In 2021 our 14-year-old son developed anorexia. The following is an overview of our experience and what we learned from it. We are sharing our experience in the hope that it might help others to make more sense of their own experiences or to avoid a similar experience at all.
Our son lost weight first, and eating disorder behaviors followed. I remember the exact day that my son first asked for half a sandwich for lunch. It was the first week in October, and it was the first of many visible signs that he had developed an eating disorder.
Note: I homeschool my children and my husband works from home. Our family eats together, works together and plays together. My husband and I are observant parents and had not noticed any abnormal eating habits prior to that day in October.
Coincidentally, I had just weighed my son the month before so that he could rent equipment for his upcoming ski season. Now curious about his weight because of his new eating habits, I went back to evaluate his most current weight and saw that it was actually lower than it had been the year before. Much to my surprise, during that year he had grown two inches but lost three pounds.
A loss of three pounds may not seem significant. But considering that he should have gained approximately fifteen pounds that year in order to remain on his natural growth curve, it might be more accurate to say that he lost a gross weight of approximately eighteen pounds that year.
Note: Had it not been for the ski team, I would not have had any record of my son’s weight, as we were not in the habit of doing annual well-child visits. Even having recorded weight annually for the team, I had never paid attention to weight gain (or loss in this case) or to how my son’s weight landed on his natural weight curve.
As he continued to lose weight, more abnormal thoughts and behaviors developed. We soon identified his changes as an eating disorder. Over the next few months as we futilely tried to find help, his weight continued to drop steadily and he experienced new physical symptoms, such as dizziness and a pale face. Simultaneously, he began showing new behavioral symptoms, such as compulsive rituals and difficulty sleeping, and psychological symptoms, such as a distorted view of his body and sadness.
We treated him with food. As his weight was restored, his disordered thoughts and behaviors gradually decreased and ultimately disappeared. In January I found the F.E.A.S.T. website. I quickly embraced the idea of Family-Based Treatment and with it the principle that “food is medicine” for eating disorders. Although we were not able to find a proper therapist, we were able to find a registered dietitian who specialized in eating disorders and began meeting with her.
In the beginning stages of re-feeding, the anorexia seemed to intensify. But after approximately six months of refueling and substantial weight gain, his body and his mind were restored. His compulsive behaviors and thoughts faded away, and he returned to his usual self. This is not to say that the process was easy; I have omitted many details for the purpose of making my point as clear as possible.
Note: Our son was assessed for a partial hospitalization program, but we chose not to admit him for treatment. We interviewed six different therapists, but for various reasons declined each one. Our son also never took any medication to treat any symptoms. This is how we know it was the food that healed his mind. Because traditional treatment for eating disorders includes both a dietitian and therapist, many people may conclude that food heals the body and therapy heals the mind; but our son’s case is evidence that food can heal both.
Making Sense of Our Observations
Because we did not have a therapist for our son, I felt responsible to do whatever I could to help him. I spent hundreds of hours researching eating disorders. Much of what I was hearing partially explained my son’s experience, but nothing explained the complete picture.
Then one day I came across the Minnesota Starvation Experiment. Although the purpose of the study was to learn how to re-feed people who had been starving, what struck me was the serious effect that starvation could have on a person. During the experiment, a group of thirty-six men with good physical and mental health were intentionally starved. They experienced physical, mental, emotional, and psychological symptoms, many similar to what I was seeing in my son.
Could it be that the disordered thoughts and behaviors I was seeing in my son were symptoms too?
If his distorted thoughts and behaviors were symptoms of starvation, that would explain why they appeared after he lost weight. It would explain why they got worse as he continued to lose weight. And it would explain why they went away as he refueled his body and his weight was restored.
Throughout my research, I had repeatedly heard that eating disorders and mental illnesses are co occurring. I automatically interpreted that to mean that eating disorders were a specific type of mental illness that came from a larger pool of pre-existing mental illness in the person. Yet I kept rejecting the idea because my son had no pre-existing mental illness.
Suddenly, in light of the Minnesota Starvation Experiment, things made perfect sense. If mental, emotional, and psychological problems are symptoms of starvation, then of course eating disorders and mental illness are considered co-occurring! When someone is starving, the entire body suffers, including the brain and with it the body’s normal functions. There are physical, physiological, and psychological consequences; the whole person suffers. Quite frankly, it would be odd if someone was physically starving and didn’t experience related physiological and psychological consequences.
Yes, it made sense that the disordered thoughts and behaviors we were seeing in our son could be symptoms of starvation. But naturally, the next question was: had our son been starving? As we took an honest look at the months leading up to our son’s eating disorder, the answer was a shocking but resounding yes.
