Although men suffer from anorexia, most commonly they are found to be like Novak — binge eating and/or going to extremes to maintain a muscular physique.
It becomes a problem when it begins interfering with their day-to-day functioning, according to Kary Woodruff, a sport dietitian at The Orthopedic Specialty Hospital in Murray.
"I always present the question of: ‘What are you having to do to maintain this?’" Woodruff said.
At his worst, Novak’s cycles lasted for days during a period of one to two years. He estimates he suffered from an eating disorder for four to six years.
“I didn't have any resources," he said. "I didn't know where to go.”
The secretive nature of the addiction often makes it hard for family and friends to recognize symptoms, Spigarelli said.
“That, to me, is the biggest tragedy in this whole thing,” he said.
Society has adopted the incorrect assumption that when someone who is normal weight says they're fat, it is solely a symptom of insecurity, Spigarelli said.
"So when somebody says to their parents or friends or to their significant other 'You know, I'm feeling kind of fat,' the general expectation of the public is that they're looking for some kind of compliment, not that they’re saying they have a symptom of a disease,” he said.
Spigarelli encourages family and friends to speak up if they notice that a loved one may be struggling with an eating disorder.
"I think we learn to not see them, and I think part of that is because we worry that we might be offending somebody," he said.
The bottom line, Spigarelli said, is "treatment works and people get their lives back."
What matters most is “how bad the disease is, how long it's gone on for and what their personal beliefs are as to what the disease does for them in a positive way," he said.
"If you think about people who by definition are afraid of becoming overweight, the disease provides some reassurance to that fear,” Spigarelli said.
Because of this, he tries to help patients see that he will not make them become overweight, but will help them reach a healthy weight.
Ideally treatment comes in a trifecta, where a nutritionist, therapist and doctor will work together, said Alyssa Anderson, a registered dietitian at St. Mark’s Hospital.
A good indicator that someone is on their way to recovery is their willingness to talk about their disease, she said.
“Eating disorders thrive in secrecy,” Anderson said.
Treatment options range from seeing an eating disorder specialist, nutritionist and perhaps a therapist for a handful of visits for mild cases, or residential treatment for those with more severe conditions, Spigarelli said.
Novak now studies eating disorders in men as part of his doctorate work at BYU. He has been able to use his experiences to help others struggling with similar issues.
Novak went to therapy for the depression that was the root of his eating disorder, but he was never asked about his relationships with food and exercise.
He eventually began developing friendships with other men and felt more accepted, which led to his recovery.
The eating disorder is still something in the back of Novak's mind. When he misses a day at the gym or eats food that is not as healthy, he has to remind himself to not feel guilty.
“Everybody has to negotiate their experience with food and exercise,” he said.
Weiss now meditates for an hour every day, an integral part of his recovery, and said he is glad he sought help.
"Because I've dealt with this, I'm extremely happy today," he said.
Weiss admitted that it is difficult to find residential treatment for men with eating disorders. One thing he hopes to see is an increase in awareness to help the disease move out of the shadows.
"I'm just interested in a dialogue," Weiss said.
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