Editor's Note: This if the first of a two-part series examining eating disorders at Dartmouth. The first part discusses the problem as it pertains to the College and the second part will evaluate how students and administrators are working to alleviate the problem.
As Dartmouth students trade fleeces for shorts, the rising temperatures can also reignite anxieties in image-conscious students and exacerbate their eating and weight-related issues. The Eating Disorders Peer Advisers recently pointed out eating disorders by hosting a "No Diet Day" in Collis Commonground to celebrate "healthy, balanced, non-restrictive lifestyles."
According to the National Association of Anorexia Nervosa and Associated Disorders, 7 million women in the United States have an eating disorder. Awareness of anorexia nervosa, bulimia nervosa and "eating disorders not otherwise specified" (abbreviated EDNOS) has increased, and the pervasive nature of these diseases on college campuses has become more apparent. EDNOS refers to an eating disorder that doesn't fit the specifications of anorexia or bulimia but involves symptoms of both, such as binge eating without purging, or vomiting after eating small or regular quantities of food. Most students who see Peck experience symptoms of EDNOS.
While male cases are recorded at Dartmouth, females are, by far, the most susceptible to eating disorders, according to the College's part-time nutritionist Claudette Peck, who sees relatively few male patients.
"Anything a dietitian could have told you, I could have told you," said Clara Aranovich '07, a recovered bulimic and outspoken advocate for eating disorder awareness. Like a student reciting facts before a midterm, she cited measurements of sugar, fat and carbohydrate counts, the glycemic index and the caloric values of her favorite foods.
Peck said that in competitive environments at elite academic institutions such as Dartmouth, students tend to place a heavy emphasis on being perceived as in control and meeting all cultural ideals.
"I think, often, eating disorders are seen in people who are striving for control in their life in some way," Peck said, adding that patients may turn to food if they cannot manage other aspects of their lives, such as their emotions or performance in classes. "They feel like they can control their eating."
People with eating disorders often begin their illnesses with self-esteem issues that can grow under the pressures of an elite college, according to Peck.
"Dartmouth is a very competitive environment, academically, socially, from a body image standpoint and from an exercise standpoint," Peck said.
Dartmouth alumna Naomi Shike '05 grew up in an environment she describes as similar to the competitive Dartmouth social scene and attended a prestigious New York City-based private school, Horace Mann School.
"They totally objectified people based on what they wore and what cars they drove," said Shike. "The way people placed value on other people had nothing to do with who you were." She described a feeling of constant anxiety in high school that propelled her to begin throwing up occasionally at 12 or 13.
By her freshman summer, Shike began bingeing and purging; upon returning to Dartmouth in the fall, Shike grappled with bulimia again, as well as intense feelings of depression. Uncomfortable with the fraternity and drinking scene, she spent most of Fall term of her sophomore year in her apartment, watching television and eating.
The eating disorder treatment team at Dick's House consists of one dietician, one counselor, one psychiatrist, one nursing practitioner, two doctors and one athletic trainer.
Peck receives about 100 visits per term, approximately 35 percent of which are related to the diagnosis of an eating disorder. She explained that the national population demonstrates a bell curve of weight, in which some people are extremely thin, some are extremely heavy, and everyone else falls somewhere in the middle.
"Dartmouth doesn't really have a bell curve," Peck said. "There isn't a statistical spread of diversity when it comes to body image and body shape here."
When Aranovich, a former member of the women's crew team, injured her knees during freshman winter, she was forced to stop exercising and engage in rehabilitation.
"One day, I hopped on the doctor's scale in the training room where I did rehab, and it said 140," she said. "And I thought, 'I'm 10 pounds heavier than I thought I was.'"
By Spring term of her freshman year, Aranovich began counting calories obsessively, trying to eat below 1,000 a day, as well as running in the morning and at night.
Peck voiced concern about the competitive attitudes around eating that emerge when specific groups of people eat together regularly. When an athletic team, for example, eats together frequently, an athlete with an eating disorder may compare his or her meal to a neighbor's and criticize his or her own eating choices.
While eating disorders among men were previously estimated at 8 or 9 percent of the population, Dartmouth Director of Health Programs Laura Rubinstein said that health professional now estimate this percentage at 16 percent. Yet Peck continues to see only a few males per term regarding eating disorders.
Peck said men sometimes approach her with health or training-related questions that indicates to her that they may have an eating disorder. Diagnosing eating disorders in men is difficult because their symptoms of compulsive exercise or bingeing tend to be more culturally accepted, Peck said.
"General Dartmouth culture views dieting as really normalized," Rubinstein said. "Body obsession is really normalized and exercising for aesthetics is really normalized and self-loathing is really normalized."
The feeling of isolation or fear of not fitting in is often a predominant factor in eating disorders, but there seems to be a precise set of conditions at Dartmouth unlike any other Ivy League school. Not only is Dartmouth the smallest college in the Ivy League, but it is also one of the most isolated.
"I think one of the things is that you put a bunch of overachievers in a rural community and the only comparison they have for achievement is each other," Rubinstein said.
In addition, the highly competitive and comparative environment heightens the intensity of social interaction, much of which is based on the drinking and fraternity scene.
The "Students Say" section on the Princeton Review website quotes Dartmouth students describing the Greek scene as "pervasive." Dartmouth ranks number 13 on the Princeton Review's top 20 list of colleges with a "Major Frat and Sorority Scene" and is the only Ivy League school to make the list.
"I come to college, I'm drinking like mad and I can't figure out where the weight's coming from," Aranovich said, describing her weight gain amidst the beer pong-dominated social scene.
Peck identified a significant problem with drinking and drinking-related food choices on campus. Specifically, she said that there is a tug-of-war between young women's desire to stay thin and their worries about the amount of calories they consume in alcohol each night.
"They say, 'Do I eat or do I drink, because I can't go over a certain amount of calories tonight,'" Peck recalled. According to Peck, young women debate how much they should eat so they can allow themselves to consume the often enormous quantities of beer commonly drunk in games of beer pong.
Although she did not see a significant increase in patients this year, in previous years Peck has experienced increases in appointments during the two weeks before rush begins.
"There is a lot of anxiety about being picked and how body image plays a huge role in that event," Peck said, citing the platters of food at each interview. "[Sophomores] wonder, 'Should I eat? If I eat, what will they think, and if I don't eat, what will they think?'"