Our son is a competitive athlete. Just prior to showing symptoms of anorexia, he had spent a solid six months rigorously training and competing in mountain biking races.
Also prior to showing symptoms of anorexia, my family and I were relatively modest eaters. My husband and I quickly and regretfully realized that we had not been providing our son with increased nutrition to sustain him during his athletic training. Quite possibly, we had not been providing him with adequate nutrition for his normal adolescence growth, even apart from training.
Note: See more details about how our son’s intense athletic training and insufficient nutrition led to the development of anorexia in my post titled The Biology of Anorexia.
Note: After even closer examination, I recognize that our family’s lifestyle, specifically the fact that we are extremely active people and had been relatively modest eaters, may have been contributing to our son’s anorexia for some time prior to its visible onset.
The way I saw it, we had accidentally recreated the Minnesota Starvation Experiment. For a period of approximately six months, our healthy son participated in intense athletic training without proper nutrition and consequently lost weight. Starvation resulted in eating disorder thoughts and behaviors, followed by further weight loss and additional disordered thoughts and behaviors. As he was re-nourished and weight restored, the disordered thoughts and behaviors initially grew stronger, then gradually lessened and eventually disappeared.
Note: One major difference between our experience and the Minnesota Starvation Experiment is that we were dealing with a child, whose brain had not fully developed, rather than a grown man. Another difference worth noting is that our son was not aware of what was happening to him, whereas the men were voluntary participants who had agreed to deprivation, suffering and rehabilitation.
But the conclusions from our experience were just as straightforward as they were in Minnesota: Our son’s anorexia was an involuntary response to his physical state of starvation. Put another way, weight loss led to an unsolicited desire for more weight loss.
-Further weight loss resulted in additional physical, physiological, and psychological symptoms. With food and weight restoration, the physical, physiological, and psychological symptoms improved and the eating disorder resolved.
It is hard to fathom all that has happened over these past few years. What began as a “starvation accident” has ultimately changed our lives forever. Today, we are not just relieved that our son has recovered, but genuinely thankful for the experience that we had because of the life lessons and eating disorder knowledge that we learned along the way. Our hope is that our experience can similarly be of some value to others.
Rachel, thank you for sharing your family’s story and for telling it in a way that is so clear and powerful.
Excellent post. Your observations fit with mine, only our kid was a competitive lightweight division rower. As she grew in height she gradually restricted intake of food to keep her weight below the mandatory limit of 130 pounds for her sport. Them semi-starvation caused the symptoms of AN — depression, anxiety, obsessive thinking, etc. The only cure was a large amount of food, weight gain, scaling back (not completely eliminating) exercise, and time, using the principles of FBT. Talk therapy was counter-productive. A good summary of the Minnesota Starvation Study is an article entitled They Starved So that Others Be Better Fed, in the June 2005 issue of the Journal of Nutrition.
Thank you for taking the time to share your story. I am very new to this situation and I am terrified for my 12 year-old daughter. I hope her situation turns out as well as your son’s did. I am very happy for you.
Was your son hungry during his intensification of athletic training? Was he aware of his own food deficit?
Hi! I don’t know if our son was “aware of his own food deficit,” but he was definitely hungry during his athletic training. The problem was that he ate the same amount throughout his training (and growth spurt) as he always did, instead of eating more like he should have. Unfortunately, the reason he didn’t eat more was not because he didn’t want more- it was because we just weren’t providing him with more.
As inexperienced parents with little background in nutrition and child development at the time, we just didn’t understand the importance of food, weight and maintaining a positive energy balance throughout adolescence. We made a lot of mistakes, thinking we were living healthy, “simple” lives, without having any idea that our child’s health was being compromised. For example, we would:
-use water in recipes such as oatmeal that called for milk or water.
-never add butter in recipes when butter was optional.
-only drink water (no milk or juice).
-use almond milk instead of whole milk for cereal.
-not make meals big enough for extra servings. (For example, now I know that my son needs two hamburgers for dinner instead of just one. I also need to make three pizzas for the family instead of two, two pounds of pasta instead of one, etc.)
-and so on.
Also, we’ve always been very active as a family doing things like mountain biking, nordic skiing, backcountry snowboarding, day hiking, overnight backpacking, etc. It was very common for us to go on all day excursions in the mountains with a simple, lightweight bagged lunch.
In hindsight, it was the combination of the way we lived plus the way we ate that resulted in negative energy balance in our son, which had detrimental effects. I believe that if he had been given the opportunity to eat more during that time, he certainly would have. He is definitely hungry ALL the time now and we are so thankful for that! As you can imagine, we’ve made many changes in the the way we eat as a family.