"I don't know if my body is even capable of gaining three more pounds."
The nurse looked at me apprehensively. "It's easy to gain a couple pounds. What I'm afraid will happen is that you'll lose it again and you'll just be cheating yourself."
I couldn't keep the impatience out of my tone. "So you're just going to keep checking on me until I graduate?"
"If we don't tackle your low weight now, it will kill you."
In the past three weeks alone, I have spent ten hours at Yale Health, our student health center. Since December, I have had weekly weigh-ins and urine tests, three blood tests, appointments with a mental health counselor and a nutritionist, and even an EKG done to test my heart. My heart was fine -- as it always has been -- and so was the rest of my body. So what was the problem?
The medical professionals think I have an eating disorder -- but they won't look past the number on the scale, to see the person right in front in them.
I visited the cancer hospital on September 17, 2013, worrying about a lump in my breast. It turned out to be benign, but I received an email in November from the medical director about "a concern resulting from your recent visit." My stomach lurched. Was the lump malignant after all?
I met with a clinician on December 4 and was told that the "concern" was my low weight and that I would meet with her for weekly weigh-ins. These appointments were not optional. The clinician threatened to put me on medical leave if I did not comply: "If it were up to the administration, school would already be out for you. I'm just trying to help."
I've always been small. I've been 5'2'' and 90 pounds since high school, but it has never led to any illnesses related to low weight or malnutrition. My mom was the same; my whole family is skinny. We all enjoy Mom's fabulous cooking, which included Taiwanese beef noodle soup, tricolor pasta, strawberry cheesecake, and cream puffs, none of which make the Weight Watchers shortlist. I just don't gain weight easily.
Yet the clinicians at Yale Health think there's more to it. Every week, I try to convince my clinician that I am healthy but skinny. Over the past several months, however, I've realized the futility of arguing with her.
"You should try to gain at least two more pounds." (What difference does two pounds make?)
"Come next week to take a blood test to check your electrolytes." (No consideration that I had three exams that week.)
"I know you've said in the past that you don't eat as much when you get stressed out." (I've never said that.)
So instead of arguing, I decided that perhaps the more I complied, the sooner I could resume my normal life.
I was forced to see a mental health professional. She asked me all of the standard questions -- how I felt about my body, how many calories I ate. I told her everyone's body is beautiful, including mine. When I said I didn't know how many calories, since I don't care to count, she rephrased the question, as if that would help.
Next step was a nutritionist. The nurse passed a post-it note, saying "Here are two times for the nutritionist next Tuesday. Usually it takes three months to get into nutrition at all." What a privilege! Now I get to feel guilty about using clinical resources in desperately short supply!
Finally, I decided to start a weight-gain diet. If I only had to gain two pounds, it was worth a shot to stop the trouble. I asked my health-conscious friends what they do to remain slim and did the exact opposite. In addition to loading up on carbs for each meal, I've eaten 3-4 scoops of ice cream twice a day with chocolate, cookies, or Cheetos at bedtime. I take elevators instead of stairs wherever possible.
Eventually, the scale said I was two pounds heavier. When I saw her last Friday, I felt my stomach tighten, my heart racing. Would I finally be granted parole?
"You've gained two pounds, but that still isn't enough. Ideally, you should go up to 95 pounds." I hung my head in disbelief. I've already shared with you the memorable exchange that followed.
She had finally cracked me. I was Sisyphus the Greek king, forever trapped trying uselessly to push a boulder up a hill. Being forced to meet a standard that I could never meet was stressful and made me resent meals. I broke down sobbing in my dean's office, in my suitemate's arms afterwards, and Saturday morning on the phone with my parents. At this rate, I was well on my way to developing an eating disorder before anyone could diagnose the currently nonexistent one.
It seems Yale has a history of forcing its students through this process. A Yale Herald piece from 2010 told the story of students in similar situations. It's disturbing how little things have changed. "Stacy" was "informed that if she kept failing to reach [Yale Health]'s goals for her, she would be withdrawn for the following semester." Unfortunately, "the more she stressed out about gaining weight, the more she lost her appetite."
Furthermore, a recent graduate messaged me saying that her cholesterol had actually gone up due to the intensive weight-gain diet she used to release herself from weekly weigh-ins.
It is clear that the University does care about students suspected of struggling with eating disorders. And it should. Eating disorders are particularly prevalent on college campuses and Yale is no exception. However, because the University blindly uses BMI as the primary means of diagnosis, it remains oblivious to students who truly need help but do not have low enough BMIs. Instead, it subjects students who have a personal and family history of low weight to treatment that harms our mental health. By forcing standards upon us that we cannot meet, the University plays the same role as fashion magazines and swimsuit calendars that teach us about the "correct shape" of the human body.
I was scheduled to have a mental health appointment at 9:00 a.m. and a weigh-in at 10:30 a.m. this past Friday. But I'm done. No more weigh-ins, no more blood draws. I don't have an eating disorder, and I will not let Yale Health cause me to develop one. If Yale wants to kick me out, let them try -- in the meantime, I'll be studying for midterms, doing my best to make up for lost time.
If you are struggling with an eating disorder, call the National Eating Disorder Association hotline at 1-800-931-2237.
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