Sunday, October 9, 2016

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Thursday, April 21, 2016


It is with a very heavy heart that I pass along the news that Karlene Lindenmuth passed away today, April 21, 2016, after struggling for years with anorexia and bulimia.  Karlene was such a sweet, loving, and caring person.  Her death breaks my heart.

She wanted to share her story to warn others about the devastating effects of eating disorders, so encouraged me to chronicle her hellish journey on my blog.

Rest in peace, Karlene.  I was honoured to be your friend.

Many thanks to Karen for letting me know of Karlene's passing today.

You can read Karlene's story here:


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Sunday, July 12, 2015


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anorexia-Bryan Bixler "Bryan Bixler is dying. He feels it in his bones a little more each day, as if passing the mirror in his apartment and glancing at himself isn’t evidence enough."
Some photos by Mark Boster

[July 12, 2015]

His amazing story of recovery...



To say that Bryan Bixler's road to recovery from anorexia is remarkable is an understatement.  

When I first posted about Bryan back in 2009, he was deathly ill.  Between 2009 and 2011, I lost track of Bryan until I received an update in January of 2011 from a reader (see Update below).  I was thrilled to learn that Bryan was doing so much better.

Bryan has made four appearances on Dr. Oz, the last being in December of 2013.  You will find the links to the Dr. Oz videos on Bryan's website here:

Last week, I was contacted by Bryan's lovely partner, Kristen, who updated me on Bryan's progress, which is nothing short of miraculous.  The pictures below say it all:  Bryan is healthy and happy.    

Bryan is now a Program Director and Nutritional Advisor at Hotel California by the Sea, a rehabilitation treatment centre for men in Newport Beach, California , which provides addiction treatment for dependence on alcohol and other substances. 

Please check out Bryan's profile at this link:

For those of you who are suffering from anorexia, bulimia, and other EDs and see recovery as daunting or impossible, Bryan's journey is evidence that once you take that first step, you CAN recover.

 Below are two beautiful and inspirational quotes that Brian has posted on social media: 

"The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers."
~ Unknown

"Compassion is not a relationship between the healer and the wounded. It’s a relationship between equals. Only when we know our own darkness well can we be present with the darkness of others. Compassion becomes real when we recognize our shared humanity."
~ Pema Chödrön

Please take time to read my earlier posts below about Bryan's journey...

[January 30, 2011]

Many thanks to "C." for this update on Bryan sent to me on December 30th, 2010:

"I don't know if you're aware that Bryan Bixler was back on the Dr. Oz show on Nov. 27 - and he's made astounding progress. It brought tears to my eyes to see how much better he is doing.
Here are the links to watch the show:

Part 1

Part 2

Part 3

"Bryan Bixler suffers from anorexia nervosa, an eating disorder that causes him to deprive himself of enough food. He wants to get well, but the treatment Medi-Cal will cover falls short.
By Dana Parsons
6:29 PM PDT, April 2, 2009
"Bryan Bixler is dying.

anorexia-Bryan Bixler Bryan Bixler feels he can't escape the truth in the mirror. At 39 years old, 5 foot 9 and 82 pounds, he is growing weaker by the day

He feels it in his bones a little more each day, as if passing the mirror in his Laguna Beach apartment and glancing at himself isn't evidence enough. Here's what greets him: sunken eyes, paper-thin arms and legs that hang like a puppet's, the slow-motion gait that he fears will define his movements for the rest of his days. What happened, he wonders, to that young man who once ran half-marathons?

anorexia-Bryan Bixler

It's all so crazy. That's what he tells himself. Dying a bit more every day and knowing how to fix it but being unable to do it. Knowing that if he would just start eating like a normal person, he'd give himself a fighting chance.

But he's not a normal person, not anymore. Not at 5 feet 9 and 82 pounds. Not when he's got a master's degree and knows how the body works and yet can't make himself fix spaghetti or drink a chocolate malt.

Bixler is 39 and anorexic, suffering from an eating disorder traditionally associated with young women but which generally has been thought to include a 5% to 10% male component. In recent years, however, some researchers suggest that figure may be approaching 15%.

He doesn't remember a day or week or month that he turned the corner and inexorably headed down the path to anorexia nervosa, but he and family members think it was a slow-moving journey that started in his teens. He remembers those years as a time when his parents went through a difficult divorce and he was simultaneously caught up in the fitness craze and bent on avoiding junk food.

