Out of Control

At first it seemed like a minor, if mystifying, problem: In the spring of 1996, plastic sandwich bags began disappearing by the hundreds from the kitchen of a sorority house at a large northeastern university. When the sorority’s president investigated, she found a disturbing explanation: The bags, filled with vomit, were hidden in a basement bathroom. “I was shocked,” says the president (who later learned that the building’s pipes, eroded by gallons of stomach acid, would have to be replaced). “Yet in a way it made sense.” Most of her 45 housemates, she recalls, worried about weight. “It was like a competition to see who could eat the least. At dinner they would say, ‘All I had today was an apple,’ or ‘I haven’t had anything.’ It was surreal.”

And, sadly, all too typical of scenes at colleges across the country. Since singer Karen Carpenter’s death from complications of anorexia nervosa first jolted the nation into an awareness of the disease in 1983, the numbers of women seeking treatment for eating disorders has skyrocketed. Sufferers—5 to 10 million females and 1 million males—tend to be young (from 14 to 25), white, affluent, “perfectionistic, type-A personalities,” says Marcia Herrin, codirector of Dartmouth College’s Eating Disorders Education, Prevention and Treatment Program.

It’s a problem that is raging on college campuses. In a PEOPLE poll done last fall of 500 coeds (see page 62), the figures were alarming: More than half of the young women respondents said they knew at least two schoolmates with an eating disorder. In a second poll, of 490 college health officials, commissioned by PEOPLE (see page 57), 70 percent said the problem was “common” on their campuses. According to Seattle’s Eating Disorders Awareness and Prevention group (EDAP), an estimated 5 to 7 percent of America’s 12 million undergraduates are afflicted with anorexia (a pathological fear of weight gain leading to extreme weight loss), bulimia (bingeing followed by purging) or binge eating (compulsive overeating). “College women are away from their families, and there’s tremendous pressure to find their way in the world,” says Jennifer Biely, EDAP’s director. “Food is one thing they can control.”

The idolization of wispy models and actresses adds to the problem. “I can tell a girl that what matters is what’s going on in her head and heart,” says sociologist Traci Mann, author of a 1997 study on campus prevention programs. “But when she turns on the TV, she sees that what matters is how you look.”

Many schools are working to counter the media message. Freshman orientation programs routinely include information, once nonexistent, on eating problems, and “virtually every college has some kind of program, either a student-run group or treatment options through health services,” says Charles Murkofsky, president of the New York City-based American Anorexia Bulimia Association. In February 1998 more than 600 college campuses participated in a National Eating Disorders Screening Program; of the 26,000 students who filled out questionnaires, 4,700 were referred for treatment.

Yet girls at risk often deny the problem or avoid getting help because of the stigma attached. And many college administrators “are not aware or don’t want to become aware of the extent of the problem,” says William Davis, a vice president of Philadelphia’s Renfrew Center, a private eating disorder treatment facility. “They have to make choices about how they use funds: for education on drug and alcohol abuse or date rape or eating disorders.” What’s more, treating eating disorders is usually lengthy and expensive. A recent UCLA study found that the median recovery time from anorexia is seven years; many insurance companies cover only a fraction of the estimated $150,000 cost.

As colleges are discovering, however, not intervening can be far costlier. Bulimics may develop heartbeat irregularities from vomiting and laxative use, and anorexics have a mortality rate of nearly 20 percent, the highest of any mental disorder. Then there’s the psychological toll. “I finally realized I didn’t want to keep living like that,” says Laura Mislevy, a recent Michigan State University graduate and a recovered anorexic. “There’s more to worry about in life than what’s for dinner.”

On the following pages, four college women describe their agonizing struggles with eating disorders and the long road back.

Sara Hunnicutt

An anorexic, she took her need to excel to unhealthy extremes

It was good news, and on I some level Sara Hunnicutt knew it. At her doctor’s office last December, she learned she had put on two pounds the previous week and now carried 93 pounds on her skeletal, 5’1″ frame. “It’s a step in the right direction,” Hunnicutt said. Then she added, “But gaining isn’t fun for anyone, not when you’ve been maintaining a low weight for so long. You don’t want to destroy that achievement.”

