On his more charitable days, Bixler tries to avoid recriminations.
In his 20s, before he fully grasped what was happening to him, Bixler saw a future for himself. With degrees from UC San Diego and the University of Georgia, Bixler wanted to work in the education department of zoos or aquariums. Instead, the eating disorder overtook him, and after short stints at two zoos and teaching while a graduate student, he went on full-time disability nine years ago.
He subsists on Social Security and lives in a studio apartment with a view of the Pacific Ocean, the beneficiary of cheap rent because his parents own the building.
He typically sleeps until late morning and stays up late. His sister, Kimberly Leeds, thinks that's so he can avoid normal social contacts and justify living his life mostly in the night.
She's the one who pulled his shirt over his head about 15 years ago and made him look at his rib cage. "Look at yourself," she said. "How can you think you're OK?"
Even though she understands the disorder, her brother's eating habits both cause her to marvel and madden her.
"He will not eat any dairy, but he eats frozen yogurt all the time," she says. "He won't eat certain lettuce because it gets caught in his teeth, but he will eat iceberg lettuce. He'll eat popcorn all night long but won't eat roast beef because it sticks in his teeth."
If they go out to eat, she says, "He can't order something off the menu. There are about five or six statements that have to go along with it." Forget rice or beans, if that comes with the entree. He has to have shredded lettuce and cilantro on the side. He will eat vegetables and protein foods, but carbohydrates are a non-starter, she says.
Leeds may be frustrated, but she hasn't given up on her brother. To the contrary, she's joined him in his fight to get more extensive care.
Their parents, she says, have been dealing with the situation for half of Bryan's life and it is wearying.
"Mother feels like she's done everything. She's mentally, physically and emotionally exhausted," Leeds says. "Her life has been dedicated to him for the last 20 years."
All of which Bixler knows and which makes him sigh.
His father tells him he's not trying hard enough. What's so hard about fixing a bowl of oatmeal and eating it? They have shelled out the money before and might again, but the failing economy has hurt their finances.
"They blame me, their blame reinforces my own self-blame," he says. "I'm my own worst critic. I look in the mirror at night, saying I'm insane. What's wrong with me?"
He knows the answer, of course: a disorder with numerous dark corners that enveloped and then overwhelmed him.
"I can't understand why I can't do what a 6-year-old can do -- feed myself."