"I was Mr. Healthy," he says. "I was a vegetarian, I wanted to be a runner. Before I knew it, I lost weight without realizing it."

anorexia-Bryan Bixler
Bixler holds a photo of himself and his sister, Kimberly Leeds, from high school days

As he moved through his 20s, the disorder plunged him into what he calls "the vortex," a swirling downward spiral of weight loss and a deepening inability to reverse course.

But if there was a time back then when Bixler either denied he was anorexic or thought people were overreacting to his looks, those days are gone. "I see when I look in a mirror a walking caricature of a human being," he says. "A skeleton."

anorexia-Bryan Bixler

But what's different now than, say, even a year or so ago is a new resoluteness. The most primal cause of all.

"I want to live," he says.

To do that, he believes, he needs intensive coordinated treatment at an eating disorder center. Bixler's Medi-Cal insurance would pay for medical help and psychiatric or psychological treatment -- through care providers Kaiser Permanente and the Orange County Health Care Agency -- but not for long-term coordinated treatment at an eating disorder clinic.

The gap between what he needs and what his insurance will cover has been played out around the country. Many insurance companies increasingly have questioned the need for long-term residential treatment programs and balked at paying the high costs for them.

Seven years ago, with his parents footing the bill, Bixler spent several months at a treatment center in Wisconsin. Even though his weight climbed from 92 pounds to 120, he considered it a prison. When his parents' money ran out, he left and immediately relapsed.

anorexia-Bryan Bixler

Last fall, Bixler returned to the Wisconsin center but stayed only six days. Assigned to a psychiatric unit, he refused treatment, and his parents told him they could no longer afford the bill.

Since then, Bixler insists, he's seen the light and would stay in a long-term treatment program as long as it took. The only other option, he says, is death. "Obviously, my way is not working."

Neither is the limited psychological or psychiatric care he can get through Medi-Cal, says Terry Schwartz, medical director at an eating disorders program at UC San Diego. She supervised a recent psychiatric exam of Bixler, which he requested in the hope that it would bolster a claim he's made with the state for increased Medi-Cal coverage. The claim is pending.

Bixler isn't at an acute stage, Schwartz says, but his laboratory results and weight put him at "high risk" of dying from anorexia. American Psychiatric Assn. guidelines alone, she says, put him in the category of someone who needs either inpatient or residential care.

What he needs is a coordinated program that would run the gamut of medical, psychological, psychiatric, nutritional and dietary treatment. Bixler would be most vulnerable, she says, to sudden cardiac death or an inability to fight off an infection because of his depleted white blood cell count.

While convinced it's nowhere near what he needs, Bixler still avails himself of the counseling services offered through the county and Medi-Cal. If nothing else, he reasons, it'll perhaps send a signal that he's trying to play ball.

On his more charitable days, Bixler tries to avoid recriminations.

anorexia-Bryan Bixler

"I'm not blaming anybody," he says, "not Kaiser, not the county. I try not to blame myself, because of course I feel like I caused it. For me, it's the anger, the sadness that a life doesn't mean anything unless you have money."

In his 20s, before he fully grasped what was happening to him, Bixler saw a future for himself. With degrees from UC San Diego and the University of Georgia, Bixler wanted to work in the education department of zoos or aquariums. Instead, the eating disorder overtook him, and after short stints at two zoos and teaching while a graduate student, he went on full-time disability nine years ago.

He subsists on Social Security and lives in a studio apartment with a view of the Pacific Ocean, the beneficiary of cheap rent because his parents own the building.

He typically sleeps until late morning and stays up late. His sister, Kimberly Leeds, thinks that's so he can avoid normal social contacts and justify living his life mostly in the night.

anorexia-Bryan Bixler
Bixler has always been close to his sister, Kimberly
She's the one who pulled his shirt over his head about 15 years ago and made him look at his rib cage. "Look at yourself," she said. "How can you think you're OK?"

anorexia-Bryan Bixler Bixler is growing weaker by the day

Even though she understands the disorder, her brother's eating habits both cause her to marvel and madden her.

"He will not eat any dairy, but he eats frozen yogurt all the time," she says. "He won't eat certain lettuce because it gets caught in his teeth, but he will eat iceberg lettuce. He'll eat popcorn all night long but won't eat roast beef because it sticks in his teeth."
anorexia-Bryan Bixler Bixler, his nephews, his sister and her husband, Clay, say grace

If they go out to eat, she says, "He can't order something off the menu. There are about five or six statements that have to go along with it." Forget rice or beans, if that comes with the entree. He has to have shredded lettuce and cilantro on the side. He will eat vegetables and protein foods, but carbohydrates are a non-starter, she says.

