The Neurocritic: Anorexia, Insomnia, and Paranoia

The Machinist, a 2004 film directed by Brad Anderson, features the emaciated skeleton of Christian Bale as a haunted character named Trevor Reznik. He suffers from chronic insomnia ("haven't slept in a year" [which is impossible]), a cleanliness obsession that compels him to scrub his hands and bathroom floor with bleach, and a massively unhealthy case of anorexia complete with regular weigh-ins.

Reznik was involved in a horrible tragedy, is an outcast at work (even before causing an accident that amputates a co-worker's arm), and begins interacting with elusive individuals. You wonder how he has the energy to do anything, let alone work in a machine shop. He can only find solace in the arms of the proverbial hooker with a heart of gold, with Jennifer Jason Leigh in the typecast role. While they're in bed together, it seems the petite Jason Leigh might crush him.

I recently watched the film for the first time, and Bale's anorexic body obviously played the starring role. The 6 foot (1.83 m) tall actor lost 60 pounds (27 kg) for the part, reaching a low weight of 119 (54 kg). This put his body mass index (BMI) at 16.1, clearly in the range that should not have been allowed by the film crew.

He supposedly starved himself for 4 months, consuming only coffee, apples, and tuna. Was that really necessary? No. 140 pounds would have been sufficient. Usually anorexia is viewed as a disorder that only occurs in girls, but it can affect boys (and men) as well (Woodside et al., 2001; Scagliusi et al., 2009).