Case Study: Joe’s Story

Joe is born six weeks early, but is healthy, and leaves the hospital two weeks later. He grows into a happy boy with a healthy appetite. He loves being outside and plays sport at every opportunity. Just before his twelfth birthday Joe has a growth spurt and starts to become even more serious about his sport. His muscles quickly become clearly defined and Joe’s friends at school praise him over his new found physique. Even his mum has to admit he looks in fine shape. Joe feels on top of the world. He is the best footballer and cross-country runner in his year group and he intends to stay that way. Unfortunately Joe’s euphoria is short lived. Each day Joe finds he wants to exercise a little more and eat a little less. This soon has a dramatic effect on his weight. Joe loses a quarter of his body weight in four months, falling from 42kg (6 stone 8 lbs) to just 31.4kg (4 stone 13 lbs). When he reaches 37kg his mum takes him to the doctor for the first time but is told not to fuss. Joe has several more visits to the doctor before being finally referred on to a specialist. It is a painfully slow process. Meanwhile Joe’s behaviour changes. He becomes distant from his friends. He can’t concentrate at school. He becomes angry and aggressive if anyone challenges him about his weight or his diet. He gradually becomes superstitious and his days are filled with rituals. He becomes severely emaciated, and his skin is dry and scaly. The whole family is being affected by Joe’s behaviour. Just as the specialists finally agree that Joe is suffering from anorexia, Joe collapses and is rushed into hospital with a suspected heart attack. He is on a drip for three days before being admitted to a residential adolescent unit. The treatment regime is very strict and extremely difficult for a twelve year old boy to cope with. A fragile emaciated young boy thrust into a world of teenage girls with a wide array of behavioural issues ranging from anorexia to self harm and attempted suicide. Unsurprisingly it takes Joe a while to settle, but unusually for an anorexic he is determined to get better. Even though his mind is distorted by his illness he can see that if he doesn’t beat it, he will never play competitive sport again. He complies with the treatment regime, and, despite the odds seeming to be towering against him at times, he does get better. When Joe finally returns home there are some very difficult moments but the family works hard together, and, with the out patient professional team to ensure the anorexia doesn’t return. For the first six months back at home Joe struggles to maintain his weight within an acceptable range, as he gets used to having to consume the huge quantities of food that an active teenage boy needs, to grow. His weight fluctuates a little, but never falls enough to cause real concern. Within a year Joe is signed off by the psychiatrist and is relieved to hear he has no more therapy sessions to attend. He continues to be fit, healthy and happy and no longer has to think about what he is eating. There is also a very similar story to Joe’s featured on the BBC News Health website. It was written in August 2003 and features a 13 year old boy who wanted to get fit for the rugby season. The doctors were mystified when George became ill and lost weight. Like Joe, George did manage to get the appropriate treatment just in time and has now made a full recovery.