Leeds may be frustrated, but she hasn't given up on her brother. To the contrary, she's joined him in his fight to get more extensive care.

Their parents, she says, have been dealing with the situation for half of Bryan's life and it is wearying.

"Mother feels like she's done everything. She's mentally, physically and emotionally exhausted," Leeds says. "Her life has been dedicated to him for the last 20 years."

All of which Bixler knows and which makes him sigh.

His father tells him he's not trying hard enough. What's so hard about fixing a bowl of oatmeal and eating it? They have shelled out the money before and might again, but the failing economy has hurt their finances.

"They blame me, their blame reinforces my own self-blame," he says. "I'm my own worst critic. I look in the mirror at night, saying I'm insane. What's wrong with me?"

He knows the answer, of course: a disorder with numerous dark corners that enveloped and then overwhelmed him.

anorexia-Bryan Bixler
Bixler reads to his nephews, Jeremy and Elliott Leeds, at his sister's home

"I can't understand why I can't do what a 6-year-old can do -- feed myself." "


Audio slideshow:,0,848624.htmlstory

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Friday, August 2, 2013


On July 27, 2013, I received the following heartbreaking comment on this post from glen d about his niece's death:   

glen d said... my niece was 16 she was anorexic and she was in the hos ital then she was back home and she took her own life i can't understand this i've been reading about it on these sites I've been sick for about 2 days can't sto thinking about Rachel she was a lovely girl exce tional in so many ways if someone can hel me i want to understand what went wrong with her July 27, 2013 at 3:17 AM
If any of my readers have had a close friend or relative, who was suffering from an ED, take their own life, would they please share with glen d (in the comment section below) their feelings, their thoughts about what drove their loved one to commit suicide, and how they're coping with their loss.  Many thanks.

"Attempted Suicides in Anorexia Nervosa

They are frequent and serious.

Suicide is the second leading cause of death in anorexia nervosa (AN), and the suicide rate is eight times higher among young women with AN than in young women generally. To better delineate the issue, investigators analyzed data from 413 participants with current or lifetime AN (95% female) who were enrolled in an NIMH genetics study.

Overall, 17% had made a suicide attempt. An attempt was significantly more common among those with binge-eating, purging, or both (21%–29%) than among those with the restricter subtype (7%).

Of all suicide attempters, 52% reported one attempt; 39% reported two to four attempts; and 9% reported five or more attempts. Fifty-five percent had required medical attention for their most serious attempts, and 47% were hospitalized. Also, 78% reported wanting to die, 57% thought that they would die, and 54% made attempts rated as moderate to extreme.

Impulsivity accounted for 49% of attempts, with the remainder somewhat or thoroughly premeditated (each, 25%). Seventeen percent reported concurrent alcohol abuse at the time of the worst or only attempt, 9% reported concurrent drug abuse, and 82% reported a concurrent depressive episode. After adjustment for depression, attempts were associated with other impulsive behaviors (e.g., self-injurious behaviors, shoplifting), excessive drinking, substance use, panic disorder, post-traumatic stress disorder, and cluster B personality disorders.
Since this study recruited from both clinical and nonclinical populations, the very high rates of severe suicidality in patients with AN, particularly of the binge-eating/purging subtype, are particularly alarming. Clinical studies of AN patients have reported even higher rates.
Clinicians assessing and treating these patients should be alert to the constant risk for suicide, particularly among patients with indications of impulsivity and the other comorbid conditions identified here.
Joel Yager, MD"

Published in Journal Watch Psychiatry on May 23, 2008

Citation(s): Bulik CM et al. Suicide attempts in anorexia nervosa.

Psychosom Med, 2008 Apr; 70:378"

Suicide Is Not Painless

The Downside of Suicide
By Nancy Schimelpfening,
"Guns aren't lawful;
Nooses Give;
Gas smells awful;
You might as well live. "

Dorothy Parker (1893-1967): 'Resume' (1937)

"If the topic of suicide seems particularly gruesome or morbid, that's because it is meant to be. Suicide is not a fool-proof or painless proposition. The fact is that suicides fail and even when they succeed, it may not be at all like what you had imagined.

Even the Best Planned Suicide Can Fail

The New England Journal of Medicine (Feb 22, 2001, Vol. 344, No. 8) dealing with physician assisted suicide shows that even with expert medical advice, things can and do go wrong. The study was conducted in the Netherlands, where euthanasia is legal. Some of the statistics reported:
In 16% of cases where patients tried to kill themselves with drugs prescribed by a doctor, the medication did not work as expected.

