is

• 53:22Speaker 05

  Julia Leo.

• 53:23Dan Pashman?

  Music help from Black Label Music. The Sporkful is a production of Stitcher Studios. Our executive producer is Camille Stanley. Until next time, I'm Dan Pashman.

• 53:30Speaker 05

  And I'm Alice in Ottawa, Ontario, reminding you to eat more, eat better, and eat more better.

• 53:52Speaker 05

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