By Hara Estroff Marano, published on January 1, 2008 - last reviewed on September 16, 2014
"I started starving myself when I was 12 or 13," Chloe, an absolute beauty, recalls. "I wasn't overweight, but I wasn't as thin as a lot of my friends. It was just something I noticed."
Around that time, "a lot of problems" erupted in her family. "Dieting made me feel like I was in control of something. It was the one thing I knew I could change on my own. I would diet and get positive feedback and feel really good. So I wouldn't eat for a few days at a time."
Dieting also bound her to her peers. "A lot of girls at school would skip meals. We'd do it together. We went on fad diets together, too." Her family never noticed her food fetishes. "I had trouble impressing my mother. I could never achieve enough for her. But she definitely noticed when I lost weight."
From the beginning, starving consumed her life. "You think about it everywhere you go. And you compare yourself to other people. Each of my friends was vying to be better than the others. I was in a restaurant with my boyfriend and a girl walked in who was really pretty and much thinner than me. I saw him glance at her. I went into the bathroom and cried."
She couldn't look at a picture of a celebrity without feeling bad, either. The boys at her public school didn't help. "They're constantly comparing women to each other: 'That girl is really hot; she's so much hotter than her friends.' So we compete to be the hotter friend. Some days it makes you feel fat. On particularly bad days, I can look at children and think that when I'm older, that little 3-year-old girl is going to steal my husband."
In a culture of plenty where the young are pressured to succeed even before birth, the achievement package has come to include, especially for girls, a "perfect" body. Starting at puberty, sometimes before, the mounting pressure launches girls into the stratosphere of fat fear, in part fueled by the ubiquity of food, in part by new sensitivities adolescence brings to the judgments of others.
But perhaps the greatest accelerant of fat fear and distorted eating is the peer culture to which adolescents have been consigned for the past few decades. Age segregation isn't new to America's schools. But since the middle of the 20th century, it has gathered critical mass until it has also come to dominate the extracurricular life of the young in their insular march through middle school, high school, and beyond.
Between 1960 and 2000, the percentages of 20-, 25-, and 30-year-olds enrolled in school more than doubled, with females becoming an increasingly larger part of the total.
The extension of schooling for more young people, especially girls—now the majority of college attendees—requires them to be warehoused together for years with those deliberately selected to share many of the same attributes, constraining exposure to the broader range of humanity. Ongoing shifts in communication technology (think: MySpace, YouTube, and mp3 files) may employ up-to-the-nanosecond science, but they turn out to be extraordinarily conservative social and developmental forces, keeping the young tightly tethered to each other, cloistered among those like themselves, and sharing sights, sounds, and other cultural effusions targeted exclusively at them, further age-stratifying their souls.
Superimpose on that, nature's compulsory contribution, the mating sweepstakes, and each cohort of girls seems forced to make ever more minute distinctions between themselves—just as they compete to distinguish themselves on their college application essays. Thus does dieting become a competitive sport with the gold medal going to the thinnest, a triumph of the cultural ideal for appearance that almost every American girl will unwittingly internalize by middle school.
The strongest predictor of eating disorders among middle-school girls today is the importance that peers place on weight and eating, researchers report in the International Journal of Eating Disorders. The perceptions of peers outweighs, as it were, such traditional factors as confidence level, actual body mass, trying to look like the girls and women appearing on television and in magazines, even being teased by family and others about weight.
In highly age-stratified education, particularly for females, whose attractiveness depends so heavily on youth, "all the most attractive females of a cohort are competing with each other" for the attention of males, explains Geoffrey Miller. "They are seeing only rivals who are quite similar to themselves," says the University of New Mexico psychologist. "They're not seeing the mating market as a whole. Their frame of reference is artificially constricted."
The result is "extreme intensification of sexual competition." And with increasing numbers of young women not merely going to college but getting advanced degrees, age segregation and stratification continue much later in life than they did even a few decades ago.
Modern schools, Miller points out, are often so homogenous in terms of class and race as well as age that "kids have to invent ways to be different from each other that they never would have had to invent a hundred years ago." As they jockey intensely for skinny status, their very limited involvement with the outside world helps keep them highly focused on themselves.
Richard Hersh calls it the culture of neglect: kids grow up overly dependent on their peers—"in essence, kids raising kids"—without developing a strong sense of self. A RAND scholar, former director of Harvard's Center for Moral Education, as well as former president of Trinity College and William Smith and Hobart Colleges, Hersh contends that adults—parents, neighbors, teachers, professors—have inadvertently done children and adolescents an injustice. They allow them to be socialized by television, the Internet, and by their peers rather than by caring, demanding, and mentoring adults. At the same time, the adults view kids as helpless, sheltering them from a wide range of experiences, "the risk of failure and being hurt being so great."