Now, after seven months of treatment for anorexia, not viewing emaciation as an achievement remains the hardest part of recovery. Though her arms and legs are no longer stick thin, and the peach fuzz-like hair on her face—a result of near-starvation—has nearly disappeared, she refuses to talk about her current weight. “As I’m getting close to a normal range, it’s scary,” says Hunnicutt, 20, who began treatment at Philadelphia’s Renfrew Center after her weight dipped to 80 pounds last fall, forcing her to leave the University of Richmond and move back home with her mother, Kris, in Ambler, Pa. “As much as I want to be normal, there’s a part of me that’s holding on to the eating disorder,” she says. “It takes you over, and my healthy side is still trying to fight back.”

A hard-driving, popular student who was president and one of three valedictorians of her 1995-96 senior class at Wissahickon High School, Hunnicutt says that before she went to college she “ate what my mom made and didn’t think about weight.” At Richmond she indulged in late-night pizza-and-beer fests and put on the “freshman 15,” going from 115 to 130 pounds. When “watching what I ate” that summer didn’t help, she says, she returned to school serious—but sensible—about dieting and exercise. By Christmas ’97 she was back to 115. “I thought she looked great,” recalls Kris, 51, a secretary in an orthodontist’s office.

In fact, Sara seemed to be blossoming after a tough transition to college. The death of her father, Bruce, a financial analyst, of brain cancer at 51 the January before her high school’ graduation had left Hunnicutt reeling. “I kept going, but there was a lot of pain,” she recalls. In addition, “I was a big fish in a small pond in high school,” she says. “Now people would say, ‘Oh, you were valedictorian too.’ There were lots of big fish.”

But by sophomore year, Hunnicutt was making new friends at her sorority, Delta Gamma, and maintaining a 3.8 grade point average. Feeling in control, she made sure her eating was too. In May, when she moved off-campus and began cooking for herself, she adopted a rigid diet: cereal with skim milk for breakfast, a cereal bar and fruit or pretzels for lunch and a light supper, often pasta. “I was hungry, but I didn’t think I was depriving myself,” she says. “I was pretty proud of the tight rein I had on my eating.”

With Hunnicutt’s weight hovering between 90 and 100 pounds, her mother was worried. Over dinner last June, Kris recalls, she told Sara, “You’ve lost a lot of weight. Maybe you’d better stop.” It wasn’t that simple. Although she was down to a size 0 and bought some of her clothes in children’s departments, “in my mind,” Hunnicutt says, “anorexics ate a leaf of lettuce a day and were stick thin. That wasn’t me.” The gynecologist her mother suggested she see in June—after Sara hadn’t had a period in four months—apparently agreed. The doctor said a lack of body fat can make menstruation stop. “She said I should gain weight,” Hunnicutt recalls, “but not that I needed help.”

Working during the summer as a temp, Hunnicutt, who liked the way she looked, threw away the sandwiches her mother made her for lunch, allowing herself only fruit and nonfat yogurt. After work she ran “no matter how tired I was,” she says. Increasingly concerned, Kris began researching eating disorders. On a Web site sponsored by a Eugene, Ore., group called Anorexia Nervosa and Related Eating Disorders, she learned that Sara displayed many of anorexia’s symptoms: She had lost nearly 30 percent of her body weight, exercised compulsively and denied feeling hunger. “I finally asked, ‘Do you have anorexia?’ ” Kris recalls. “She looked at me as though I was crazy.” Strangers stared at her, Kris notes, but Sara didn’t have a clue.

That changed in August. Back at college, Hunnicutt was confronted by a faculty member and a fellow student. “They wanted to make sure I was going to get help,” she says. “I broke down in tears. I felt they were disappointed in me. I had always done well in everything. How could this happen?” She went to the university’s free counseling service, but feeling uncomfortable opening up to school staffers, she turned to a private therapist. “But I couldn’t concentrate on my classes,” she says. “I had this feeling of being so tiny. It was really scaring me.” Early in September 1998 she and her mother agreed that she should come home.

