Campaigns promoting awareness about eating disorders have sparked discussions within the Duke community regarding how to best address the issue.

Approximately 25 percent of all college students have an eating disorder, according to a 2011 survey by the National Eating Disorders Association. Student Health sponsored Celebrate Our Bodies Week from Feb. 17-21 in conjunction with several other on-campus organizations to increase awareness of the spectrum of disordered eating.

“There is definitely an eating disorder problem at Duke, but no one wants to talk about it,” said junior Taylor Turkeltaub, who spearheaded eating disorder awareness efforts on campus last year. “There is a façade of perfection that exists here.”

A missing piece in campus dialogue

Last year, Turkeltaub worked extensively with a committee that included staff from Counseling and Psychological Services and Student Health to spearhead the first Duke Eating Disorder Awareness Week.

Turkeltaub said she felt that discussions about eating disorders were largely missing from the campus dialogue.

“The majority of eating disorder campaigns focus on body image and the idea that the sufferer thinks he or she is fat,” Turkeltaub said. “I find that these statements can be somewhat offensive, as if the only problem was that I did not think I was attractive, and that the solution simply lies in someone telling me that I am and therein I will find my validation and my cure.”

This year's Celebrate Our Bodies Week attempted to increase awareness of resources available to students suffering from eating disorders, said Kate Pilewski, a Student Health nutritionist who organized the events two weeks ago. She noted the "How to Help a Friend" discussion in particular helped to "debunk myths" about eating disorders and help friends offer support to those in need.

Lawn signs and a number of posters about popular diets were also displayed throughout campus. Although intended to inform students of the dangers posed by many popular diets, the brightly colored posters received mixed reviews from some students.

“I felt like the posters glamorized fad diets,” said freshman Neda Jamshidi-Azad. “After seeing one, I remembered a grapefruit diet that a friend of mine did last year. I can see how if someone who is struggling with his or her weight sees the posters, he or she might view such a diet as a valid option.”

Each poster was titled “Fad Diet: The Picture of Restriction” and featured photographs of foods allowed by diets like the Vice-Busting Diet or the Rainbow Diet.

“They kind of glamorized fad diets, and even seem to recommend them to the viewer,” Turkeltaub said. “If you’re going to do photographs of fad diets, at least make it obvious that they’re bad and why.”

In addition to a number of events meant to increase awareness, last year’s week featured a photo gallery through which Turkeltaub and co-creative director Ashley Tsai, Trinity '13, sought to convey the raw reality of eating disorders. The gallery featured ten pictures of young women who had suffered from eating disorders.

“My gallery was conceived as a counter and a challenge to that status quo campaign,” Turkeltaub said. “The goal was and is to portray an intimate look at and to give a voice to an issue that is most often only allowed to speak with a shallow tenor or in whispers.”

Turkeltaub and Tsai photographed the mostly anonymous participants in different positions—one reaches for a slice of pizza, another sits with jeans in different sizes and a third unveils the tattoo that she got to mark her recovery.

“I did it to gain control—to have some say over something in my life,” wrote one student on a picture of herself reaching into a store’s refrigerator. “I thought that each pound lost would magically improve all aspects of my life. I was wrong. My eating disorder didn’t help me gain control—it made me lose it.”

Turkeltaub and Tsai designed the pictures to look like Polaroids and had the participants write their stories in their own handwriting in an effort to make the project more personal.

“When I watched people last year looking at the gallery and letting out gasps...I knew that I had done my job,” Turkeltaub said.

Although no one from Student Health, CAPS or Eating and Body Image Concerns involved Turkeltaub in planning Celebrating Our Bodies Week this year, she still plans on displaying a gallery.

Pilewski noted the shift in the program's emphasis from the previous year.

“Last year we focused more on clinically diagnosed eating disorders, which is just part of the spectrum,” Pilewski said. “This year we wanted to focus on the positive—that recovery is possible—as well as disordered eating behaviors.”

Disordered eating on campus

Director of the Duke Center for Eating Disorders Nancy Zucker estimated that her clinic treats 200-250 patients each year. The clinic is open to all patrons and is not limited to Duke students.

Gary Glass, the associate director for outreach and developmental programming at CAPS, was unable to give an exact number of students referred by CAPS to the center.

"There is really no reliable number to report of students who seek our services with eating disorders because there are so many different nuances of what can constitute 'eating disorders,'" Glass wrote in an email Sunday. "The number of those who meet diagnostic criteria for some form of an eating disorder does not capture how pervasive eating and body image concerns are."

Zucker noted that high stress environments like Duke can be conducive to disordered eating.

“Individuals may be biologically inclined to develop an eating disorder and being in an environment that is particularly stressful or competitive can set the wheels of that disorder in motion,” Zucker said.

Treatment can be difficult, especially on college campuses, where students are often far away from home and hesitant to seek help.

“If an adolescent has anorexia, the most effective treatment is family-based,” Zucker said. “We need to find a replacement treatment for young people that develop eating disorders in college, and the truth is that we don’t have an empirically validated new strategy."

Turkeltaub said it is important to consider all types of disordered eating in the category of an eating disorder, rather than simply focusing on commonly known bulimia and anorexia.

“Eating disorders tend to get lumped into black and white categories of having one or not having one, when it’s not actually that black and white,” Turkeltaub said.

Ultimately, Zucker said any treatments to disordered eating should involve the student's support network and cognitive behavioral therapy.