Both forms of deprivation weaken the young from within, so that kids go off to college socially and emotionally fragile, manifest in a rising tide of distress: anorexia and bulimia, along with depression, physical violence, alcohol and other drug abuse, and suicide attempts. Approximately 40 percent of females now experience an eating disorder at some point during their years of college, data show.
Missing in action is a rich internal life independent of peers. Hersh sees residential college life perpetuating and intensifying an adolescent pattern of overreliance on peer approval. It also, he says, elevates the body over the mind. And that combination subverts the developmental challenge of finding something far more durable: a stable identity.
The way New York psychotherapist Steven Levenkron sees it, the adults essentially outsource parenting. Levenkron has been treating young women with eating disorders for more than 30 years. He wrote one of the first books about anorexia, The Best Little Girl in the World, in 1978, and he has written textbooks on treatment of the disorder. Why is it, he asks, that some girls succumb to the peer pressure and some don't? "Those who aren't mentored by parents are not inoculated against peer pressure. They wind up turning to their peers and to the media, to the outside society, for guidance on how to appeal to men." Without a strong, healthy attachment to parents, kids become fair game for what he sees as destructive messages about femininity from Hollywood.
But the damage goes especially deep because contemporary adolescents "have no language for reflection," he says. "They don't know how to think about hurts. That makes them feel alone in the world." Anorexics, he contends, have only a very primitive language. "They can talk your head off about body measurements and fats. It's all transacted with about 12 words."
It's bad enough that teens are swaddled in software and bound by a branch of consumer culture crafted exclusively for them. But there is something about herding them together 24/7 that actively distorts their thinking, specifically about bodies. As a result, America's universities have become incubators of eating disorders. Attending a residential college actually warps perception of self in relation to others, finds psychologist Catherine Sanderson. At a time and place where people should be getting smarter about everything, they are getting a lot less smart about themselves.
A professor of psychology at Amherst College, Sanderson looked at perceptions of the norms of thinness among women at Amherst, Princeton, and Smith colleges. When women arrive at college as freshmen, they believe that all the other women at their school are highly motivated to be thin—much thinner than they themselves want to be.
Mistakenly, they assume that other people's statements accurately reflect their behavior. They know that they themselves talk the talk in the dining hall and other public places—but privately slip out later for a bag of Doritos. They feel ashamed and isolated, without realizing that almost everyone else is wolfing down chips in private, too. Students develop a false impression of the norm.
But the damage is done. The feelings of shame and isolation lead almost directly to bingeing and purging and other forms of disordered eating. "The more women perceive themselves as different, the more symptoms they show of anorexia or bulimia," Sanderson finds.
"The problem with college is that the norms are in your face," she notes. You eat in a common dining hall, exercise in a common fitness center, shower together, and get dressed together. "The togetherness surrounds people at the key life period in which this stuff matters."
Norms matter especially at times of transition, such as going off to boarding school or starting college. In order to make it in their new environment, students look to others there to figure out what's normal. We all navigate the social universe by making comparisons to others, but researchers have long known that widespread insecurity (Will I get into Harvard? Is my family coming apart at the seams? Do I even have an identity of my own? Why do I feel so different from everyone?) exacerbates the process, turning comparison—with peers, with media figures—into cutthroat competition.
In such environments, misperception accelerates over time. Asked what they weigh, freshmen say "around 130," exactly what they believe other women weigh. But surveyed again the next year, after gaining about five pounds, the same women say—accurately—that they weigh 135. However, they think others weigh "around 125." "You're gaining weight and you know it, yet you believe that other women are losing weight," explains Sanderson. It's ironic, she notes, that this is a topic about which college actually makes people stupid: The more time they spend in school, the less accurate they become in their perceptions.
Columbia University psychologist Barbara Von Bulow co-runs a day-treatment program in Manhattan for eating disordered students who have been sent home on leave, asked by their out-of-town colleges to take time off for treatment. So competitive are the women about their weight-control strategies that the program has had to separate the bulimics from the anorexics.
"It's difficult to treat anorexics if they don't see themselves as unhealthy," Von Bulow observes. "Yet the bulimics look at the anorexics as successes because they are so thin." On the other hand, the anorexics "are terrified when they look at the bulimics, most of whom are normal weight. They see them as failed anorexics."
In reality, as in the dictionary, anorexia comes before bulimia; about 50 percent of the time, restrictive eating begets binge eating. Candice Sombrero, 19, a sophomore at Babson College outside Boston, endured six months of anorexia while a student at the prestigious Iolani School in Honolulu, where she grew up. "I'd grab coffee at home and tell my parents I'd get breakfast at school, which I never did. For lunch I prided myself on sipping an extra-large Diet Coke." The endless hunger made her preoccupied with food. "Once you get your hands on food, you stuff yourself. Then you feel physically uncomfortable and guilty for eating, so you start to purge." For the next year and a half, she was "stuck in the bulimic cycle, throwing up eight to 10 times a day."