Since then, Hunnicutt has made great strides. She spent a week in September as a patient at the Renfrew Center. There, at a cost of $1,000 a day (insurance covered almost two-thirds of the total, but Kris estimates she spent $2,500 in savings to pay for Sara’s hospitalization), Sara discussed self-esteem and dealing with her feelings at daily therapy sessions, learned healthy eating habits and had the number of calories she consumed recorded by a staffer. Unlike many treatment centers, Renfrew doesn’t force its patients to eat. “Our philosophy is to help women feel safe,” explains the clinic’s William Davis, “and then to help them risk new, self-assertive behaviors.”

When she had gained three pounds, Hunnicutt switched to daily outpatient care for two weeks, followed by five therapy sessions a week for two months. Today, she no longer restricts herself to low-fat foods and is out of immediate danger. “She’s not at risk of sudden death or serious medical complications,” says Renfrew’s medical director Dr. Emily Kravinsky. Hunnicutt’s therapist and physician have authorized her return to school once she weighs 106 pounds. “I’m sure I’ll be at school in the fall,” says Hunnicutt, who now works part-time as a clerk at a technology consulting company. She has visited the Richmond campus several times this year and is excited about returning. On one occasion, when she and some friends went out for pizza, “I think they were surprised I can eat as much as they can now,” she says. “It makes me feel good.”

Hunnicutt does risk relapse—one-third of people treated for anorexia fall ill again—something her four-times-a-week therapy sessions are aimed at preventing. “For Sara, the eating disorder has been a way of telling the world, ‘I’m not perfect—I have needs,’ ” says psychologist Meredith Barber, who is helping Hunnicutt voice them. “I used to be Little Miss Mute, scared to express myself,” she says. “But my ability to communicate has gotten so much better.”

As has her understanding of what made her sick. “I’m still working out what the emotions were,” she says. “School and my dad’s death were factors, but so was my determination to excel. That’s who I am.” Her brother Patrick, 25, an IBM program manager, agrees. “I can’t think of a thing she failed at,” he says. Including, until recently, her eating disorder. “I put so much energy into it,” Hunnicutt says ruefully. “I was a damn good anorexic.”

Lisa Arndt

She beat bulimia only to suffer a relapse of anorexia

As a sophomore at the University of California, Santa Cruz, Lisa Arndt followed a menu of her own making: For breakfast she ate cereal or fruit, with 10 diet pills and 50 chocolate-flavored laxatives. Lunch was a salad or sandwich; dinner: chicken and rice. But it was the feast that followed that Arndt relished most. Almost every night at about 9 p.m., she would retreat to her room and eat an entire small pizza and a whole batch of cookies. Then she’d wait for the day’s laxatives to take effect. “It was extremely painful,” says Arndt of those days in 1992. “But I was that desperate to make up for my bingeing. I was terrified of fat the way other people are afraid of lions or guns.”

For Arndt, 26, in her fifth year of recovery and working as a counselor at the Rader Institute, an L.A. eating disorders clinic, bulimia began with the college cafeteria line. As a freshman, “there was plenty of food all the time, and it seemed like it was free,” she says. Her initial weight gain—from 100 pounds to 115 pounds, which suited her 5’6″ frame—won compliments from friends. But Arndt, who had been an anorexic in high school, didn’t buy it. “I felt ugly and ashamed,” she says. Yet she gorged on junk food, thinking, “Oh, well, screw it, because I’m a big fat failure.”

Back in high school, a friend who was the homecoming queen had confided that she was hooked on 75 laxatives a day and weighed 92 pounds. “She was trying to reach out for help,” Arndt says now. But at the time the girl’s despair only inspired Arndt. “I was supportive,” she says. “But in the back of my mind I thought it was a great idea.” Within a year of starting college, Arndt was trapped in an obsessive cycle of bingeing and laxative purging that did nothing to reduce her weight, which climbed to 140 pounds. “I would sit in class fantasizing about the cookies I’d make for myself or whether to have pepperoni on my pizza,” she recalls. Grocery shopping—with four boxes of cookies and 10 boxes of laxatives in her cart—raised eyebrows. “I was so embarrassed, I went to different stores,” she says. And excruciating abdominal pains weren’t the sole side effect. “You start to smell,” Arndt says matter-of-factly. “There’s nothing you can do about it.”

