Most students are familiar with clinical eating disorders such as anorexia and bulimia, but fewer are aware of a problem that affects even more people on campus: disordered eating.
"While an eating disorder is a clinical diagnosis with specific criteria, disordered eating has a whole range of symptoms like compulsive exercising, obsessive exercising, constantly worrying about food, avoiding food in social situations and excessive dieting," said Becky Griesse, a health education specialist with the Healthy Devil.
Griesse estimates that disordered eating affects 70 to 80 percent of the University's female population. Nationally, an estimated 3 to 5 percent of women suffer from clinical eating disorders.
"Disordered eating behaviors that negatively impact quality of life is one of the biggest problems on campus," said Stacie McEntyre-Pope, a licensed clinical social worker and certified eating disorders specialist at Counseling and Psychological Services. "Although we don't have actual numbers, I think that most of the women on this campus struggle with disordered eating behaviors at some time during their four years here."
The lack of numbers makes it difficult to determine how extensive the problem really is. To combat this, CAPS is organizing a survey to be completed as a screening tool to assess the size of the problem at the University, McEntyre-Pope said.
Resident advisers will distribute the brief questionnaire this fall, and the National Eating Disorders Screening Program will score the surveys, as they have done at other schools. The Duke surveys can then be compared with the national database.
"We need to know exactly how bad the problem is here. Quantitative numbers would get more of a response from the administration," said junior Mollie Page, president of Educational Support To Eliminate Eating Misconceptions, a student group that tries to raise awareness. "It's not a very obvious problem. It's considered normal; people consider it part of the Duke culture. If we could make it a more open problem, that would be a wonderful thing."
In the past, both eating disorders and disordered eating mostly affected upper- to middle-class white women, but they are on the rise in men and minorities, Page said. Some speculate that the problem is especially bad at the University.
"From what I've heard, Duke is worse than other places. It is a prestigious school where people strive for perfection," Griesse said.
Others attribute the problem at the University partly to the nature of the students here.
"The main thing we see at Duke is disordered eating. There is the trend of the salad and fro-yo diet that the frat boys like to make fun of, but it is there. There is over-exercising, there is a huge lack of size diversity, very few people are overweight, yet most of the campus is on a diet," Page said.
McEntyre-Pope said there are many reasons people engage in disordered eating on this campus, ranging from the media and advertising to issues of perfection, acceptance, competition and envy. "It is a sad situation-we are an affluent university, yet so many go hungry every day trying to achieve the ideal body."
While there are numerous resources and support systems to help those who are suffering from eating and body issues, students don't always feel their presence.
"It is a taboo issue, a very private thing," Page said. "Dieting and obsessing and being compulsive about exercise are normal to a point. There is an invisible line to cross, and a stigma that comes once the line is crossed."
In an effort to raise awareness, Page teaches a house course on disordered eating. ESTEEM also runs programs on campus, including a workshop on helping friends with eating issues.
"It is an overview of how to help a friend with an eating disorder, noticing problems, how to confront them, what not to do, how to be a supportive friend," said junior Maureen Kelly, an ESTEEM member who runs the program. "It's been pretty requested by RAs, and there's been a good turnout. The feedback I've gotten has been pretty positive."
Students also can get support from CAPS, the Healthy Devil, the on-campus nutritionist or the infirmary.
"We're pretty top-of-the-line. We have a team of nurses, doctors and psychologists who work together to treat people," said Griesse.
"Things are just recently changing to be adequate, with the full-time nutritionist, the Healthy Devil and CAPS. Other people, like professors, are acknowledging that they need to be aware," said Kelly.
While Duke has established support options for eating and body issues, the issue of prevention still looms.
"I would like to see a larger network of people whose focus would be prevention efforts," McEntyre-Pope said. "I would be delighted to see an effort to prevent disordered eating similar to the effort that's going on with alcohol and binge drinking."
Get The Chronicle straight to your inbox
Signup for our weekly newsletter. Cancel at any time.