An American doctor is helping treat a set of Australian twins who have suffered from anorexia nervosa for more than two decades.
The ordeal of 34-year-old twins Clare and Rachel Wallmeyer has been followed closely by the public in their home city of Melbourne, Australia. Several months ago, Clare, who has the bone density of a 72-year-old, weighed only 58 pounds, and Rachel, with a bone density of a 100-year-old, weighed 48 pounds.
The Wallmeyer twins are extreme, but not alone. The American Psychiatric Association estimates that anorexia afflicts as many as one in every 100 girls. It has the highest mortality rate -- 10 percent -- of any mental illness. It used to be thought that a weight-obsessed culture was what drove anorexics to starve themselves, but recently, a new study said the disease could be attributed to an individual's genetic makeup.
"We're learning that there is a genetic predisposition, but obviously the environment, the culture, is also a major factor," said Dr. Ira Sacker, an American eating-disorder specialist who flew to Australia to help the twins. "We're really only beginning to understand the deeper causes of anorexia."
Sacker, president and founder of the Help and Eating Disorders Foundation and an associate professor at NYU Medical School, already has made two trips to Australia to see the women and plans to return soon.
According to their mother, Moya Wallmeyer, the twins' anorexia started off as a way of getting attention. They have also exhibited some dangerous behavior and have had a number of run-ins with the law, involving petty thievery, dangerous driving and drugs.
Earlier this year, Clare received a two-month jail term for stealing chewing gum, a soft drink and a blender. Rachel received a 21-month suspended jail sentence for driving offenses, theft and for pushing a man who she said insulted her off a railway platform. In 2003, Rachel was involved in a police chase through the city of Geelong when she ran a red light and lost control of her car. She was also charged with injecting heroin in public.
In October, a judge released the twins without recording convictions and dismissed all charges against the twins except for those for which they had already paid the fines.
Earlier this year, the girls were on Australia's version of "60 Minutes." They revealed that they had never been in love, never had a job, and never gone to college, and that they believed that it was just a matter of time before they died. But at least, they said, they will die together.
But there is hope. Sacker said the twins had been doing much better since their appearance on the program.
"They've gained a lot of weight," he said. "They're no longer at death's door, though their health is still in great danger."
Sacker, who has suffered from compulsive overeating, said he had made it his goal to get the twins to like and trust him. Once he finally got them to that point, he persuaded them to enter a hospital. They were fed through a nasal gastric tube and were hydrated intravenously. They also began to eat a little food and soon got up to 75 pounds -- which put them out of immediate danger, Sacker said.
Sacker, who said the United States had more advanced eating-disorder facilities than Australia, would like to bring them here if he cannot find a place in Australia.
Nevertheless, Sacker says that the treatment of anorexia still has a long way to go in the United States. Insurance often cannot pay the full cost of the best treatment and it often takes three to five months of inpatient care that costs $1,500 to $2,000 a day. Additionally, the patient should go to a transitional care facility before returning home. Those kinds of halfway houses are still rare and Sacker is in the process of opening one.
"A lot of people have a mistaken idea of who the disease affects," Sacker said. "Anorexia has an image of being an upper-class disease, but it affects people across the social spectrum."