Becky Henry | the nutritionist's dilemma

Well, the storm that prevented my presenting on the panel as described in A Meteorological Change of Plans has moved out to sea–not without causing some serious ruckus. But another strong one is moving in right now, rerouting regular daily trajectories, thus providing me another opportunity to curl up and explore the thorny business of eating disorders on college campuses.

Campus Eating Disorder Notebook

Eating disorders are very complicated–and at their crux, are not about food. They have long been, and continue to be, the cornerstone of study for many a scientist and mental health clinician, in terms of the identification of their etiologies and appropriate treatment. Underlying biological genetic-based factors seem to seed the predisposition for the development of one of these conditions that take root by substituting out healthy development and replacing it with one which has a laser-like focus on the control of body weight and shape–and the feeding behaviors that determine such. While advances are being made, these are hard nuts to crack from a mechanistic standpoint.

However, this should not mean that we ignore the evidence that socio-cultural and psycho-social variables also play a causal, and not merely triggering role in eating disorders, and thus should be considered as potent avenues of prevention. And while each and every person exists in relationship to the social and cultural environments with which they interact, college campuses constitute a unique microcosm providing a unique breeding ground for the germination of these disorders. (Today, I discovered the term ‘culture-reactive’ which I think is relevant to this issue.)

I worked at a small liberal arts, predominantly white, self-contained campus in a non-urban community. While there, I would remind my students that this 4-year college experience was just a stage they were going through. It is temporary and somewhat illusionary. Even working there only part-time, I could get sucked into seeing life through a campus-view lens and would have to remind myself that this was not ‘the real world’.

Within this world, everyone is–well, young, with all the usual archetypes that youth is associated with. Like some mythical island, it seems like all the inhabitants possess beauty, vigor, vitality–and unbridled brilliance and talent. Each attribute is defined by the normative cultural standard (including thinness) established by no fault of one’s own. Such concentrated energy is pulsating, exhilarating, intoxicating–as well as deceiving, and potentially health diminishing or downright dangerous. Here, often impossible standards present themselves as expectations that should be assumed with ease–forcing any self-perceived failure or deviation from the norm to greatly magnify.

The maintenance or pursuit of this idealized persona and its requisite body weight and shape are challenged on college campuses by a few particulars. Firstly, there are the potent triggers that come from living day-by-day, night-by-night in close proximity to only one’s peers. At this vulnerable developmental stage there is much peer pressure, exposure to all types of media–including unregulated body-focused content, vocalized body shaming of self and others, unending body comparison opportunities, and a multitude of ways to feel “different than”.

Then, there are the academic, social (and athletic) pressures that college students have and the hungers such pressures activate. The non-stop studying, paper writing, exam-taking (and sports training)–and attendant lack of sleep, make for long days and extra hungry brains and bodies. These hungers may be physical, “emotional” or stress-related. But even stress-related hunger is physiologically driven. This hunger is powerful and real and involves late-night eating associated with studying or socializing. Stir this together with the stress of high personal standards, perfectionism, and anxiety and you have all that contribute to uncontrolled feeding impulses, or to advancing control behaviors and starvation.

The college eating experience is also an exception. Many colleges now market their dining venues and meal plans to lure students their way. Access to a college dining hall is like being on a never-ending cruise. Loads of offerings served from different specialty sections available from early morning to late into the evening. Standard meal plans may limit access to three meals a day, while premium ones allow unlimited visits. Many plans also allow for use at other campus food venues.

Being exposed to so much food with no limits, and having to make so many choices at every meal, can be very overwhelming with various responses. Eating (or not eating) amid the clamor of hundreds of other students also makes for challenging circumstances. Enticements also seem to be everywhere on campus. Various clubs and campus activities promise candy, pizza, or doughnuts in exchange for attendance–all within walking distance. Food, its embrace or avoidance, becomes a constant obsession.

On the flip side, students living on or off-campus without a meal plan often have difficulty accessing food or preparing meals. This precipitates and perpetuates other unhealthy feeding behaviors. Students in these settings can isolate themselves more easily, and can both yield to or hide their behaviors more–but students on campus can do so as well.

Finally, I might add the lack of parental/familial supports and/or constraints; heightened attention on ‘healthy’ foods; and increased alcohol or drug use behaviors are additional contributors to the development, unleashing or exacerbation of eating disorders in the college setting. Oh, maybe I will also include easy unlimited access to an indoor gym as another risk factor.

Given the high prevalence of such disorders on campuses, I will assume that most colleges have charged themselves with developing or strengthening approaches to care–though perhaps with continued difficulty. But, it has also been ten years since I worked on campus. Is there new information or have there been shifts in paradigms that have infiltrated and influenced changed consciousness and constructive activity on campuses? Is the explosion of people sharing photos of thinning bodies on social media exacerbating the problem or are movements like Body Positive finally exposing and mitigating this insidious epidemic of body-hating? I suspect the former and am aware that men and certain minority groups are becoming increasingly affected.

Still, I believe something is changing and that we can begin to shapeshift our perceptions of beauty. And, I believe the collective wisdom of dedicated activists and this current generation of emerging and young adults are going to demand and provide the solutions. They have already witnessed enough in too many ways. The statistics are staggering, sickening and sobering.

