Along with studying till late into the night in gothic reading rooms, Frances Chan, a Yale undergrad majoring in History, has had to endure weekly weigh-ins and urine tests, three blood tests, appointments with a nutritionist, sessions with a mental health counselor, and an EKG — all since December. The New Jersey native, who is 5-foot-2, and 92 lbs., was struggling with an eating disorder in the eyes of Yale University Health Services, and they were going to nip this problem in the bud in order to save her life. Yet, Chan has contended from the start that nothing is wrong with her, she simply has a genetic disposition toward low Body Mass Index (BMI). After all, she would know if she had an eating disorder.
Who is right? Following great struggle — and Chan’s personal account of her months-long ordeal published in The Huffington Post — Yale health officials have finally relented and now claim she is not a danger to herself. Still it begs the question why such a self-evident and seemingly clear-cut matter could become so overblown. The answer lies in the fact that eating disorders are troubling greater numbers of students every day.
How prevalent are eating disorders on campuses in the U.S.? According to the National Eating Disorder Association, the rate of eating disorders among college students has risen to anywhere from 10 to 20 percent of women and four to 10 percent of men. For many, the imprecision of these numbers contribute to the confusion surrounding eating disorders. Many students probably experiment with strange diets and unusual methods of eating while in college. After all, for many students, college is their first experience of living on their own and eating entirely as they please. Most escape their days, weeks or months of disordered eating, as it is referred by the professionals, unscathed. Past research suggests that full-blown eating disorders typically begin during the college years, with 35 percent of normal dieters progressing to pathological dieting. Among these, 20 to 25 percent continue further down the trail to partial or full-syndrome eating disorders.
Not only the numbers, then, but the distinctions gradually blur, and this is exactly where Yale may have stumbled when treating Chan. Understanding that eating disorders have the highest mortality rate among all mental illnesses, health officials there justifiably wanted to treat an issue and help Chan recover before it ruined her life.
It all began when she visited Yale University Health Services (YUHS) in mid-September of last year, worrying about a lump in my breast that was found to be benign. Yet, following up in November, the medical director sent her an email about "a concern resulting from your recent visit." Although Chan soon learned what the concern was and though she believed they were wrong, her recent health scare coupled with official medical insistence convinced her to go along with the program. “Instead of arguing, I decided that perhaps the more I complied, the sooner I could resume my normal life,” she wrote in her Huff Post blog post. And so began the weeks of stuffing herself with ice cream, cookies, anything to put on the pounds. She gained 2 lbs., but her weight did not rise to the level the clinicians mandated, and so they threatened to put Chan on medical leave for non-compliance.
At this point, she protested and in the course of her rebellion she soon discovered that she was not the least bit exceptional. YUHS has a history of flagging students with low BMI “grades,” as discussed in a 2010 article appearing in the Yale Herald, and threatening them with medical leave whenever their weight failed to comply with their standards. In the end, Chan has taken her stand and won and as a result may be a bolder, better student.
For some, though, the question raised by a previous student, who similarly underwent an ordeal due to her low BMI, remains. “The most irritating part is that while they have a cutoff for people who are underweight, there is no such cutoff for people at the other end of the spectrum,” Stacy (a fake name intended to protect the student’s identity) told Yale Herald. Now some people would simple suggest that schools stop remarking on students' BMI scores altogether. Colleges, though, are responsible for feeding students, so perhaps they have the right to concern themselves with students' weight gains and losses.
Yet Stacy's point needs to be addressed. For years, when hearing the term eating disorder, many people envisaged anorexic girls. But in recent years, people have become aware of less visible eating disorders, such as binge eating, and less visible populations, such as men. Strictly speaking, then, the term as applied by college health officials should also encompass those who are overweight... but it doesn't. Is there possibly some subtle reason for this? For example, the Centers for Disease Control and Prevention reports that low-income children, low-income adolescents, and low-income adult women (though not low-income adult men) are more likely to be obese than their higher income counterparts. Maybe colleges such as Yale believe less-expensive lives are less worth saving.