Although he should weigh 140, he reports scheming to reach 98 pounds. Video images taken by his wife show him to be extraordinarily thin.
David’s self-perception is distorted; he does not believe that he appears emaciated. And although he recognizes that his thinking is irrational, he seems helpless to break the grip of the disorder. He reports that at home he would dump his yogurt down the drain in an effort to fool his wife that he had eaten it. In the hospital, he describes his internal struggle. If he now fails to gain weight, he is a bad patient. If he does gain, he is a bad anorexic.
Treatment at Somerset Hospital includes medication, food, and therapy sessions. In group therapy, it is clear that David views his body negatively. At home, Joanne describes her husband as his own worst enemy. She finds David’s continued refusal to eat to be increasingly frustrating and tiring. When the narrator confronts David with the prospect of death from his illness, he acknowledges that possibility, but also makes the bizarre claim that it would provide “some kind of validation.”
After six months of therapy at the hospital, David has successfully gained 25 pounds and is preparing to leave treatment. However, he describes his recovery as only beginning.