Wednesday, October 25, 2017 // The Statement
4B
Wednesday, October 25, 2017 // The Statement
5B
SPINNING OUT OF CONTROL
The balance between performance and body image
b y Yo s h i k o I w a i, Deputy Statement Editor
“
Forty
kilograms,”
the
ballet
instructor
announces.
Silent
agreement among faculty and
other students is palpable in the studio,
albeit the obvious tension. It’s an easy 4
kilograms below the number where the
scale’s needle hovers — a sigh escapes,
relief fills my chest. I step off and watch
the needle bobble back to zero, a number
I will never be.
This was my seventh grade. It was
routine for me. After four hours of ballet
every day, we weighed in and heard our
“ideal” weights announced to the class,
a public service announcement to spark
incentive. A scale was kept under the
piano, right by the accompanist’s feet.
We were praised when we were under,
condemned for every half-pound we were
over. No amount of sweat — enough to
wring from our leotards — was ever good
enough. It was a balance between satis-
faction with the reflection in the mirror
and having enough fuel in your body to
get through the night. It was nothing
short of destructive.
I kept this mentality with me, through
boarding school and part of college after-
ward — the pressure to conform, the
ever-present desire to be liked by a cho-
reographer, a teacher, a coach lingered
in the back of my mind. In high school,
I listened to my friends purging in the
bathrooms, taking laxatives like candy
and throwing away food without giving
it a second thought.
The phases came in and out of my
life, as they did for many of my friends
in dance. It’s difficult to denounce a
lifestyle that has been etched into your
brain, diet and outlook on food. It’s con-
suming — present at every store, social
event, relationship. You never realize
how pervasive food is — the way it brings
people together, maintains friendships
and creates new ones.
It wasn’t until college and a pre-med
curriculum that I found some peace
with my body. Or made efforts to do so.
The facts became harder and harder to
neglect: anemia, brain defects, infertil-
ity, multiorgan failure. It quickly became
apparent that the effects were long-last-
ing and severe. For the first time, it was
real.
Over the past few decades, eating dis-
orders have been a topic of conversation
on college campuses. Universities across
the country have dedicated services spe-
cifically for eating disorder treatment.
The University of Michigan offers help
to students battling eating disorders
through programs at University Health
Services and Counseling and Psychologi-
cal Services, along with other smaller
organizations and student-run groups
like Wolverine Wellness and MBody.
Michigan Medicine has a Comprehensive
Eating Disorders Program, providing
individualized care for patients between
8 and 24 years old.
Dr. Terrill Bravender, David S. Rosen
Collegiate Professor of Adolescent Medi-
cine, is a program physician and section
chief of the University’s Comprehen-
sive Eating Disorders program. When I
interviewed him, Bravender spoke of the
college campus as a stimulant of eating
disorders.
“If you think about it, if you’re at risk
for developing eating disorders, college
culture is perfect,” he said. “You’ve got
rec centers that are open 24 hours a day,
you have high emphasis on appearance,
you have an opportunity for 24-hour-a-
day eating and all of a sudden as a college
freshmen, you are responsible for creat-
ing your own structure in your life. All of
these distractors can make people’s lives
feel like they’re spinning out of control.”
Despite the prevalence and sever-
ity of eating disorders, there are few
nationwide studies on the disease within
college students. Although surveys on
individual campuses and wellness cen-
ters have been conducted, there has been
a lack of nationwide data on the younger
18-to-24 year-old population in general.
It wasn’t until recently that two Univer-
sity public health researchers took mat-
ters in their own hands.
University professors Kendrin Sonn-
eville and Sarah Lipson, assistant profes-
sors in nutritional sciences and health
management and policy respectively,
conducted a nationwide study on uni-
versity students with eating disorders.
Published in 2017, the 9,713-person study
aimed to determine risk profiles for eat-
ing disorders in a diverse population.
The study measured the risks of students
from various backgrounds to develop an
eating disorder or disordered eating hab-
its with the long-term goal of taking pre-
ventive measures and improving current
treatment.