Later that year, Arndt got a loud wake-up call. At the age of 20, her friend, the laxative-gulping homecoming queen, suffered a heart attack. She survived, but “I remember seeing her all ghostly and pale and shaky,” Arndt says, “and I thought, ‘That could happen to me.’ ” After seeing a flyer for an on-campus support group for students with eating disorders, Arndt, a psychology major, opted to join. With the help of the group, she eventually weaned herself off the laxatives one at a time.

The weekly meetings also forced her to confront the anorexia she had suffered as a teen. Like many anorexics, her disorder had its seeds in a troubled childhood. After years of squabbling, her mother, a licensed therapist, and her father, a physician, divorced acrimoniously when Arndt was 15. “My home wasn’t just broken,” she says. “It cracked in 17 different places, then shattered.”

Life at Santa Monica High was also fraught. “To be famous, to be Hollywood is what was cool,” says Arndt. And that meant being thin. Already insecure about her features, she began dieting after a boyfriend suggested she lose five pounds and then dumped her. Arndt bought a powdered diet drink and lost five pounds in one week—only to regain the weight the next. “All of a sudden it was war,” she says. She then tried combining fasting and up to 15 over-the-counter diet pills a day, followed by what Arndt calls “the half theory: I could eat half of what everybody else ate, because I wanted to be half the size of everybody else.”

Before long, she stopped eating with others altogether. “I couldn’t carry on a conversation,” she says. “I’d get too distracted.” Family meals were rare, and neither Arndt’s mother nor father confronted her about her problem. Isolated and depressed at 16, she attempted suicide by slashing her wrists. “I thought I was too fat to live,” she says. “I hated myself.” Hospitalized for three months, she was treated for depression. It wasn’t enough. “The voices in my head,” she recalls, “said, ‘You are fat. Failure. Pig. Bitch. Greedy.’ ”

By the end of her senior year in high school, Arndt weighed 92 pounds and was living on a daily diet of one fat-free blueberry muffin, which she would cut into eight parts and eat ritualistically with a knife and fork, taking up to an hour to finish. “I had lost touch with my physical sensation of hunger,” she says. Her body, however, hadn’t. One night, Arndt passed out as she left a movie theater with her then boyfriend, Andy Gersick, who had been badgering her about her eating habits for some time. She came to on a stretcher being lifted into an ambulance. “I was looking around at all these people and thinking, ‘Oh, my God, they can all see how fat I am.’ I couldn’t stand up, so I couldn’t hold myself in a position where I looked thinner.” Though tests at St. John’s health center showed that she was anemic and dehydrated (she had stopped drinking water for a week because it made her feel bloated), Arndt’s denials of having an eating disorder were accepted, and she was released. Over the summer, with Andy’s help, she gained eight pounds and, by the time college began, considered herself cured.

In truth, she had a long way to go. Though the college support group helped Arndt face her eating disorder in part, she says, “there was competition to be the sickest. I always wanted to be the thinnest.” By graduation she had succeeded. A diet prior to graduation sent Arndt spinning back into full-blown anorexia. Before long, her hair began falling out and osteoporosis, brought on by malnutrition, had left her half an inch shorter. She joined a new support group and began working with a medical team at UCLA, where she had taken a job as a researcher in the psychology department. A nutritionist put her on a plan of foods less likely to alarm her, such as salads, lean meats and nonfat milk; a doctor tended to her illnesses, which included anemia and low blood pressure; a therapist helped her overcome her fears about food. “I took them on,” she says, “one meal at a time.”

Within a year, Arndt says, she was in recovery. And not a day passes that her patients at Rader don’t remind her of just what that means. “They’re great people,” she says, “but all of them are killing themselves. Now that I’m finally free of anorexia and bulimia, life is so much better, brighter and worthwhile. I want to share that with everyone who is caught in the thinness trap so that they too can live life for real and experience true laughter and love.”

