Although the issue of eating disorders can often be swept under the carpet of campus discussion, two new studies reveal that disordered eating behavior plays a central role in the lives of many Duke students.
The results of the surveys conducted by Duke researchers indicate a high prevalence of disordered eating at Duke, especially when compared to the two neighboring public institutions: North Carolina State University and the University of North Carolina at Chapel Hill.
"This research is important to [nutritionists] because it helps us better see the extent of the problem," said Franca Alphin, a dietitian at Student Health.
Students at the three institutions were sent a secure, web-based questionnaire on their eating behaviors. Nearly one-fifth of the Duke students who responded were engaging in disordered eating behaviors.
"Disordered eating basically means that at some point... [students develop] a dysfunctional relationship with food," said Alphin, also a clinical associate for community and family medicine.
Jean Hanson, assistant director of Student Health, commented that students often struggle with the transition to college life, manifesting this stress as disordered eating behavior.
"Eating disorders are really on the rise here at Duke," Hanson said.
The findings of the research showed that female Duke students are nearly four times more likely to have an eating disorder than male students. Freshman women, as well as women in greek organizations, were most likely to have disordered eating. On the other hand, male students describing themselves as gay, bisexual or unsure of their sexual preferences were at a higher risk for disordered eating than their heterosexual peers.
"Duke students do not have a healthy body image," said Dr. Terrill Bravender, assistant professor of primary care pediatrics and director of the Duke Eating Disorder Outpatient Program. "I think that the attitudes around food and what a normal body looks like is really distorted here at Duke - more so on the Duke campus than in other cohorts of 18- to 20-year-old groups of people."
Although Dr. Betty Staples, lead investigator of the studies, said there have been eating disorder studies on specific undergraduate groups such as athletes or dancers - already presumed to be at risk for eating disorders - no prior studies involving an entire undergraduate campus population had been done.
"Part of the problem had been that, instead of studying the campus as a whole, [other studies] only took a look at specific undergraduate populations," said Staples, also a clinical associate of primary care pediatrics. "We wanted to see if there was anything else that they were missing."
Comparison of the results from public and private institutions indicated a surprising link between racial and socio-economic factors and eating disorders.
Although disordered eating behaviors were more common at Duke than at its nearby public counterparts, race was not a contributing factor in the private setting. In the public university system, however, white students were more inclined to have eating disorders than non-white students.
Race was a relatively unimportant factor at Duke than at other schools, Bravender speculated, due to the less prevalent role of class distinctions and economic disparities at a private institution.
"There's probably something about the Duke environment or student population that equilibrates the risk of eating disorder behavior across [racial] lines," Bravender said. "I can't say specifically what made the difference between public and private institutions, but you could speculate that it may be related to socio-economic issues or the prevalence of a higher pressure environment at Duke."
With the high rate of eating disorders on campus, Alphin addressed the urgent need to aid victims of eating disorders as quickly as possible. Bravender emphasized the significance of disordered eating and the need to develop programs that encourage students to have healthy eating behaviors and body images.
"In this culture of idealizing thinness in a [society] of obesity, there has to be a socio-cultural shift on campus." Bravender said. "The way to do that is to emphasize general nutrition and exercise for general cardiovascular health. We want to help them create habits of lifelong, proper nutrition."
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