Although eating disorders and dis-
ordered eating often result in physi-
cal symptoms, the disorder is a mental
illness, characterized by an obsessive,
unhealthy relationship with food. With
the highest mortality rate among mental
illness, eating disorders remain an insidi-
ous part of American culture. According
to DSM-5, the Diagnostic and Statistical
Manual of Mental Disorders published
by the American Psychiatric Association,
there are five categories of eating dis-
orders: anorexia, bulimia, binge-eating
disorder, feeling or eating disorders not
elsewhere classified (FED-NEC), and
other eating disorders including body
dysmorphic disorder (intrusive, imag-
ined or inaccurate perceptions of one’s
body image) and orthorexia (the fixation
on overly righteous eating habits).
Researchers are studying people who
do not fit into the strict criteria of the
DSM-5, but nonetheless have unhealthy
relationships with food. Although these
people do not have full-fledged eating
disorders such as anorexia or bulimia,
they are characterized as having sub-
clinical eating pathology, or “disordered
eating,” which can develop into a clini-
cal disorder. Disordered eating affects a
much larger population in college com-
munities and is now being targeted for
earlier preventative measures.
“If you think about eating disorders
like other conditions, it would be like
saying, ‘We’re not going to treat you until
you have stage 5 cancer.’” Sonneville
said. “When you think about it that way,
it doesn’t make any sense. There are early
symptoms that if not addressed will prog-
ress to worse symptoms, and so Sarah
and I took a public health approach. We
looked at high levels of disordered eating
behaviors that are themselves problem-
atic, but may actually progress if unad-
dressed.”
The study sought to observe other
potentially
influential
characteristics
like age, degree-level, gender, sexual ori-
entation, race and ethnicity, and citizen-
ship. After extensive analysis, the two
researchers concluded undergraduate
student status, non-straight men, and
overweight or obese students were at the
highest risk for developing an eating dis-
order.
“There’s been appreciation in my field
of public health and descriptive epide-
miology about what is the face of eating
disorders,” Sonneville said. “There’s this
long-standing myth that eating disorders
affect skinny, white, affluent girls. … We
are seeing it across socioeconomic spec-
trum and across racial, ethnic groups.
What we’re realizing is that the face
of eating disorders — the stereotypical
notion of what eating disorders look like
— is not true.”
Sonneville and Lipson reported a
startling 49 percent of female students
engaging
in
binge-eating
behaviors
and 30 percent in men engaged in these
behaviors. Female students were also
more likely to engage in compensatory
behaviors like food restriction and diet-
ing compared to men — 31 percent to 29
percent.
“We wanted to get a sense of who is
actually struggling and suffering on cam-
pus, because unless you understand who
is suffering, it’s really hard to understand
how you target early intervention, how
you target prevention efforts,” Sonnev-
ille said.
Based on these findings, the two
researchers urge universities to take pre-
ventative actions by conducting earlier
and more regular eating disorder screen-
ings.
“What we found is that eating disorder
pathology is really common on college
campuses. We saw even smaller sex dif-
ferences than others find — with com-
pensatory behaviors like self-induced
vomiting and compulsive exercising to
be almost the same among males and
females in our sample,” Sonneville said.
The ever-rising, incessant presence
of social media in college culture often
perpetuates the existing problem. The
risks of exposure to idealized body types
through social media is an emerging
field of research. Bravender spoke about
unrealistic body images being projected
through media like Instagram.
“When we saw photoshopped or digi-
tally altered images 10 years ago, it was
because a beauty company or fashion
company or diet company was trying to
sell us a product. Now, if we see a digital-
ly altered image, it might be our friends
on social media using filters or other
things,” Sonneville said. “It used to be
for-profit industries that were trying to
propagate this ideal, and now, we’re all
trying to do it. That is a totally new phe-
nomena in eating disorder risk factors.”
Former U-M rower Traci Carson is
now a Ph.D. candidate in the School of
Public Health. Having personally expe-
rience with disordered eating, Carson
spoke about the role of social media in
her college and graduate school life.
“Being somebody that is constantly
comparing myself to other people, I have
seen how social media can be damag-
ing for my own thoughts about food and
thoughts about my body,” Carson said.
“In the last few months, I’ve made a con-
scious effort to make sure that the people
I’m seeing on social media are not people
who are feeding into my disorder. I will
delete or unfollow people as soon as I
see anything that triggers me to want to
restrict or go exercise more or feel shame
about the way that I look.”
