Anorexia descends on a rare victim: a male

At the age of 12, Jack Toepke almost died of self-imposed starvation

his illness, though controlled, still haunts him.

Health & Fitness

October 13, 2002|By Aline Mendelsohn | Aline Mendelsohn,Special to the Sun

Jack Toepke lay listlessly in a hospital bed. A priest knelt before him. Toepke was desperately ill. He stood 5 feet, 8 inches tall and weighed 77 pounds. His cheeks were hollow, his eyes half-closed, his stomach empty.

In a haze, he didn't register that he was sick enough for a priest to be reading him last rites. For two weeks, doctors had crowded around Toepke, taking blood samples and ordering brain scans, suspecting he had a tumor.

Finally, a psychiatrist had diagnosed him with a disease he had never heard of: anorexia.

And now, doctors had determined that 12-year-old Jack Toepke was only 5 pounds away from death.

Toepke survived that 1977 incident. But today, 25 years later, the Orlando, Fla., man still fights a disease usually associated with women. Because 90 percent of people with eating disorders are female, the other 10 percent -- the male patients -- are sometimes forgotten.

"There is still very much a stigma for males in getting treatment," says Karen Samuels, a clinical psychologist in Daytona Beach, Fla.

'A deafening refrain'

Eating disorders include anorexia, bulimia and compulsive exercising. Anorexia, perhaps the best known of these illnesses, is characterized by a paralyzing fear of weight gain.

Disorders in males often manifest themselves through excessive exercising. While women are more likely to desire a certain weight or size, men are more apt to seek a particular body shape, especially from the waist up.

The causes of eating disorders depend on numerous factors. Often, the disease stems from childhood weight problems.

"Sometimes a comment someone has said can become a deafening refrain in their head," Samuels says.

And so some people vow never to be fat again. Even if it kills them. Eating disorders have the highest mortality rate of any psychiatric illness.

Jack Toepke describes his childhood as "idyllic" before he became ill.

He doesn't know why he developed anorexia and doesn't think he ever will. Years of therapy have convinced him that it has everything to do with gaining control.

"And the control becomes your twisted sort of treasure," he says. "The weight was the only thing that nobody could screw with."

The summer after third grade, Toepke inexplicably became obsessed with his weight. He drank only Diet Cokes -- never juice or sugar-laden sodas -- and hardly ate.

Toepke limited his intake to the point where he would eat an apple and a bowl of cereal for breakfast, throw away his lunch and peck at a few bites of dinner. He found ways of moving food around his plate so it looked like he ate more than he did.

"I didn't see it happening," says Jane Toepke, his mother.

One day in the seventh grade, a wave of nausea washed over him and he crumpled to the ground. For the next couple of days, Toepke stayed in bed, weak from starving for months, so weak he could not eat.

At the hospital, doctors told his parents that Jack might not make it. Upon seeing the gaunt-faced child, a psychiatrist immediately diagnosed Toepke with anorexia.

"He has what?" Jane Toepke recalls asking.

Afraid of cookies

Like most people, she had never heard of this strange disease. It was 1977, seven years before singer Karen Carpenter's untimely death brought anorexia to the public consciousness. Jane Toepke armed herself with as much information as possible but found scant resources at the library. And most of the literature she did find was geared toward women.

Toepke stayed at Florida Hospital's psychiatric ward, a frightening place for a 12-year-old who had never been away from home.

During a counseling session, a psychiatrist waved a bag of cookies before him, commanding him to eat one.

Toepke cried. He took a bite and pushed it away, sobbing.

"Cookies were kryptonite, cyanide for me," he says. "I thought I was going to poison myself."

Still, on an 8,000- to 10,000- calorie-a-day diet, he couldn't help but gain weight. Incentives, such as weekend passes to go home, motivated him to eat, despite himself.

He weighed 100 pounds when he left the hospital and continued to see a psychiatrist weekly, where he would be weighed. He fasted the entire week and then binged the night before his appointment, gorging himself with bananas, ice cream, hamburgers. He continued this cycle for two years.

By his junior year in high school, Toepke had found a new obsession: exercise. He became an avid runner, lured by the adrenaline high it brought him. He would run eight miles in the morning and go to the gym in the afternoon.

Working out constantly allowed him to eat anything he wanted without gaining weight.

Still, he sometimes starved himself and achieved a high from hunger, a sense of psychological well-being. The more he starved himself, the more valuable became his treasure of control. No one but him could manipulate the treasure.

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