Re: Too thin to stay

Counseling and Psychological Services and the IU Health Center appreciate your calling attention to the serious disorder of anorexia nervosa.

Your noting that “20 percent of people suffering from anorexia nervosa will die prematurely of complications relating to their eating disorder” is a somber reminder that the death toll associated with anorexia is higher than that of any other psychiatric disorder.

IU students are fortunate to have an IU Health Center team, COPE, dedicated to helping affected students recover from disordered eating conditions.

CAPS counselors, IU Health Center physicians and dietitians emphasize a collaborative approach to treatment. They enlist the students’ cooperation in tailoring treatment involving a physician’s assessment, individual and group counseling and consultation with a dietitian.

Family consultations may be included.  

Counseling focuses on self-acceptance, exploration of beliefs and feelings, body appreciation and combating unhealthy media influence. Students tell us they value the opportunity afforded by group treatment to learn that others can have feelings and fears similar to theirs.

However, instances exist when even this comprehensive treatment is not enough. More intense interventions — yes, maybe even “ultimatums” are necessary.

When anorexia nervosa worsens in spite of treatment, it impairs a person’s ability to think rationally. The brain is literally starved of necessary nutrients and extreme distortions take over.

The person looks in a mirror and sees fat, where we would see protruding bones, skeletal features. The person usually will not eat more than a few calories a day, without carefully structured intervention.

Their brain tricks them into thinking nothing is wrong. Their Body Mass Index can reach a precarious point.

In such rare circumstances, after careful, extended consultation among the treatment team, CAPS and the IU Health Center, we will take necessary steps to ensure students’ safety.

Decisions are not made lightly. They are made to help ensure that our students with worsening disorders will not be in that 20 percent group who die.

I would not work at, let alone direct, a facility that, first of all, did not offer high quality, comprehensive treatment and secondly, did not take serious steps, recommended by a treatment team, to avoid tragic results.

­— stocktnj@indiana.edu