Maroon News

Issue date: 11/5/04 Section: Arts & Features

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Junior Emily Richards*, a petite blond dressed in sweatpants and a baggy Colgate sweatshirt, sits curled up on a couch in her apartment. Clutching a cup of tea, she unwittingly displays the scars on her right hand, permanent reminders of a compulsion from which she's - tenuously - freed herself. She used to inadvertently scrape her knuckles, she explains, because her teeth would gnash against her skin as she stuck her hand down her throat to gag herself.



Richards is one of approximately eight million Americans - 90 to 95 percent of whom are women - who suffer from eating disorders. She has worked to overcome both anorexia nervosa, characterized by self-starvation and excessive weight loss, and bulimia nervosa, an often secretive cycle of binging and purging through vomiting, excessive exercise and/or laxative abuse. One can hardly underestimate the seriousness of the consequences: bulimics can develop heartbeat irregularities from vomiting and laxatives, and anorexia is fatal for 20 percent of its victims. Richards knows how lucky she is that the only lasting physical reminders of her illness are scarred knuckles.



According to a study published earlier this year in the Journal of Counseling and Development, mental health professionals have long debated over two modes of conceptualizing mental illness. The Diagnostic and Statistical Manual of Mental Disorders (DSM) - which contains the criteria used to diagnose mental illness - defines eating disorders categorically. That is, the DSM delineates anorexia and bulimia as the primary eating disorders, with a third category for combinations of symptoms that may or may not constitute diagnosable eating disorders. Some experts maintain this perspective, according to the Journal of Counseling and Development, viewing mental illness as a "set of categorical (i.e., qualitatively different) disorders, distinct from normal development and from each other."



But lately many researchers and clinicians - including Colgate's Director of Counseling & Psychological Services Mark Thompson - have begun to assess mental disorders as "dimensions occurring along a continuum on which individuals vary in degree but not in kind." In other words, perhaps eating disorders fall at the extreme end of a range of eating behaviors which, according to Thompson, encompasses everything from "body image dissatisfaction - maybe behaviors that are troubling and interrupt a student's regular routine - to the extreme end of the continuum, something that would qualify as an eating disorder." In the counseling center's annual compendium of statistics related to the treatment of Colgate students, perhaps the most startling figures are those detailing therapists' diagnostic impressions of their patients. That is, Conant House's therapists tallied the numbers of students falling into each diagnostic category, often filing a student under more than one. Eating disorders, prominent as they are on Colgate's campus, only account for nine percent of the problems treated, which suggests that disordered eating is often symptomatic of some other, overarching illness - such as anxiety or depression, the top two psychological disorders Colgate's counselors treat. Therefore, part of the reason Thompson and his colleagues believe in the effectiveness of the continuum approach is because they have treated numerous students with problems that manifest themselves in terms of food but that have roots in issues more complex than a simple desire to lose weight.

Continued...

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