A weighty issue: Eating disorders at Georgetown

During his first semester at Georgetown, Zenen Pérez (SFS ‘13), to avoid gaining the dreaded “Freshman 15”, began an extreme vegetarian diet, severely restricting his caloric intake, and monitoring his weight up to three times a day. “My freshman year, I had a scale in my bathroom, and I would stand on it three times a day to make sure that every week or every couple days I had at least lost a little weight.”

By the end of the semester, Pérez had lost 40 pounds. He was unrecognizable. In an interview with the Voice, Pérez recounted an incident in which he encountered an acquaintance he had not seen since he began restricting his eating. At first she didn’t return his greeting, but once she recognized him, she said, “Oh my God, I didn’t recognize you, you look anorexic.”

“At that point I realized it was a problem because at the moment she said that I felt good about what she had to say,” Perez said. “I felt like that was a positive thing … she had noticed that I lost a lot of weight.”

In the American College Health Association Spring 2012 college survey, only 2 percent of students were diagnosed or treated for anorexia or bulimia nationwide in the past 12 months. According to the survey, at Georgetown, 3.6 percent of the student population has been diagnosed or treated for an eating disorder. While such low numbers may seem inconsequential, in 2006, 58 percent of college females and 33 percent of college males indicated that they were trying to lose weight, and 38 percent of college females and 31 percent of college males reported that they perceived themselves to be overweight.

Only a small proportion of the student population has been diagnosed with an eating disorder, however, Georgetown is far from exempt from the effects of poor body image. Fat-phobia permeates Georgetown’s culture. Fad diets and conscientious exercise routines are the norm. One can barely step on campus without seeing a multitude of confident people with the right clothes and the right body.

“Georgetown attracts, admits, and accepts students who come with really high profiles in terms of accomplishment,” said Carol Day, director of Student Health Education Services. “Sometimes with that sort of level of achievement comes a level of perfectionism, obsessive compulsive tendencies to … apply yourself to achieve, and I think those are characteristics that also seem to be prominent in people with eating disorders.”

***

One. Two. Three. My body tensed and I heaved. Nothing. One. Two. Three. I heaved again, Nothing. I stood over the toilet, staring down a toothbrush clutched in my hand. I couldn’t stop. One, two, three. I drove the toothbrush to the back of my throat, and it hit its mark. I doubled over and gripped the walls of the stall as what was once my dinner burned my insides, making its way up my throat. The burning hurt, but the pain felt like redemption. I heaved once more. I saw blood, and I relaxed. My body shook, but I didn’t care. It was almost as if the worst part of myself had vanished. I was human again. I didn’t want it to end, and before I could stop myself I was doubled over.

Eating disorders are about so much more than food. I would know.

My problem started like most: small. I would skip a meal here and there. But during my sophomore year of high school, my clothes began to get too tight and I began to lose my mind. It didn’t matter that I had grown two inches taller—all that mattered was the flashing number on the scale in my parent’s bathroom. I felt like the ideal of perfectionism was quickly escaping me, and there was nothing I could do about it. My concern turned to panic, and I began to purge.

I purged in the bathrooms in between class periods. I would excuse myself from class to purge. I didn’t want anyone to know. My beauty was supposed to be effortless, my weight was supposed to be natural. When I began losing weight, I felt amazing. My body was frail, but at least it was pretty, or so I thought.

I often heard my parents talk about me in muffled voices. “She’s skin and bone,” my father said. He sounded upset, but I was elated. My effort was paying off. They were always overprotective anyway, I ran up the stairs to the bathroom and locked the door. One. Two. Three.
Peréz also acknowledged the role his perfectionist drive played during his freshman and sophomore years, but the expectations of perfection and insecurities he experienced arose not from explicit pressure from peers, but from his own image of the Georgetown student. “I thought there was external pressure,” he said. “I thought that everybody cared, so that made me think that I should care.”

On the Hilltop, the University strives to play a collaborative role in addressing eating disorders, and developing individualized solutions to assist students in coping with these body image issues. This approach incorporates many branches of student health care, such as Counseling and Psychiatric Services, the Student Health Clinic, and Student Health Education Services. People Day and Staff Clinical Social Worker at CAPS, Mary Quigley, are on the front lines of this approach.

Day has spent her entire career at Georgetown. In addition to being a certified nutritionist, she also has Bachelor’s and Master’s degrees in nursing. She joined Student Health Education Services when the department was established in 1989. Within the department, Day plays a number of roles, and her background has allowed her to work intensely with students with eating disorders.
Day concentrates on the nutritional aspect of eating disorders, focusing her efforts on instilling life-style changes such as incremental meal plans. Quigley, who specializes in identifying and resolving the emotional causes of eating disorders, works on the other side of the coin, focusing her attention on the underlying psychological causes of the issue.

“I try and look at all the other issues underneath that might be connected. Sometimes it feels like an addiction … I always feel like there is some psychological reason,” she said.
Collaboration between departments ensures that students develop a network of support, but also ensures they receive care tailored to their individual disorder. Of the joint effort,“Mostly, the students coming in [at Georgetown] are in need of once-a-week or twice-a-week therapy with nutritional counseling and often we do the team approach,” Quigley said.

Claire McDaniel (COL ‘14), who struggled with anorexia throughout high school, also views the attention paid to appearances at Georgetown as a factor unhealthy eating habits. “It’s something that’s embedded in the culture … and it very well might be unconscious, but it’s still there,” she said. “I won’t lie, I feel like it’s less than my high school, but even watered down, it’s still a very potent force that idealizes being thin.” [Full disclosure: McDaniel is a Voice staffer.]