Josie Bode

When her college eating disorders group didn’t help, she started her own

Josie Bode was just settling into the freshman dorm at Kenyon College in Gambier, Ohio, in 1997 when she nervously asked her roommate Georgeanna Brooks, “What do you want to put in the refrigerator?” Bode was surprised—but relieved—when Brooks, 19, answered, “I have some issues with food.” That’s when Bode confided that just six weeks earlier she had been released from Indianapolis’s Methodist Hospital after eight days of treatment for bulimia and severe anorexia. Brooks didn’t flinch: For four years, she too had suffered from anorexia and bulimia, but by May 1997 was well on her way to recovery. “At that point I had never met anyone who had recovered,” recalls Bode, now 19. “It made it a lot easier for me. I was able to see the light at the end of the tunnel.”

So vital was her friend’s support during a difficult freshman year that Bode, who now considers herself “as recovered as I’ll ever be,” returned to school last fall determined to provide the same help for others. In September she and eight classmates convened the first, meeting of Kenyon’s only student-run eating disorders support group. Still growing as word spreads, it now meets weekly. “Many people with eating problems think that they’re alone,” says Linda Smolak, a Kenyon psychology professor who helped the group get started. “Talking to others who know what it feels like helps.”

That was the case for Bode, whose parents, Ken, 60, former moderator for PBS’s Washington Week in Review and now dean of Northwestern University’s Medill School of Journalism, and Margo, 53, a playwright, had trouble accepting their younger daughter’s disorder (older daughter Matilda, 21, is a senior at Kenyon). “At first,” says Margo, “I thought I could tell her, ‘Stop it,’ and she would.” A vibrant, popular student, Bode was a sports star at her high school in Greencastle, Ind. But her ebullience hid deep insecurity. Obsessed with athletic excellence, she also felt trapped in a destructive relationship with an older boyfriend. “He would cheat on me,” recalls Bode. “So I felt there had to be something wrong with me. All I could come up with was that I needed to be skinnier.”

In 1994, with 142 pounds on her 5’8″ frame, Bode began dieting to look good in a skimpy costume she would wear in a high school play. By midway through her senior year, she had lost 37 pounds by living on dry cereal, pretzels and diet colas, exercising six hours a day and secretly purging the dinners she ate at home. Concerned by Josie’s frail looks, her parents enrolled her in a $4,000-a-session group therapy program. But when a malnourished Bode collapsed at summer camp, her parents checked her into the hospital for eight days of intensive treatment costing $5,000.

Ken Bode now feels that he and Margo should have responded faster. “I thought this was self-indulgent behavior,” he says. “It was only after family counseling that we understood that you can’t just say, ‘Cut it out.’ ”

Nor did hospitalization prove a panacea. When college began, says Josie, “I knew what I needed to be doing, but I didn’t care enough yet about myself.” Still purging and dieting, she joined a free therapy group offered by Kenyon’s student health and counseling center—which employs a physician and counselors, all well-versed in eating disorders—but she felt miscast. (“The group was designed for people who felt they were at risk,” says Bode, “not those who had already been there.”) Returning to college after Christmas break was not easy. “I was under more stress than I’d ever been, and I didn’t have my eating disorder to fall back on,” she says. “But, for the first time, I had the pride and character to come back.”

One year later, Bode, now a sophomore majoring in psychology, has her disorder under control—if not cured. “When something goes wrong,” she says, “my first reaction is, ‘Okay, I can skip this meal. No one can hurt me as badly as I can hurt myself.’ That thought is getting to dismiss,” she adds, “but it is always there.”