Shannon Nulf, a School of Music, The-
atre & Dance freshman studying dance,
echoed Carson’s sentiments.
“When there’s a medium that’s usually
edited, polished and filtered, I definitely
think that plays into a mental self-loath-
ing. When you see all of this perfection
in social media, that can mess with your
head,” Nulf said.
She also spoke about the dangers of
certain social media. Some contain blogs
or accounts acting as instruction manu-
als for someone at risk or in the midst of
an eating disorder. Nulf spoke about find-
ing information on specific social media
sites that encouraged unhealthy habits
and eating disorders.
“When I was in the throes of anorex-
ia, I was trying to find other people like
me and see what I was doing,” Nulf said.
She spoke about using social media sites
like Tumblr to see how other people
with anorexia were restricting their food
intake and cutting weight—She often
compared their methods to her own or
looked for ideas on how to continue los-
ing weight. “There are Tumblrs on how
to have an eating disorder. … It was all
there for me, it was a resource that I wish
I hadn’t had.”
Perhaps our next steps may involve
using this pervasive medium to reach
large groups of people and encourage
more constructive ways of thinking about
food. Bravender spoke about the dangers
of teenagers and young adults viewing
social media’s idealized body types as
direct messages to them.
“If you’re looking at these Instagram
feeds of perfection and you believe that
that’s speaking to you and telling you
how you should be, then it significantly
raises your risk for developing an eating
disorder,” Bravender said. “If you’re able
to push that off to the side and be a savvy
media consumer and realize that these
perfect images aren’t possible and real-
ize they’re just images and just a brand
someone is trying to sell you, then that
doesn’t confer risk of an eating disorder.”
However, social media doesn’t seem
to be entirely negative. Nulf and Carson
raised similar ideas of filtering content
by unfollowing or selectively choosing
accounts. Kinesiology freshman Maddie
Ross has proactively incorporated social
media into her path to recovery, posting
on an Instagram account the food she
makes.
“I started this food Instagram account
at the beginning of my recovery because
I found other people who were in recov-
ery on Instagram,” Ross said. “There
are nutrition blogs that focus on intui-
tive eating and health at every size. You
have to find the positive pockets in social
media, because there is so much negative.
You have to realize where the negative is
and put your blinders on when you see it
or get away from it. It’s much easier said
than done.”
Despite the abundance of these “com-
munication” channels for photos and
videos, many illness narratives and expe-
riences are left untold.
Ross spoke about the onset of her
anorexia when she was in middle school
and high school.
“I felt like I had no control over my
friendships or anything, but eating was
the one place I could control. I thought
that I was being healthy,” she said.
Nulf’s story followed a similar pattern
of downward spiral and loss of control.
“It was all rooted in a big, body dys-
morphic view I had of myself. Then, it
just spiraled and spiraled,” she said. “My
hair started falling out and I just wanted
to sleep. I started to fight with my friends
and parents. I couldn’t sleep. I lost my
period — a lot of medical effects.”
Students, myself included, are often
unaware of exactly how ubiquitous the
issue is. For how widespread and lethal
the consequences are, the lack of dia-
logue on campus is striking.
“Eating disorders in general are dis-
eases of denial and secrecy,” Sonneville
said. “There is shame, there is fear, there
are a lot of underlying emotional things
for someone who is actively struggling.”
Eating disorders, like other mental ill-
nesses, generally lack dialogue on cam-
pus, there is a smaller subpopulation
within the community that is often over-
looked: athletes.
According to Bravender, there are
three types of athletic endeavors that
put students at particular susceptibility
for developing eating disorders or disor-
dered eating.
The first group are athletes who may
experience an initial improvement in
performance from weight loss. These
often include cross-country or long-dis-
tance runners.
“In people who are at risk, there’s a lit-
tle click that happens, and thinks, ‘Well if
I lose five pounds and I improved a little
bit, maybe if I lose 10 pounds I’ll improve
more,’ and they try that,” Bravender said.
“Of course, there’s a point of diminishing
return, and as you lose more weight, your
running
ALEXIS RANKIN/Daily
Maddie Ross
ALEXIS RANKIN/Daily
See BODY IMAGE, Page 6B