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There's a reason students at the University of Chicago call it "the place where fun comes to die." Its students are competitive. Its teachers, unforgiving. In short, the school demands 110 percent from you. Which, I can only imagine, is hard to give when you're starving.
Natalie developed an eating disorder as soon as she left home for U of C. She skipped meals and purged multiple times a day. She danced 10 hours a week. She couldn't stop working or start eating. Her behavior became so extreme that she suspected she might have bipolar disorder. At which point she finally decided to go to the university's student resource center, thinking the staff there could help her overcome whatever psychological problem was keeping her from eating. But she said the counseling center's health professionals addressed only her body mass index, not her mind.
"My behavior was basically dismissed," said Natalie, who is now 22 and uses medication and therapy to treat the diagnosed bipolar disorder that she thinks made her anorexia so severe. Each visit to the center was the same. "Before discussing medication or asking me how I was doing, [my doctor] would march me upstairs to the bathroom, weigh me, and then march into her office, where she would whip out a body mass index chart to see if I had crossed the magical line or not."
It turns out the University of Chicago is not alone. According to a recent New York Times article, college campuses across the country are struggling to provide the mental health resources for behavioral problems that take a physical toll, like anorexia and binge drinking.
"The only treatment that we know of that is effective is the restoration of calories and weight," said Becky Steinhauer, a psychiatrist at the University of Chicago's health clinic. While medication can help with the psychological symptoms that accompany eating disorders, for the physical ones, Steinhauer says she uses the body mass index (BMI) to calculate whether a student is healthy or not.
But the former students I talked to who struggled with eating disorders said their doctors focused so much on their BMIs, they all but ignored the mental issues they had simultaneously.
"The school doesn't seem to care much if you're addicted to cocaine or methamphetamines," said U of C alumna Lauren, now 28, who struggled with drug addictions, as well as self-mutilation and an eating disorder. She said the health center's staff never addressed the drugs or cutting, even after she admitted she was having serious problems with them. To her, the eating disorder was a defense mechanism at a time when she felt otherwise mentally incapable to dealing with her life in college. "As long as I was in pain I felt invincible," she said.
But for health professionals, there's reason to view the eating disorder as the chief medical concern. According to Steinhauer, anorexia nervosa is the most deadly of all psychiatric diseases, with 20 percent mortality rates in adults due to complications of starvation and the high suicide rate associated with the disorder.
"It can constitute a medical emergency," said Steinhauer, who considers a BMI level of 19 – 25 to be healthy. "If someone comes to my attention because they have anorexia, and have lost a lot of weight, and are at the gym for several hours a day, they get railroaded to the hospital," she said.
And that removal from campus may be part of the treatment. A college atmosphere can put extra pressure on students with eating disorders, and Steinhauer said sometimes the university needs to take action to remove them from it. "These students get straight A's, but they're subsisting on 800 calories a day… what prisoners at Auschwitz subsisted on. Students here are doing high-powered intellectual work under conditions of starvation. The loss of gray matter in your brain – the stuff you think with – is not reversible. They're asked to go to an in-patient treatment center because they're going to die."
However, according to the three University of Chicago alumnae, the prospect of leaving school came up too fast, without any alternative options. The third alumna, a 25-year-old whom I'll call Sally, recovered from her eating disorder before she went to college, but was identified by the university as someone needing regular check-ups. In hindsight, she said removing students from the university atmosphere can often do more harm than good. "I know from personal experience and from others that it is empowering (and the only way to fully recover) to develop independence," she said.
Natalie and Lauren both took leaves of absence from the university, and resented the process. They wanted to feel like valued members of the student body.
"I was in the hospital for maybe two weeks, and then I was transferred to a New York state psychiatric institution…" said Lauren. Before leaving, she had a conversation with the dean of students, after which Lauren came away feeling that the school was more concerned about the liability of a student dying on campus, than her own well-being.
Another aspect of feeling pushed out of the student body, was the amount of money the girls paid for mandatory treatment. Sally said she was told she had to make an EKG appointment, but had to pay for it herself.
After Lauren spent six months alternately in cardiology wards and psych institutions, she returned to the University of Chicago to face lots of fees. "The school set the following condition: I would see a psychiatrist at the hospital once a week. Since students are only allowed a set number of appointments at the Student Counseling and Resource Service Center (SCRS) I had to pay out-of-pocket to see someone at the hospital. This was incredibly expensive, as I did not have health insurance that covered psychiatric care," she said.
Sabrina De Lay, a University of Chicago graduate, wrote her undergraduate thesis in 2008 on the university's mental health policy. Her main argument was that the university should lay out specifically what a student's rights are, and be held accountable to respecting those rights. A few bullet points from this policy talk about allowing students to continue their education as normally as possible, and refraining from discrimination against students with mental illnesses including punitive actions toward those in crisis.She included a model policy in her thesis that she suggested the University of Chicago adopt. The SCRS did post language from the policy on their website, but later took it down.
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