I remember a therapist telling me not to worry about how my kid got sick.
Meagan was anorexic. That much we knew. The focus, he said, needed to be on making her well again, not on trying to figure out how she got to the point where she hated herself and her body.
I understood that. Or at least I tried to. Along with my amazing wife, Donna, I put as much energy as I could into every family therapy session and every possible solution we explored.
Anti-depression drugs. Art therapy. Music therapy. Group sessions. Individual sessions. Sessions with just Donna and me. Sessions without Donna. We tried it all, and while not all of it made a difference, I believe we worked hard to find a way through.
Meagan had been a good athlete, an equestrian. It wasn't long before we had to take her out of the saddle. Emaciated and weak, she just wasn't safe on the back of a horse. The doctors told us if she lost any more weight, she was headed for hospitalization.
Anorexia nervosa kills. It takes the life of one person nearly every hour. And, according to the Eating Disorders Coalition, anorexia has the highest mortality rate of all mental disorders.
So, let me tell you something. When you look into the eyes of the girl you helped raise -- that same little girl you taught to catch and throw and ride a bike, the one you read to sleep and encouraged to take on the world -- and she can barely look you back so ashamed is she of herself, well, as a father, you're going to start wondering what, if anything, you could have done to prevent this.
This is our story, Meagan's and mine. We're not licensed therapists. Not doctors. Not experts on eating disorders. And we make no pretense of knowing the best treatment for others.
Each case is unique. And they are all complex. Anorexia is both a physical and a mental disease. And it can take a long time to recover. Even today, Meagan struggles to ward off the bad thoughts, thoughts that started a long time ago. And that's probably the best place for us to start.
Here's how she remembers it:
I'll never forget the words that changed my life, the words that changed the perspective I had of myself.
The words that led to a six-year struggle with anorexia and depression: A friend said to me, "I finally got the abs I've always wanted, and look at you with all that belly fat."
The word "fat" was punctuated by the same person pinching my stomach trying to show me just how "fat" I was. I was too bewildered to respond. It threw me for a loop.
I was never an overweight child. I was a fit, somewhat muscular and thin 15-year-old at the time. I practically lived outside, either on my bike or the back of a horse.
My mom always kept healthy food in the house and cooked every night, but we still ate a reasonable amount of dessert. She never uttered the words, "I'm going on a diet." Instead, she said, "Everything in moderation."
My dad routinely worked out, showing my brother and me the importance of physical fitness. When we were young he used to take us in the jogging stroller or out on bike rides, and those are some of my fondest memories. Dad also encouraged us to play sports; it didn't matter which ones, but he understood the value of them.
Unfortunately, growing up in an environment that emphasized a healthy well-being was no match for the comment. It completely changed my life.
Leaving for Italy
That life of hers was about to take another dramatic turn as we prepared in the summer of 2004 to leave for Italy. I had been posted there to the staff of the commander for all US naval forces in Europe, based in Naples.
None of us, not even Meagan at that point, knew we were taking anorexia along as well.
Soon after we arrived, we noticed she wouldn't eat. At best she picked at her food. She was always cold, always wrapped in layer upon layer of sweatshirts and pants. And she was depressed, maybe not clinically at that point. But she was definitely not herself.
I chalked it up to adolescence. Girl stuff. Not my concern. As long as she was doing well in school and not getting into any trouble, what was going on between her ears was none of my business.
Like a lot of fathers, I suppose, I started pulling away from my daughter around this time. Her body was changing in ways I didn't like to think about.
She was becoming a woman. And I didn't like to think about that either.
Meagan had been a daddy's girl. We were very close. But now, as she started to grow up, I became a little frightened. I withdrew.
Donna, on the other hand, leaned in. And thank God she did.
After the move to Italy, I started working out excessively at the gym and even in my room alone at night.
I counted calories obsessively. I began to analyze everything I ate and drank and how it affected my body. I would look at myself sideways in the mirror, pulling my shirt taut. If I looked or even felt bloated, whatever I had just consumed was put on the "bad food" list.
I lived in baggy clothing, ashamed of my body, trying to hide it from everyone ... including myself. This made it difficult for Mom to notice what was happening to me, until one day she walked right up to me and said, "I think you're anorexic."
I hadn't fooled her.
"No mom," I said, "I'm fine."
She begged me to tell her what was going on.
At last, I blurted out the "fat" insult that had hurt so much, the one I couldn't get out of my head.
And then we talked. It felt so good to talk.
There would be a lot more talking to come. Years of it, actually, as we moved back to Washington and lurched and lunged between a series of different doctors, nutritionists and therapists. We knew there was help out there, and we were determined to find it.
Eventually, we met a talented social worker named Helen La Rose. Helen had a lot of experience with eating disorder patients. She taught us to think about anorexia holistically, as an outgrowth of many different and sometimes competing factors -- psychology, genetics, social and cultural expectations -- as well the natural desire for young people to be accepted and valued.
With Helen, it was OK to talk about potential causes. We focused a lot on the family, and, in particular, on the father-daughter relationship. Helen didn't ignore other familial bonds, but, knowing how close we were, she pushed Meagan and me to explore the degree to which our relationship factored in.
Helen believed I was a good father, loving and supportive. But she also felt I was too protective of Meagan, and perhaps a bit too controlling. Part of Meagan's struggle -- not all of it -- was figuring out who she was, establishing a sense of independence. In a weird way, anorexia helped her do that.
"She is not ready to give up this disorder," Helen said, "because she is not ready to become an adult. It has made her feel good about herself, when she did not have confidence or self-esteem. Right now she doesn't have anything to replace those feelings."
A father can be a crucial part of helping a daughter replace those feelings. But he has to be ready to do that ... to help her move on. I'm not really sure I was.