Technical problems or unexpected side effects occurred 7% of the time.

Problems occurred so often that in 18% of cases a doctor had to intervene to ensure death.

Even when a doctor performed the procedure, patients took longer to die than expected or awoke from a drug-induced coma that was meant to be fatal in 6% of cases.
If a physician can't pull off a perfect suicide, what are the odds that you will?

Suicide is Not Pretty

Assuming your suicide does go as planned, what do you imagine will be the scene left behind? Do you have glamorous fantasies of being found with a peaceful smile upon your face? Consider the following:

When you die, you lose control of your bodily functions. To put it nicely, you defecate and urinate on yourself.

If you have taken an overdose, you may vomit before you become unconscious.

Violent forms of suicide such as cutting ones wrists, hanging or gunshots leave a very grisly task for whoever has to clean up afterwards.

Victims of strangulation and hanging will be bloated and purple.

Your chosen method of self-annihilation may present a safety hazard to whoever finds you.

The High Cost of Living

So what are the consequences if you survive a suicide attempt?

The best is that you will live to discover the truth about depression: that it really is a temporary condition. Circumstances change and medications work. The old saying that suicide is a permanent solution to a temporary problem is sage advice. When the blinders of depression are lifted you see very clearly how true this is.

The worst result of a failed suicide is that you will be worse off than you were before.
Consider these facts:

If your brain goes without an oxygen supply for more than about three minutes, you will suffer permanent brain damage.

Gunshot wounds that miss will leave you with permanent disfigurement and disability.

Overdoses on many substances will leave you with damage to kidneys and liver.
People who have swallowed caustic substances like lye can survive with severe burns to their GI tract.

Just about all suicide methods have the risk of severe, possibly prolonged pain if things go awry.

The Hurt Doesn't Go Away After Suicide

Perhaps the most common reason people commit suicide is to stop the pain the are feeling inside. The thing is, the pain doesn't go away. It gets transferred to those you love. Your parents, your spouse or significant other, your kids, your friends and acquaintances. Everybody you know is touched to some extent by suicide.
Grief is one of the strongest emotions a person can feel. Do you really want to make your loved ones feel the sort of pain you are feeling? Think about it. If you are convinced that people will be better off without you, you are dead wrong.
It's Your Choice

This article is not meant to be an all-inclusive list of reasons why you should not take your own life, but is meant to give you a starting point in really thinking about what it is that you are considering.
If you are reading this, then you are an intelligent person who is capable of making informed choices about where you want your life to go. Do you really want your life to end? Or just the pain?
Depression is a treatable illness. If what you really want is relief from your depression then you owe it to yourself to exhaust all of your treatment options before choosing the final solution of death.

Warning Signs of acute risk for suicide

Talking About Dying -- any mention of dying, disappearing, jumping, shooting oneself, or other types of self harm.
Recent Loss -- through death, divorce, separation, broken relationship, loss of job, money, status, self-confidence, self-esteem, loss of religious faith, loss of interest in friends, sex, hobbies, activities previously enjoyed

Change in Personality -- sad, withdrawn, irritable, anxious, tired, indecisive, apathetic

Change in Behavior -- can't concentrate on school, work, routine tasks

Change in Sleep Patterns -- insomnia, often with early waking or oversleeping, nightmares

Change in Eating Habits -- loss of appetite and weight, or overeating

Diminished Sexual Interest -- impotence, menstrual abnormalities (often missed periods)

Fear of losing control -- going crazy, harming self or others

Low self esteem -- feeling worthless, shame, overwhelming guilt, self-hatred, "everyone would be better off without me"

No hope for the future -- believing things will never get better; that nothing will ever change

Other things to watch for: Suicidal impulses, statements, plans; giving away favorite things; previous suicide attempts, substance abuse, making out wills, arranging for the care of pets, extravagant spending, agitation, hyperactivity, restlessness or lethargy.
If you feel you can't go on, please give yourself a chance to get help by either calling the suicide hotline numbers or clicking on the links listed below:
Suicide Hotlines:

National Suicide Hotlines USA
United States of America

Toll-Free / 24 hours a day / 7 days a week

1-800-SUICIDE 1-800-273-TALK
1-800-784-2433 1-800-273-8255

1-800-799-4TTY (4889)
Deaf Hotline

Many thanks to Sherrie of pinch of... for bringing the Anorexia Nervosa/Suicide study to my attention.

(all bolding mine throughout this post)

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