This article contains graphic material
Miami University sophomore Jen Smith* opened her dresser drawer, the middle one, and shuffled around its contents until she retrieved a blue tattered hard-cover journal, “Let me read you something,” she said as she flipped to a page dated November 18, 2011.
“I think I’ve made it quite evident that I hate myself and so I will mention now how I use food as a form of self-harm,” Smith read, “Rather than slitting my wrists or drowning myself with alcohol or turning to drugs and substance abuse, I have found the next best thing: food. I want to be skinny…yet when I am feeling quite terribly, I gorge myself. Disgusting. It is absolutely disgusting the amount of food I consume. And I feel so much worse about myself than I did before I ate the pounds of food. But I can’t stop. I cannot stop. Why can’t I stop? I’m not skinny. I’ll never be skinny if I eat this way. I just want to be skinny.”
The entry ends with Smith’s longing for the perfect body, her desire for the ‘thin ideal’. Smith is not alone, according to the National Eating Disorders’ website, a half million American teens suffer from eating disorders or disordered eating.
Of the three main eating disorders (Anorexia Nervosa, Bulimia Nervosa, and Binge-Purge Disorder), anorexia is thought of as the most dangerous, according to MU Psychology graduate student, Dorian Dodd.
According to the National Institute of Mental Health’s (NIMH) website, 0.6 percent of the adult population in the US will suffer from Anorexia Nervosa, a mental disorder characterized by low body weight.
The website goes on to say that women are three times more likely than men to develop anorexia.
Dodd said that there are two subtypes of anorexia: restrictive anorexia, in which a sufferer restricts his or her calories in order to lose weight, and anorexia binge-purge which involves consuming large amounts of food but then engaging in compensatory behaviors such as over-exercising, using laxatives, or restricting food in-take following the binge.
Smith was diagnosed with the binge-purge subtype of Anorexia Nervosa in early January of 2012, her senior year of high school.
According to the Diagnostic and Statistical Manuel of Mental Disorders, in order to be diagnosed with anorexia there must be evident restriction of food, the intention to prevent weight gain, an intense fear of gaining weight, and a disturbance in self-image.
“I was the thin girl,” Smith said, “that’s how I was known, at least.”
She began receiving treatment for her disorder at the end of winter break her senior year of high school. Her mother decided she was grossly underweight and it was time to get a medical opinion. At the time, Smith’s mom believed her daughter had a medical condition that was causing rapid weight loss.
“You don’t really talk about it, you kind of just do it. You just don’t eat,” Smith said.
It was easy to hide that she was not eating, but it was impossible to hide the emaciating figure that resulted, and Smith’s appearance raised enough concern to warrant professional intervention.
“The picture is pretty bleak on treatments for Anorexia Nervosa,” Dodd said.
Professionals find anorexia difficult to treat, Dodd said, and the disease has high relapse rates due to its connection to a person’s sense of self.
Sufferers, such as Smith, cannot separate themselves from their appearance. Dodd said the value an anorexic puts on body size is much higher than normal, and those who try to undergo treatment often fail. In their eyes, gaining weight involves losing a part of themselves.
“Anorexia is one of the most morbid psychological disorders,” according to Dodd.
Rose Marie Ward, a professor in Miami’s Kinesiology Department, has done several studies about the prevalence of such morbid disorders as anorexia on Miami University’s campus.
Ward’s interest in Miami’s potential problem with disordered eating was sparked by talks among faculty and students claiming one in five Miami students had an eating disorder.
“I didn’t believe it,” Ward said, “We wouldn’t have the resources on campus to deal with that.”
She collected data via anonymous surveys and her results showed that Miami’s average anorexia prevalence paralleled the national average of less than one percent.
However, Ward said Miami does have an image and students may have expectations about appearances that are reinforced by their peers on campus.
“I think it’s because of the pressures,” Ward said, “we’re seeing increasing levels of perfectionism.”
For Smith, anorexia was more of a control issue than a perfectionist issue.
“When things were bad, if I could control what I was eating things would be better. It was the difference between a good day and a bad day. That sounds strange, but if I threw up everything I ate I slept easier at night. Mentally, not physically; physically it sometimes hurt. But at least my mind relaxed a bit,” Smith said.
According to Dodd, the reason the national prevalence of anorexia is the lowest of the three main types of eating disorders is because the process is painful.
“There are biological mechanisms that our bodies react against,” Dodd said, “our blood sugar drops and the chemicals in our bodies send signals to our brains that it’s time to eat. Evolutionarily we are pretty well programmed to maintain homeostasis, so overriding those mechanisms is really hard.”
It took Smith a while before she was able to completely ignore the hunger pangs that plagued her constantly, but her body adapted to the low amount of food she managed to keep down.
“I would get so hungry that I’d have to eat something, an apple or a cheese stick or three of each if I was really binging, something ridiculous like that, then I’d be off to the bathroom,” Smith said.
That was a temporary solution for Smith, who said she was hungry again in an hour and the cycle would repeat.
“It was exhausting. Looking back, I don’t even know how I did it. Actually, looking back that time of my life is mostly a blur. I’m not sure how I existed before treatment.”
Despite roadblocks, Smith’s recovery has been successful. It took time and effort but she was able to finish high school and start college while working through anorexia.
Smith knows that she is luckier than most who try to combat their eating disorders and she says a lot of her strength comes from family and friends back home and in the Miami community.
“The group of friends I have here are awesome. They look out for me. I trust them,” Smith said.
Ward said Miami students can help each other out by reinforcing good eating habits. The people you surround yourself with make a difference, and it is important to have friends that boost your sense of self-worth so you do not feel as though you have to compare yourself to others.
Smith agrees that Miami has an ‘image’ and she has had to learn to stop comparing herself to the girls on campus.
“It was-still is-hard to stop the negativity. My therapists and family and friends have given me a lot of tools and guidance and I am happy to say that I’m in a better place than I’ve ever been.” Smith, who was not sure she would make it through her first year of college without a relapse, said.
“It’s been since May of 2012 that I made myself purge,” Smith said, slamming her worn diary shut on her lap, “I’m not this girl. I’m not perfect, but I’m not this scary, obsessed, thin girl anymore.”
Smith put the diary in her dresser, buried beneath clothes that no longer sag off her body, and shut the drawer.
* Name has been changed for privacy