May 6, 2004

Cornell Students Deal With Eating Disorders

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When Durga Sundaram ’04 first got to Cornell she had all of the traditional freshman jitters and anxieties on top of problems back at home. Her father passed away from lung cancer during her junior year of high school and her mother was diagnosed with ovarian cancer right before freshman year began. With family responsibilities resting on her shoulders, the stress of adjusting to a new environment, and no one making her sit down for dinner every night, Durga developed a full-blown eating disorder.

“My eating disorder started when I was in eighth grade. Being in college where I could pretty much do anything I wanted and I didn’t have my parents harping down my back to eat made it a lot worse,” she said.

Sundaram is one of many students whose eating habits go awry upon entering college.

“Eating disorders typically manifest when there is a transition in life,” said Carolyn Hodges, a nutritionist at Gannett: Cornell University Health Services. “College happens to be a major transition and so often eating disorders occur with that change.”

Eating disorders are extremely prevalent on this campus and among college students nationwide. Because many people with eating disorders are undiagnosed and do not seek help, it is impossible to know the exact number of people currently confronting disorders like anorexia, bulimia, or compulsive overeating.

In a 2002 study reported by the Journal of Adolescence, researchers surveyed late-adolescent women at a large midwestern university and discovered that 17% met diagnostic criteria for anorexia nervosa or bulimia nervosa.

“We would guess that 17% is higher than in our population unless you take a broader definition of eating disorders to include binge eating disorder… in addition to anorexia and bulimia,” said Sharon Dittman, associate director of community relations at Gannett.

“This figure is probably capturing many sub-threshold symptoms that do not meet the full diagnostic criteria for an eating disorders.”

Sub-threshold symptoms are behaviors like occasional vomiting, laxative use, bingeing or restrictive eating which are not at the level of being diagnosable as anorexia, bulimia, or another clinical disorder. According to Greg Eels, director of Counseling and Psychological Services (CAPS) at Gannett, these sub-threshold behaviors are cause for concern.

“If you look at some of the survey data nationally on sub-threshold issues it gets into the twenty to thirty percent range,” he said. “I think there are a lot of students who are really on the cusp of that. They feel like they’re overweight by all national norms, and they are engaging in some ways that aren’t healthy.”

The results of the National College Health Assessment collected at Cornell in the fall of 2002 reveal that over half of students surveyed reported making some efforts to lose weight in the past 30 days. Exercise was the most frequently reported means of losing weight, but about 23% of students reported dieting, 2.3% reported vomiting, and about 2% reported taking diet pills. According to Dittman, Gannett saw roughly 200-250 patients for eating related issues during the 2002-2003 school year.

Many factors can trigger an eating disorder on a college campus like Cornell. According to Eels, social pressure plays a big role. “Eating disorders are like any physical or mental disorder. If someone has problems with their self-esteem or problems with their body, being in a social environment where they see others engaging in this behavior often can exacerbate the problem,” he said.

Other factors include the University’s emphasis on achievement, fear of the “freshman fifteen,” the availability of good food which can lead to overeating, involvement in athletics or sororities, and the demanding schedule and stress which with college students deal on a regular basis.

For Sundaram, the adjustment to the Cornell workload and the daily stresses of freshman life meant eating had to take a back seat.

“It just made it really easy to forget about eating because I had so much work to do, plus I was going home every other weekend. I felt like I didn’t have any time so cutting out eating was really easy,” she said. “The time became an excuse not to eat.”

A student in the department of textile and apparel, Sundaram was also concerned with body image. “Being in TXA where all the girls are perfect and thin was an added stress,” she said.

During her freshman year, a typical day of eating for Sundaram meant skipping breakfast and lunch and picking at a salad for dinner. When she returned home to St. Charles, Illinois, family members noticed she was not eating much and forced her to eat. “Being home and being forced to eat brought on my bulimia,” Sundaram said. “I would just throw up whatever they made me eat, and it was kind of like that from then on. When my friends got concerned and made me eat, I would throw it up.”

By her sophomore year, family members caught wind of Sundaram’s eating behaviors and insisted she seek help from counselors at Gannett. By that point, she was teetering at the point of being underweight. She had low potassium levels and as a result she often could not feel her fingertips. Her family gave her an ultimatum: get help or pay your own way through college.

Sundaram saw a therapist outside of Gannett but consulted with Hodges, her nutritionist at Gannett. It was Hodges who eventually referred her to Renfrew, an inpatient clinic in Philadelphia specializing in eating disorders. Sundaram was admitted to Renfrew in the fall of her sophomore year but checked herself out after only a week.

“I wasn’t ready to get better,” she said. “I felt like I was being forced to get help and I was terribly afraid of gaining weight.”

Under pressure from her boyfriend and Hodges, Sundaram finally decided to check herself back in to the clinic after sophomore year for a month.

Now only weeks before her graduation from Cornell, Sundaram estimates she is about 90 percent better than she was at the height of her eating disorder, although she still struggles daily with the problems and consults regularly with therapists and her nutritionist.

“It was mainly stress triggers,” she says looking back at the factors that fostered her anorexia and bulimia. “Some of the faculty made it really difficult to do well in classes. I really think a lot of the faculty need to be aware of what’s going on and know how to deal with it.” Eels said CAPS and the University administration have been making a concerted effort to educate faculty members about mental health issues and services offered at Gannett.

“Faculty members aren’t therapists, and we can’t expect them to be, but they are often times the first people to contact students,” he said. “These issues affect all of us and so we are making efforts to reach out to the community and help them recognize students in distress.”

Gannett offers the “Cornell Health Eating Program” (CHEP) to students with eating disorders. CHEP treatment consists of a combination of nutrition, medicine, psychiatry and psychotherapy visits for either individuals or groups.

Another effort on the part of Gannett to help students with eating disorders has been the recent creation of the CHEP clinic. On Tuesday afternoons and Thursday mornings, eating disorder patients can consult with a psychiatrist, physician, therapist and nutritionist all in one visit. Eel called it “one stop shopping,” where students will be able to get all the appropriate care in one as opposed to several visits per week.

Despite these programs, Gannett staff is still concerned that many students with these problems will not ask for help.

“Our concern is that an untreated problem may get worse and/or become chronic after a student leaves Cornell,” said Myra Berkowitz, a nutritionist and health educator at Gannett. “Even if the problem is not getting worse and seems bearable in the short term, it may result in serious health problems later.”

Students concerned that they or someone they know may have a problem are encouraged to contact Gannett.

A
rchived article by Stacey Delikat
Sun Senior Writer