SALT LAKE CITY — Madeline Thompson's descent into an eating disorder is a story of degrees.
It started in high school when she began exercising and throwing up to get rid of excess calories.
By her junior year in college, this developed into anorexia. Her diet consisted of egg whites, ketchup and sometimes vegetables. She estimates she ate no more than 400 calories per day.
"No one knew that I was struggling with it," Thompson said.
She is one of the 30 million Americans who suffer from eating disorders at some point in their lives. During National Eating Disorder Awareness Week, Feb. 23 - March 1, organizations and individuals are trying to bring attention to this often secret problem.
Eating disorders are gender-neutral. Men account for 10 million of those who have disorders, according to the National Eating Disorders Association. In the past 30 years, the number of men who are not satisfied with their bodies has jumped from 15 percent to 43 percent.
Men are less likely than women to request professional help, the association reports.
That was the case with Brian Cuban, author of "Shattered Image: My Triumph Over Body Dysmorphic Disorder."
Cuban was overweight as a child. Comments from his mother about his weight and bullying from his peers led him to feel depressed and go to food for comfort. When he was 11 years old, he had reached 270 pounds.
No matter what he tried, Cuban could not escape the mental image of himself as a shameful, fat 11-year-old. Bulimia, anorexia. steroids. alcohol, drug use — nothing seemed to take away the feeling of worthlessness, he said.
"Every time I looked in the mirror, no matter how thin I got, whether it was my dorm mirror, whether it was a reflection in a car window, store mirror, I saw this fat, bullied child," he said.
He hid his eating disorders from family members for decades, even after his brothers discovered his other addictions.
At 44, he considered suicide as an escape from the persistent thoughts of worthlessness. His brothers intervened. He underwent a "self-imposed rehab" and was soon back to his addictions. A second hospitalization for his alcoholism helped him see that he would push all of his loved ones away if he did not correct his behavior.
Recovery has been a process, he said, and it continues. He eventually confronted the Body Dysmorphic Disorder that was at the base of his eating disorders. He still battles thoughts of inadequacy or wanting to return to his addictions, but he has been able to learn to manage the thoughts.
"I was able to help myself not become my thoughts," he said.
Eating disorders include anorexia, bulimia, binge eating disorder and eating disorders otherwise specified.
Every time I looked in the mirror, no matter how thin I got, whether it was my dorm mirror, whether it was a reflection in a car window, store mirror, I saw this fat, bullied child.
Binge eating disorder is the nation's most common eating disorder, affecting 2.8 percent of all adults in the United States at some point in their lifetime, according to the American Psychological Association. Someone with this disorder eats substantially more in a small period of time than they would ordinarily, or eats food quickly even if they are not hungry. They repeat this behavior regularly over a period of months. It is often associated with the person feeling little control over their behavior.
Of those affected by this disorder, 57 percent will never receive treatment.
Some of those affected by eating disorders may not seem like they are by those looking in from the outside, according to Rachele McCarthey, a child and adolescent psychiatrist and medical director at the University of Utah Behavioral Health Clinic.
These include those who have lost a lot of weight who are still obese or overweight, as well as those who have stopped their eating disorder behaviors but still struggle with intrusive thoughts or "delusions of how their body looks," McCarthey said. "(The eating disorder) is not something that disappeared."
Well-meaning remarks about food or telling someone to eat more may often be misinterpreted, she said. She encourages loved ones to lend support without being judgmental.
Thompson's recovery came after her family intervened. She began with three therapy sessions per week, gradually decreasing to therapy once a week. It took her six months to realize she had a problem.
It has been three years since she began recovery and feels that she has "definitely overcome" the addiction. Even at this point, though, she still struggles with thoughts, but has learned how to control them.
Cuban said he hopes more people "speak up and break the stereotypes."
Remaining events for National Eating Disorder Awareness Week include the Nedawareness 5K, 9 a.m. Saturday at Draper Park and a Beauty Redefined lecture, Thursday, March 6, 7 p.m., Salt Lake City Main Library.