The fossilized shells neatly arranged on the huge coffee table in Dr. Thomas Holbrook's office are relics of the past in more ways than one. "I used to walk at noon every day," recalls Holbrook, 57, gazing through his office window at the rolling Wisconsin hills, "until I found a fossil better than the one I'd found the day before." Sometimes, he adds, "I'd be gone for hours."
Holbrook's compulsive fossil-hunting was not the pursuit of an archeology buff, but of a man struggling with anorexia. For 12 years, Holbrook exercised obsessively—sometimes walking for up to eight hours a day—and eventually limited his daily food intake to a single salad. By 1988, the 6-ft.-tall psychiatrist weighed just 135 lbs. "I was terrified," he says, "of being fat."
New evidence suggests that thousands of men feel the same way. "It used to be that we considered 1 in 10 anorectics to be men," notes Holbrook, who is the coauthor of a new book, Making Weight: Men's Conflicts with Food, Weight, Shape & Appearance. But a recent study puts that ratio at 1 in 6 and "that's probably a better picture. We don't know if the number itself is increasing. Perhaps men are simply more willing to talk about it."
Since 1997, Holbrook has been encouraging men to do just that. Director of the eating disorder center at Rogers Memorial Hospital in rural Oconomowoc, Wis., Holbrook is a pioneer in the relatively uncharted terrain of male eating disorders. "Tom's book is a watershed experience for the field," says Dr. Craig Johnson, president-elect of the national advocacy group Eating Disorders Awareness and Prevention. "I think it will destigmatize this for men."
For now, though, "the denial is even thicker" for men than women, says Holbrook, whose patients sometimes don't admit they have a problem until their 40s. "It's hard for them to accept that they care so much about how their bodies look."
Holbrook's residential treatment program, which can last up to six months based upon individual needs, slowly introduces patients to healthy eating, along with group and individual therapy. The men-only environment and Holbrook's openness about his own experiences are critical as well. "It made me feel less alone as a man dealing with this problem," says one patient, a California graduate student and recovering bulimic. "He has an understanding of things that I don't think is achievable if you haven't been there."
Having been there and back, Holbrook traces his struggles with food to lifelong insecurities. "My experience —and it's at the heart of the eating-disorder issue—is that I was never adequate," says the youngest of three children of a Milwaukee insurance agent, who battled alcoholism before committing suicide in 1975, and his society matron wife. "I'd stare at Charles Atlas and fantasize that I was that big and powerful. My father was always proud of his physical strength, and I never felt I measured up."
Before graduating from Baylor College of Medicine in 1970, Holbrook married high school sweetheart Jane Ewens, now 56, and the couple had two children: Ben, 26 and a member of the National Rowing Team, and Sarah, 23, a recent college graduate. By the mid-'80s, Holbrook says, his eating disorder was consuming so much of his time and energy that "the effect on my marriage was tremendous." He was divorced in 1989 and five years later married Joan Caley, 54. Last February, that marriage too ended in divorce. "My issues played a part," he admits. "I was not as emotionally available as I might have been."
Since self-diagnosing his disorder in 1988 ("I thought of the symptoms of anorexia and I knew I had them all"), Holbrook has achieved a healthy weight of 170 lbs. Getting to that point "was a struggle," he says. "There wasn't any formal treatment for men back then. But I was motivated."
So too are the 80 men who have participated in his program so far. "I'm amazed at how candid they can be, how they can allow others to comfort them," he says proudly. "They connect, in a way they haven't before."
Margaret Nelson in Oconomowoc
- Margaret Nelson.