Meagan has a slightly different view:
I agree with Helen that Dad was protective when I was growing up. He became more so the older I got, and I've always chalked that up to the anorexia. I was his little girl. I was hurt. Every day was a living nightmare, and I couldn't escape it. No parent wants to see their child in pain, either physically or mentally.
I didn't feel I could be quite as open about certain things with Dad as I could with Mom. With her, I could share my thoughts and know she would be able to understand easily. That's not to say Dad wouldn't, but Mom had that female perspective I felt I really needed back then.
But I also believe Dad is being too hard on himself. My interests changed as I grew up, and my parents were letting me explore my passions. I don't view that as Dad pulling away from me. He's always been there for me no matter the circumstance. He's active in my life and supportive of my interests.
Frankly, in my case, I believe that in many ways the eating disorder was inevitable. I was a teenage girl with low self-esteem, a victim of shaming, who was born with a genetic predisposition for an eating disorder. The fat comment was the trigger, but only the trigger.
My relationship with my Dad ultimately changed for the better because of my struggle with anorexia. Therapy forced us to dive into our thoughts and emotions and be honest with each other in ways we might not otherwise have been.
Don't get me wrong. I wouldn't wish this ordeal on anyone. Neither would he. But fighting the anorexia -- together and as a family -- drove us closer to one another and faster than we thought possible.
Learning from the experience
Meagan is healthy now ... and a new mom herself. As she noted, we came away from the experience a little stronger, well, actually a lot stronger -- as father and daughter and as a family, too. But we also came away smarter.
We offer the insights below humbly and with only the best of intentions. As the #MeToo movement gains steam and as America continues to struggle with gender equality and women's empowerment, it seems a propitious time.
You are not alone. At least 30 million Americans suffer at some point in their lifetime from eating disorders. And eating disorders are the third most common chronic illness among adolescent females. Anorexia doesn't discriminate between race, creed, color, class or even gender. It is an equal opportunity killer.
"Despite having a great support system," Meagan says, "I still felt alone, because I didn't know anyone else who was battling these same thoughts and fears."
So, when you think no one else understands what you're going through ... please know that someone does, that others are enduring the same pain and trying to work their way through it.
There is help out there, and it can make a world of difference. The science behind treatment for eating disorders has come a long way, even in just the last few years. But sadly, fewer than 20% of adolescents with eating disorders receive treatment.
"I had a feeling something was wrong," Meagan recalls, "but thought I could manage it. There's this idea if a person is suffering they should just figure it out -- that you're weak if you ask for help. Nothing could be further from the truth. When I finally opened up to Mom, I began to realize how much trouble I was really in."
If you think you have symptoms, please reach out. Let someone know -- a parent, a friend, anyone you trust. It could save your life.
Dads matter. Not every person suffering from anorexia will have parents to assist them. And not everyone who does will have a father in the picture. But for those who do, particularly girls, dads can play an important role not only in therapy but also in potential prevention.
Margo Maine, the author of "Father Hunger: Fathers, Daughters and the Pursuit of Thinness," hit the nail on the head for me.
"What your daughter needed from you when she was five is not the same as what she requires at the age of 15 or 30," she writes. "Consciously try to let go of the little girl you cherished and allow her to become a woman."
I'm not blaming myself for Meagan's eating disorder. But I also don't think I did her any favors when I let her adolescence scare me away. It wasn't a conscious decision, at least I don't think it was; it was really just masculine discomfort about what was happening to her body.
I should have found ways to stay close to Meagan, while still respecting her maturation and natural desire for control and boundaries.
Words matter ... and so does culture. In Meagan's case, the lit match that set her anorexia on fire was an insult, hurled at her by a close friend. That it could do so much damage speaks as much about Meagan's vulnerability as it does to the hyper-charged and unrealistic expectations society continues to place on young women today.
It's a toxic environment, made all the more so by the instant, constant and persistent access to unhealthy ideas and imagery propagated online and through social media. It's too easy to shame or bully a young girl on Twitter or Snapchat. It's too easy for them to feel inadequate as a result of swimsuit advertising, diet programs and entertainment vehicles propagating "ideal" shapes and sizes for women.
Some of this is starting to change. Modeling agencies are hiring more plus-size women, and Hollywood is beginning to cast in leading roles women of all shapes. But it's not changing fast enough and nowhere near as completely enough. Children still get bullied for being different, for being less than ideal.
Here again, Dads matter. Pay attention to what your daughter is hearing and consuming. Talk to her about those things, about her feelings. Engender an atmosphere that celebrates the contributions women make across the spectrum of society -- that places a premium on value and courage and intelligence, not looks.
As boys, many of us learned to objectify women. We made fun of fat people, too, even as we obsessed about our own bodies. All too often we carry those stereotypes into adulthood. I'm guilty on all counts.
Think carefully about what you say in front of your children. And be careful what you say to them as well. Meagan was always sensitive to even the slightest criticism from me. When anorexia took over, even the slightest hint of any disappointment by me took on new gravity. It hurt her even more.
Words matter. And your daughter is listening.
Finally, remember that each of you will experience this disorder in different ways.
Meagan disliked therapy sessions that explored why she became anorexic. She found them demoralizing and preferred to focus on how to get better. But I found comforting, in a strange way, the discussions that delved into our relationship and my role in it. To me, that seemed a key component to developing a strategy.
In the end, we were both right. We learned Meagan wasn't alone, that help was available, and that anorexia could be beaten. We also learned that, as father and daughter, we were still on a journey together. We look forward to each new day of it.
National Eating Disorders Awareness Week is February 26 through March 4. Log on to the National Eating Disorders Association's website to learn more about eating disorders and how you can help raise awareness. If you or a loved one is suffering, call their help line at 800-931-2237.