My humble little suggestions for colleges (and every place) include the following: create Body Shame Free Campuses; further media literacy as a prevention tool; include and support the parents/families of college-age students with eating disorders and provide resources; stop the demonizing of all dietary fats as agents of weight gain, and appreciate their vital importance in maintaining body functions; and, educate and inform all campus personnel about eating disorders and maintain trained staff to help students.

And, I strongly invite you to read the article, A Generation of Shrinking Girls by Laurie Penny, that my dear friend Chris just happened to send me this morning, that defines Eating Disorders as a social crisis and political issue–and explains why we really must care.

What might you add?

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

Most Sincerely Yours, Elyn

John Lennon’s My Plate

My Plate Expression

I hope someday to look back on this time in our history and only read about the curious phenomenon of anorexia and bulimia to be touched by it, not have to witness its destruction and ruin on the bodies and faces I pass on the street.

Excerpted from individuals’ stories of recovery from the book, The Secret Language of Eating Disorders by Peggy Claude-Pierre.

“The public is silent when young women die.” charges Naomi Wolf, author of The Beauty Myth.

I have just returned from an annual conference that I attend on Eating Disorders. The conference, in its eleventh year, is sponsored by The Nutrition Clinic and Sol Stone (Update 2020: Upstate New York Eating Disorder Service); Clearpath Healing Arts Center; and Ophelia’s Place who work together to form a strong, sensitive and progressive treatment network in central New York.

Image by Mystic Art Design at Pixabay

Each year, near the end of the conference, a handful of individuals in the recovery stage of their eating disorder are invited up to share some part of their story. This is, of course, the most enlightening and always most emotional part of the day. The wisdom acquired in overcoming such a strong opponent is very deep and these very intelligent women articulate it beautifully.

This day, a young woman in her mid-twenties, stood before the two hundred or more attendees and shared that in the darkest days of her eating disorder, she almost walked into traffic–but only stopped herself because she felt it would be immoral to place such a horrible burden on whoever might have killed her. To witness someone so young describe such a depth of despair was both bone-chilling and deeply heart-opening.

On some level, we know that there are people who are suffering from eating disorders, but essentially they are invisible. However, when one is privy to the stories of those who have had one of these crippling conditions; and you couple that with statistics like one in 100 individuals has an eating disorder—it is imaginable that there are truly some “walking dead” amongst us.

To offer some response to this young woman who had the courage to expose her pain and vulnerability and who has found the strength to persevere and to heal, I bring to this conversation– about the realities of eaters and eating– a discussion about eating disorders. I know that it does not do justice to the topic. It is a contorted and rather incomplete version of something I have written before. But, it seems a fitting time for me to introduce this part of the story. In honor of that woman and the four others who stood before me a few days ago, please consider the following.

We may have seen or heard about someone who is nibbling on only lettuce and carrots at mealtimes; wearing heavy clothing in moderate temperatures; exhibiting extreme weight loss; exercising excessively or appearing listless at a team practice or dance class. But, to the inexperienced eye, even extreme physical changes or behaviors can be overlooked or ignored. We may have even encountered someone who we suspected was suffering from an eating disorder, but we did not know what to do or say.

Most definitely, we have all had dealings with eating disordered individuals whose behaviors escaped our radar screen. The very nature of eating disorders is secretive and manipulative. Average-weight or over-weight individuals may be suffering as much as their noticeably underweight counterparts; older persons as well as younger ones; and men as well as women. Compounding the issue is that in certain environments like high schools and college campuses—but in the larger world as well—there is a “culture of thinness”. In such environments, underweight individuals can appear almost normal looking. Responses to eating disorders can include, “Oh, I wish I had that problem”, or “Why don’t they just eat?”

Even when we are cognizant and concerned about eating disorders, it is impossible to consider or measure the loss of potential and achievement, the degree of nutrient deficiencies, the magnitude of depression and anxiety, the potential for long-term health problems, and the possibility of sudden death from complications or suicide that eating disorders engender.

Eating disorders tend to leave people feeling frustrated, confused and helpless. Despite this normal reaction, it is really important that our society and our public health policymakers begin to better acknowledge, support and treat those with these disorders. Without intervention, chances for a full recovery are slim for those with severe conditions.

I have discussed my concern about the panicked way in which we are “battling” obesity. For many, overeating is an eating disorder–as deserving of a very sensitive and holistic approach to care as does “undereating”. We have the opportunity, and perhaps the obligation, to create an environment and dialogue that challenges the attitudes that make individuals feel bad about their bodies and that feed the medium in which all eating disorders thrive.

We can only hear the wisdom of those who have confronted an eating disorder if we are very quiet. If we can move the lens away from the obesity issue and reframe the disgust we harbor about fat, we may realize there is a gentler and more important conversation to be had about feeding, eating, and nourishment.

Frances Berg writes, “Our children, our daughters, and sons, are growing up afraid to eat, afraid to gain weight, afraid to grow and mature in normal ways. They are desperate to have the right bodies, obsessed with the need to be thin and fearful they won’t be loved until they reach perfection. This is the point to which our weight-obsessed culture has brought us. Our children are innocent victims.”

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

the nutritionist's dilemma

a nutritionist's musings on the realities of eaters and eating

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