Macaulay Culkin, the one-time cherubic acting prodigy, is now 31 years-old and no longer so cherubic or prodigious. In fact, Culkin’s emaciated frame and gaunt appearance have led to speculation that the actor, star of such movies as Home Alone and Richie Rich, is suffering from an eating disorder or some other medical condition. Pictures posted on the Entertainment Tonight website in February raised alarms about the health of Culkin. In wake of the photos, Culkin cancelled his monthly gig deejaying at Le Poisson Rouge in New York City’s West Village. A representative for Culkin denied the actor is suffering from health problems, telling E.T. “Macaulay Culkin is in perfectly good health.”
Eating disorders affect up to 25 million Americans, according to the National Institute for Health. The National Institute of Mental Health (NIMH) website states that there is a 0.9% lifetime prevalence rate of anorexia nervosa among females in the United States, compared to a 0.3% lifetime prevalence rate among males. The average age-of-onset for the disorder is 19. Though anorexia primarily affects adolescent females, male anorexia— often referred to as “manorexia”—appears to be on the rise. It’s estimated that more than 1 million American men suffer from the disease, according to the American Journal of Psychiatry. Actor Dennis Quaid dropped 40 lbs for his role as Doc Holliday in the 1994 film Wyatt Earp and subsequently found regaining the lost weight a nearly impossible task. Fellow thespian Billy Bob Thornton also battled the disorder after dropping 60 lbs for his role in the 1998 film A Simple Plan. Both actors have since overcome their struggles with anorexia.
Anorexics view themselves as overweight no matter how thin they are in reality. People suffering from the disorder have an intense fear of gaining weight and distorted perceptions of their physical appearances. In order for a person to be diagnosed with anorexia, he or she must weigh less than 85% of what is considered a normal weight for that person’s age and height. According to the Diagnostic and Statistical Manual of Mental Disorders, there is an increased risk of developing the disorder among “first-degree biological relatives of individuals with the disorder.” First-degree biological relatives include parents, siblings, and offspring. Anorexia is the deadliest of all mental disorders, with a mortality rate of approximately 10%.
There are numerous methods and modalities used to treat anorexia nervosa. Counseling is one, and Psychotherapy and Cognitive Behavioral Therapy (CBT) are the most common modalities currently in use. Exposure and Response Prevention (ERP) therapy, a subset of CBT, has proven particularly effective in treating eating disorders of all kinds. The Maudsley Approach takes a family approach to treating adolescent eating disorders, where the parents of a child or teen with an eating disorder take on the responsibility of making their child eat healthfully. Siblings and other family members are often involved in the process as well. The Maudsley Approach was developed at the Maudsley Hospital in London in the mid- 1980’s. Medication, including selective serotonin reuptake inhibitors (SSRIs) and tricylics (TCAs)—both antidepressants— as well as antiemetics, have also been shown to be helpful in some cases. Nutritional counseling is also necessary to aid patients with eating disorders in transitioning to a healthy diet regimen.
According to the National Institute of Mental Health website, there are three components to successfully treating anorexia nervosa:
1. Restoring the person to a healthy weight.
2. Treating the psychological issues related to the eating disorder.
3. Reducing or eliminating behaviors or thoughts that lead to insufficient eating and preventing relapse.
Culkin rose to fame in the 1990 John Hughes smash Home Alone, which went on to gross more than $476 million worldwide. Subsequent films, including a Home Alone sequel, enjoyed more modest success at the box office, and his career went into a sharp decline in the mid- 90’s. He married his childhood sweetheart, actress Rachel Miner, in 1998; the couple separated two years later and divorced in 2002. An eight-year relationship with Mila Kunis ended in December 2010. In an interview with Harper’s Bazaar, Kunis described their time together as “fantastic.” It was during their relationship that Culkin was arrested on drug charges in 2004 after being caught in Oklahoma with marijuana and controlled substances without a prescription.
He most recently appeared in the 2011 Adam Green film The Wrong Ferrari, which was shot entirely on an iPhone. Culkin’s sister, Dakota, died in 2008 after being struck by a car in Los Angeles. She was 29 years old.