Georgetown culture exacerbates pre-existing conditions that come from a variety of psychological issues. “I don’t think [Georgetown] promotes eating disorders, but I think it’s a culture of competition and high achievement,” McDaniel said. “A lot of girls say ‘why does everybody look so beautiful and thin?’ … There’s a level of competitiveness, but I think people tend to bring that with them from their pasts.”

Day went on to say that although student life at Georgetown is remarkably competitive, eating disorders are multifaceted and students often allow their need for perfection to drive unhealthy eating and exercise habits without knowledge of proper nutrition. “People struggle at some level that is not officially diagnosable … something under that level of criteria that you have to match to qualify as having an eating disorder,” she said. “I think a lot of people struggle with undereating or the wrong kind of eating, over exercising and being concerned with their body image.”

Pérez echoed Day’s observation, reflecting on his decision to become a vegetarian. “I thought about why I became vegetarian in the first place, and, although I came to other reasons like environmental and ethical reasons, I realized that the main reason was not a very good one to begin with.”

Special diet restrictions are not inherently problematic. Becoming vegetarian or more health-conscious is not a problem in and of itself—but sudden diet changes becomes dangerous when students undertake them without proper knowledge, or in more severe instances, simply to justify under-eating. The danger at Georgetown lies not in explicit pressure to be thin, but in the attitude that extreme dieting is not only acceptable, but preferable to gaining weight. Such an attitude desensitizes people to the physical and emotional trauma that causes and results from eating disorders.

In addition to the other pressures at Georgetown, Pérez’s struggle with his sexuality further complicated his insecurities with his body image. “There’s a very big image of what someone who’s a gay male should look like. I wanted to come out, but I always thought that I needed to look a certain way.”

According to the National Association of Anorexia Nervosa and Associated Disorders, males make up 10 percent of people with anorexia and bulimia.While men remain an oft-forgotten minority when it comes to eating disorders, the underlying psychological pressures are equally strong to those of their female counterparts. Both Day and Quigley emphasized that male eating disorders, although related to female disorders, generally come with a different set of emotional baggage and are even more under-diagnosed than female disorders. Of the 3.6 percent of students who were diagnosed with eating disorders last year, none were male, although individuals such as Pérez confirm that men struggle with the same insecurities as women. “I think a lot of the time that we talk about these issues we talk about women,” said Pérez, “I think that women have an absolutely different experience.

“I would come late at night,” he recounts, “and just hear people trying to throw up. I knew what was going on, but I knew it wasn’t necessarily what was happening to me.”

***

Five minutes became 10, and 10 became 30. I was gasping, I was in agony, I was in ecstasy. I did everything in my power not to cry. The walls were thin and no one could know. I lay on the floor the vent on the ceiling faded in and out of focus. Then a knock pierced the air. Shit, they heard. They know. They’re going to stop me. I stumbled to my knees, still shaking. I pulled my sweatshirt over my head to hide the blood, and unlocked the door. It was my sister. Could she have her towel, the one with Princess Aurora on it? My breathing relaxed. Of course.

Counseling and Psychiatric Services and Student Health Education Services have launched several initiatives to raise awareness on campus about eating disorders. On such initiative is training RAs to identify and help students deal with eating disorders, running publications such as the Stall Street Journal, and engaging in outreach education programs such as the Engelhard Project, which integrates health and wellness education into courses ranging from hard science to philosophy.

Although these initiatives aim to establish the right precedent, people living with eating disorders often do not wish to acknowledge the issue, and, consequently, may not be proactive enough to seek out the resources that Day and her colleagues have to offer.

“So much of what I went through happened because I was in denial that I had a problem,” McDaniel said. “The sooner that they admit it to themselves, the sooner that they acknowledge a problem, then the sooner they can seek out people who can help.”

Quigley, however, insists that outreach education can only go so far. In her view, in order to repair our culture of body dissatisfaction, eating disorders cannot remain on the outskirts of polite conversation. When asked what she would change about Georgetown culture to help students with eating disorders she said, “I think maybe more students talking to other students about their experiences, and I think in general for Georgetown to promote more sort of mindfulness, meditation, holistic kinds of events. Anything that promotes wellbeing.”

McDaniel said, “It’s going to take things like better education on prevalence of eating disorders in college, on helping people who suffer from them. The Women’s Center and Health Education do a tremendous amount of that already, but I think if it had a greater impact on the student body, it would go a long way. I know it would have enormously helped me in high school.

Eating disorders can be life-long ordeals that almost never truly go away, but with effort and support, people can learn to cope and move on. “I don’t think I’ve ever really gotten over these kinds of things,” said Pérez, “I still think about it every day, but I think the process that can help start it really is thinking about the self-harm that I did.”

Pérez never received formal treatment for his condition, but through personal reflection and support from peers in the LGBTQ community, he started on the road to recovery. He has got rid of his scale and his vegetarian diet.

I never received formal treatment for my condition either. Even if they knew, my family never said a word to me about it. Perhaps it wasn’t possible for their straight-A, varsity athlete to be starving her body. My awakening came ironically it came in my school’s cafeteria. It was as normal a day as any other, I was busy chatting with friends when I saw a familiar face across the table. It was an old rival from middle school. I always avoided her, but that day, I couldn’t stop looking at her. One look of her skeletal features and I knew she purged, like me. I was nothing like this girl. I wanted no part of anything she did. I can’t explain why, but that was my moment. I never purged again after that day, but I was lucky. Most people don’t get the luxury of a moment.