Annenberg_Hall,_Memorial_Hall,_Harvard

Annenberg Hall at Harvard

Junior year of high school marked the beginning of my preoccupation with eating. I developed stringent standards that would keep me under a certain weight. Even before my junior year, I had a problem with how I looked in a sports bra, or my perceived “medium” size compared to my flat-chested friends who seemed to have no flab even when they were sitting.

I am still amazed when I reflect on the dramatic food restrictions that my destructive body image caused me to impose on myself. I did not forgo my ritual of a hefty meal and ice cream at Friendly’s every Saturday after my lacrosse game, and I still participated inmilk and cookies during Wednesday night dorm functions. Eating was satisfying, and I wanted to embrace my natural cravings. But every time I gave into my desires, I withered in self-hatred for not having the discipline to say no to food and sabotaging my goal to become skinny. I resorted to purging; it appeared to be my only recourse, as I could not escape my draconian eating expectations nor the irresistible lure of food.

My abusive relationship with food continued into college, yet there were differences at Harvard. My problems with eating manifested in the opposite extreme––I adhered to an unrelenting eating regime, to the extent that eating one more teaspoon of oatmeal than I thought was “safe” to consume for the day would burden me with extreme guilt. I was hardly aware of my problems. My clothes kept getting looser over freshman fall, and people would occasionally tell me things like, “you weigh nothing.” But I looked at the mirror with a distorted image of myself. I was shocked at my mom’s horror towards my thinness when I returned home for Christmas break.

I am now in my junior year, but my ups and downs since my time at Harvard began are too painful and tiresome to recount. Despite my significantly improved eating habits, I still struggle to stay away from the scale, or to stop strategizing my daily food intake to comply with my draconian metrics. I do not know when I will be completely free from the fear of gaining weight. Due to my own personal experience with eating and body image, I started looking into eating disorders at Harvard–hoping to start an honest dialog around an issue which has affected countless students on this campus.

Student reflections on HUDS

The lack of comprehensive data on Harvard students’ eating habits, especially on how HUDS influences them, prevents any conclusive recommendations for creating a better environment for students with eating disorders. Regardless, conversations with clinical experts and students who have had a history of disordered eating reveal some important insights. These responses warrant more extensive education on eating disorders, nutrition, and positive body image for the entire student population. Most importantly, there must be greater efforts to foster an environment where students can comfortably talk through issues with eating and trust their peers to empathize, so that those who need help seek out treatment and consultation. Although these administrative initiatives are imperative, it is still important to assess the influence of the dining hall on student eating, since the space serves as the primary food provider for most undergraduates. Student comments that focused on eating struggles experienced in the dining hall frequently highlighted the unlimited swipe system, which leads to decreased control over portion size, and the need for “healthier” options like less fried foods and more fresh fruits and vegetables. Many also pointed out a convergence of factors, most often short dinner hours and the predominance of high-carb and high-sugar brain break options like cereal, as reasons for their compunction about “eating badly.”

In particular, students who have suffered from eating disorders tended to emphasize their reactions to the unlimited availability of food as freshmen, whether they were affected by the prevalence of guilt-inducing foods or perceivably “healthy” options that thus enabled them to overeat.

Andie Turner, who came to Harvard with a history of orthorexia, a fixation with righteous eating and an adherence to an extremely rigid eating style, told the HPR: “I kind of went the opposite of restricting myself and [ended up] over-indulging in food. I would just go into Annenberg and load up my plate with foods I thought were “healthy” and gorge on them until I was uncomfortably full.” She attributed the change in her eating habits freshman year to the buffet-style and absence of detailed labels in the dining hall.

Karen Maldonado, a former co-director of Eating Concerns and Hotline Outreach who recovered from her eating disorder during college, was similarly overwhelmed by Annenberg. “As someone who struggled a lot with things like guilt, having cereal right there, or an ice cream machine right there, became emotionally overwhelming.”

Limited Remedies to Disordered Eating

National statistics on the status of eating disorders across colleges suggest that a large number of Harvard undergraduates likely wrestle with a range of eating concerns. Whereas the new freedom and responsibilities of college life are correlated to a rise in mental health problems, the social pressure to make friends, have romantic relationships, and achieve academically can lead to maladaptive coping mechanisms in the form of disordered eating,” according to a 2013 survey by the National Eating Disorders Association. College students are at an increased risk of eating disorders also because they fall in a period of development in which disordered eating is likely to arise, resurface, or worsen for many young men and women. Full-blown eating disorders typically begin between 18 and 21 years of age.