Bulimia testifies to the difficulty of the restrictive eating that defines anorexia. On the other hand, not every girl can make herself throw up. Katy Palmer is one of the latter.
At 17, she was at the top of her high school class in Atlanta, looking at colleges and locked into competition with another girl for class valedictorian. "We knew each other's GPA down to the hundredth of a point," she recalls. The academic pressure was intense. That year her grandfather died, and suddenly family life was dominated by grieving. "I didn't have control over the college application process and I couldn't make any school accept me; I knew it was an arbitrary process. I didn't have control over what was happening in my family. Eating became the least complicated thing I could do that was under my control. I read an article in Self magazine all about calories. Cause and effect were clear: Fewer calories equal less weight."
Gradually, she shriveled into her five-foot-10-inch frame, until she weighed 115 pounds. "I was always in a bad mood. I stopped having a personality. I stopped thinking about boys. All I thought about was food. Everything had to be carefully portioned. Any spread of food, any open box, was dangerous waters. I was always hungry. My dreams were nightmares about eating too much."
But people told her she looked great. And her parents never picked up on her calorie restriction. In fact, she became locked into competition with her mother, a true peer in weight obsession. "She'd say, 'Your thighs are skinnier than mine; let's get out the tape measure.' We never actually did, but we did feed off each other. We talked about how good it feels to be hungry. She told me she wouldn't be attracted to my father if he were overweight.
"Initially it's a choice," she says now. "You start dieting to be in control. But then it veers out of control. Anorexia is so dictated by fear. You're just a puppet of fear." That sleight of slight is likely accomplished through an array of cognitive changes, purely the effects of starvation on the brain.
Fear is the dark heart of contemporary girl culture. Courtney Martin, an instructor at Barnard College and author of Perfect Girls, Starving Daughters: The Frightening New Normalcy of Hating Your Body, contends that a whole generation of young women was told that they could be anything. What they heard was slightly different: "We have to be everything." And that's terrifying. The pre-college emphasis on achievement leads them "to compose the self as perfect, with a perfect resume and a perfect body," since they were socialized to believe they can look any way they want if they just try hard enough. Unfortunately, it's hard to create a sustainable self-image without a sense of self.
The pursuit of perfection is always self-consuming, and it locks young women into a vicious cycle. The struggle to achieve so much in so many different areas overwhelms them with anxiety, and anxiety generates constant comparison, which only makes them see themselves more negatively, which pressures them to try harder.
Martin regards the rising rate of suicide among girls 10 to 14 as alarming proof that girls today increasingly lack the inner resources to disarm the anxiety of achievement pressure and fat fear. "Neither parents nor schools are nurturing kids' well-being," she says, "because they themselves are caught up in the anxiety dance."
Psychologist Janell Mensinger views it as fallout of the Superwoman Syndrome. Head of health research at Reading Hospital in Pennsylvania, Mensinger has been looking at eating disorders among girls for over a decade. In a recent study reported in the journal Sex Roles, she and her colleagues found that the more adolescent girls perceived behavioral commands for excellence in academics, appearance, and dating, the more they subscribed to the superwoman ideal and the more disordered their eating became.
What's more, in surveying 1,200 students in 11 schools in New York City and Philadelphia, she found that the all-girls schools fostered greater competitiveness on appearance-related issues than did the coed schools. "Girls at single-sex schools appear to be at a disadvantage in that they are more dissatisfied with their bodies," she reports.
That body competition is worse among students at all-girls schools makes perfect sense to Geoffrey Miller. The psyche reads the environment as a scarcity of males. And that only ups the mate competition among females. "It's a supply-and-demand effect," he suggests. Candice Sombrero would agree. A transfer student, she finds that eating disorders are much less prevalent at Babson than at most other schools. "This is a business college, and the ratio of males to females is 60:40 or 70:30."
If it is indeed a supply-and-demand effect, then America's campuses ought to be bracing for a near epidemic of eating disorders. The ratio of males to females is shrinking dramatically at most colleges; even Babson, able to draw from a larger pool of women, aims to add more female students.
It is a particularly cruel irony that, through unforeseen shifts in gender balance, higher education as it's now constituted winds up lowering the threshold for one of the most mentally and physically disabling disorders of our time.—Hara Estroff Marano
Just as there is no single cause of eating disorders among the young—they are rooted in conditions set long before college—there is no one solution. But many contributing elements can be addressed by schools, parents, and the culture at large.