Anna Eidson

Starving herself gave the homesick freshman an excuse to rejoin her family

The 1995 Christmas formal was two weeks away, and freshman Anna Eidson, who had gained 15 pounds since coming to DePauw University in Greencastle, Ind., three months earlier, had a problem. The black pants and vest she had chosen for the occasion were size 6, but the 5’6″, 135-lb. Eidson was not. “I said to myself, ‘I am going to eat only salad, bagels and water,’ ” she recalls. ” ‘No meat, no protein, no dessert.’ ” Ten pounds lighter by party time and pleased when friends told her how good she looked, Eidson kept cutting back, until she was living solely on water and two bagels a day. Says Eidson, now 21: “I thought life would be perfect at 110 pounds.” She now knows she was deluding herself. “I was starving myself so I could go home—back to my parents, to the comfortable, controlled life I knew,” she says. “I wanted to be small again.”

To Eidson, her childhood in the Kansas City, Kans., suburb of Fairway was “an All-American dreamworld.” A popular teen, she was a high school cheerleader, sang in the choir and mentored middle-school students. Although she was excited about going to DePauw, she became despondent as departure time drew near. “I cried the whole way there,” she says. “Going away was the hardest thing I’ve ever done.”

Although she was accepted into the sorority of her choice, Eidson felt insecure for the first time in her life: “There were so many beautiful women there that I was irrational about how my body looked to everyone else.” Unaware that she was starving herself, Eidson says she “felt guilty if I diverged from my routine. If I ate something with more calories than usual one day, I would not eat as much the next. I would compare myself with others, but it was more like trying to beat the scales.”

Back home for Christmas, she continued to lose weight. Her parents, Dianne, director of volunteers at Kansas City’s two Ronald McDonald houses, and Al, who owns an advertising agency, noticed how thin their daughter had become. A school friend of Anna’s, John Peryam, recalls telling her mother during a Christmas party, “Mrs. Eidson, Anna is not eating.” At first, though, the Eidsons blamed bad cafeteria food and tried to make up for it by cooking Anna’s favorite meals. “She fooled me,” says Dianne. “Anorexics are great at pushing food around the plate and looking as if they’ve eaten something.”

Back at DePauw in January, the deprivation was taking a physical toll. “I was exhausted all the time,” says Eidson. “My period stopped for four months, my hair was thinning. But I never connected it with not eating.”

Friends did. During orientation at DePauw, residence advisers and mentors talk with students about eating disorders and where to go for assistance. Classmates confronted Eidson in early January and urged her to see a school counselor, who, Eidson recalls, told her she was anorexic but not to ” ‘feel alone. You haven’t created some new disease.’ ” Eidson was also encouraged to call her parents. “At first I was mad,” says Dianne. “The second reaction was, ‘We have to do something quickly.’ ”

Two weeks later, Eidson returned home and began seeing a $110-an-hour psychiatrist. But when she continued to lose weight her parents, with Anna’s consent, admitted her to Baptist Medical Center’s eating disorder unit. The approach was tough. At therapy sessions throughout each day, Eidson and her 11 fellow patients talked about self-esteem, anger management and healthy exercise. Forbidden to discuss calories, fat content or other issues anorexics commonly obsess about, participants had to eat at least half of everything on their plates or face drinking an 8-oz. can of Ensure. “We all knew how much fat and calories were in those meals in a can,” says Eidson. “They were the kiss of death.”

Still, says Eidson—whose $8,000, five-day hospital stay was followed by a $4,000, 10-day outpatient program—it was a “relief” to get help. “I had lost all sense of taste. Hunger pains were nothing to me,” she says. “There were two people inside me. The irrational side took over and wouldn’t let me eat. Finally the split personality decided that what I was doing was wrong, and I began to eat again.”

Eidson returned to school in August 1996 and has gained back much of her lost weight. She has also made up her missed year and will graduate with her class in May. But, she concedes, anorexia still has an emotional hold on her. “Unfortunately, if I get upset and stressed or there’s change, the first thing that goes is my eating,” she says. “But now I’m able to notice the warning signs and can ask for help. I have the tools to handle it.”

Written by: Kim Hubbard, Anne-Marie O’Neill and Christina Cheakalos

Reported by: Ken Baker, Leslie Berestein, Giovanna Breu, Tom Duffy, Joanne Fowler, Lisa K. Greissinger, Nancy Matsumoto, Patricia Smith, Fannie Weinstein and Michelle York