Clinical knowledge on triggering elements of eating disorders corroborate common themes in student perspectives. “Intervention [for binging disorder] starts with controlling access to something that is a typical binge food for them, ice cream, peanut butter, cereal, etc. And over time, when people have managed to reduce bingeing, you reintroduce those foods to their diet. So, a dining hall could just make that [process] more difficult because you have less control over what foods are available” explained Rebecca Shingleton, a Postdoctoral Fellow at VA Boston Healthcare System, in an interview with the HPR. But on the flip side, she explained that for someone who may be trying to gain weight or expose themselves to a larger variety of foods, perhaps as a part of their treatment, having access to a vast array of foods in the dining hall can be very helpful in accessing different types of food.

Shingleton’s description of both the costs and benefits of introducing a wide array of foods to students struggling with eating disorders highlights an important point: strategies that may help certain students who struggle with eating concerns may harm others. Therefore, it is particularly difficult to make general claims about how certain HUDS policies perpetuate or reduce the impact of eating disorders.

Administrative Support for Eating Concerns

Eating disorders necessitate intensive medical help, but the undergraduate populations that suffer from a range of disordered eating also deserve support and warrant treatment. Nationally, 45-55 percent of undergraduates had shape or weight concerns above normative body image dissatisfaction, 25 percent engaged in some level of dietary restraint and 21 percent reported experiencing objective binge episodes. But a much smaller percentage reported clinically significant levels of eating disorder symptoms. The rates of actual eating disorder diagnosis are lower because a diagnosis takes into account numerous components including weight and occurrence of binge and purge episodes.

The diverse spectrum of eating anxieties requires improved initiatives to address detrimental restrictive behavior at the sub-clinical level. Meeting these varied needs lies largely outside the purview of Harvard’s dining services. Harvard students can turn to Eating Concerns and Hotline Outreach, a group of undergraduate counselors who have specialized training to address concerns about exercising, body image, food, eating, and eating disorders, a team of dieticians at The Center for Wellness, and the eating disorder specialist at the HUHS counseling and mental health group, or make an appointment with a nutritionist without referrals. Off-campus resources include the Cambridge Eating Disorder Center, the Renfrew Center for Eating Disorders, Boston Student Eating Disorder Association, and McLean Hospital’s Klarman Eating Disorders Center.

The National Eating Disorders Association’s 2013 survey measured the frequency and perceived importance of a variety of programs and services on 165 colleges and universities in the United States and contained recommendations that could help Harvard support students with eating disorders. Key findings highlighted the serious lack of screenings for eating disorders––a critical component of identifying those struggling and intervening early––and the unmet need for individuals on campus who are qualified to identify and refer students. Additionally, the results called for greater educational programming. The only eating disorder workshops at Harvard, ECHO’s Body Image Workshop and Love Your Body day, are offered by demand and once a year, respectively. Moreover, Harvard does not offer programs on eating disorders during the annual National Eating Disorders Awareness Week, unlike 65.6 percent of campuses in the survey that reported doing so.

These workshops cultivate a love of the holistic self and help individuals make peace with food, and students would benefit from even more of them. Likewise, Harvard could offer campus-wide opportunities for eating-disorder screenings and appointments for individual psychotherapies. Another idea would be for nutritionists from HUHS to hold office hours, perhaps in collaboration with eating disorder specialists, to address students’ misconceptions about foods and weight gain, and encourage empowering frameworks for thinking about food. Precautionary efforts and interventions should start early, from incorporating conversations about body image and eating into the Opening Days program. Consistent education workshops across the college––maybe even in the form of academic courses on eating disorders––would help students build healthy relationships with their bodies.

The success of current and proposed initiatives depends on students’ willingness to seek help, which is often hindered by a denial of the existence or seriousness of the problem and the stigma surrounding eating disorders. Alana Steinberg, the current co-Director of ECHO, told the HPR that “not eating to look good or pulling a trig because you ate too much are really normalized on this campus.” She continued that, “being vocal about an eating concern is something very difficult to do.”

Therefore, the greater challenge lies in creating an atmosphere in which talking about all categories of eating-related stresses are accepted and normalized. A critical, often overlooked, part of tackling the reticence around struggles with food is to raise awareness of disordered eating as a spectrum that is relevant to almost everyone who has a body and a relationship to it. Transforming campus discourse on eating disorders could begin with the administration’s public acknowledgement that food can sometimes induce anxiety.

Bolstering solidarity through these initiatives is key to motivating individuals to seek treatment. As Maldonado told the HPR, “Food is such a massive part of college life, the dining hall is such a center of college community, and yet we talk so little about our relationship to food, and how different that could be for people.”

 

Image Source: Wikimedia/Bestbudbrian

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