If you're skinny, don't go to Yale!

[kiana]

http://www.huffingtonpost.com/frances-chan/yale-eating-disorders_b_4921382.html

 

Reading the links in the article reveals some really disturbing intrusions into the lives of students. 

[Alessandra]

Horrifying! I wonder if they take ethnicity into account. Some groups are naturally lighter in weight than others. Yale would actually expel her? Crazy.....

Aren't there other diagnostic criteria for eating disorders besides BMI?

[kitten18]

Insane

[maize]

Huh. Eating disorders are a serious concern, but...if this student is telling her story accurately someone has definitely gone overboard.

[Jennifer in MI]

Yikes! I wonder if it goes the other way around too? According to my oldest son's bmi, he is obese. He's a weightlifter with lots of muscles and a 32 inch waist. He's NOT obese.

Scary if it's accurate.

[Catwoman]

I'll bet there's more to this story that we're reading in this article. Something just doesn't seem right.

[Hikin' Mama]

I'll bet there's more to this story that we're reading in this article. Something just doesn't seem right.

That's what I was thinking.

[Jean in Newcastle]

I'll bet there's more to this story that we're reading in this article. Something just doesn't seem right.

Might be prompted by insurance if the students are offered college medical insurance.  There have been many reports of people having insurance through the workplace who have been put through the ringer for not having the right BMI because that is the only number the insurance looked at.  

[Word Nerd]

I've been 5'2'' and 90 pounds since high school, but it has never led to any illnesses related to low weight or malnutrition.

 

That's exactly my height and weight when I was in college. I didn't get above 100 until I was almost 30 and was healthy.

[Word Nerd]

I'll bet there's more to this story that we're reading in this article. Something just doesn't seem right.

 

Not from what I've seen.

 

Here's an update.

[Dmmetler]

I'm torn-I'm a person who was definitely on the verge of if not in an active eating disorder-and it was college faculty/staff picking up on it and the support and services provided that let me keep from developing a much more severe problem. I'm very glad they stepped in and said "You ARE getting help"-because I needed it.

 

But at the same time, I was seriously thin, similar to the girl in the article, until I was in college because i hit puberty late-but didn't have an ED then. It took a lot more psychologically-and, in fact, I actually weighed more during most of the time I was actively bulimic than I did in high school when I was just really, really thin. It's the psychological stuff that makes an ED, not the weight.

 

 

 

 

[catz]

I was right above 100 in college. I won't talk about what I weigh now. ;P My 13 year old son is 5'1" and 85 lbs, so 5'2" and 90 doesn't seem nuts to me. Yes, it's slim, but not necessarily unhealthy. My 13 year old has been the healthiest person in the house the past few years, eats 3 meals a day, and multiple snacks. He's also very active.

[Paige]

She is about my size. I was a good 5lbs lighter in college and high school and I am not surprised. Does the campus have the authority to declare someone medically unfit? If so, that's kind of scary. My high school guidance counselor pressured my parents to make me see a nutritionist and psychologist before she'd write recommendations for me. I had to have blood work, an MRI, and an EEG before they left me alone. I was an excellent student. The first psychologist recommended by the school said I was "clearly in denial." I hated her. She said awful things to me and stupid things. She twisted everything I said to make it look bad. She told my parents I was very articulate, intelligent, and mature. I was only 16 or 17, so clearly couldn't really be mature, and it was therefore a symptom of my disorder and I was "pseudo-mature." I was sitting w/my hands in my lap and she asked me if I always liked to touch and rub myself. She asked if I liked to feel my stomach and how thin it was. She said I lied about my food intake and told my parents I must be puking what they saw me eat because there was no way I could eat and be my size. Ugh! I refused to see her again and they found someone else for me to see for ongoing counseling. Thankfully I saw her for only a few times before she wrote a letter saying she could not in good conscious continue seeing me because I had no problems and it would be insurance fraud! I feel for this girl. 5'2 and 90lbs on a thin build can be perfectly fine.

[Jean in Newcastle]

The fact that her medical information went to Yale after a doctor's appointment makes me think even more that she must have had insurance through them.  Anything else would be a violation of HIPPA, right?

[Momling]

I went to grad school at Yale - I'm pretty sure we all had all of our health care needs taken care of at Yale. I remember thinking it was pretty cool - I don't remember any copays or premiums or deductibles...
As for the anorexia issue - no idea. I'd like to think maybe there's more to the story, but who knows. I didn't find the university or the health care system particularly intrusive in any way.

[Starr]

I've know young women who are healthy and don't weigh much and I've watched a young woman die saying she was normally low weight. I feel for anyone getting the wrong medical treatment and for health care workers who try to help those that need it and refuse. 

[Χά�ων]

Yikes! I wonder if it goes the other way around too? According to my oldest son's bmi, he is obese. He's a weightlifter with lots of muscles and a 32 inch waist. He's NOT obese.

Scary if it's accurate.

It does for my son. I heard far too often that he was fat and that was his only health issue. Umm he is not fat. He is solid. Currently he is 10 years old 5ft tall and 115lbs but can still wear boys 8 shorts. Well, they fit in the waist and look funny but you get the idea.

[SKL]

Well, first of all the doctor and everyone else who wanted to have a say about this woman's health should have gotten informed about what is biologically normal for her.  That would be based on what's normal for folks from her ultimate country/region (s) of origin.  When I was traveling in China, I was at my ideal weight and yet all the local women were much slimmer.  I've worked with orientals who were very slim (by our standards) despite eating heartily; they were also very strong and energetic.  People from different biological backgrounds need to be compared to different growth curves.

 

Now as for the university bullying her in this way, I would like to know if they do the same thing to overweight people, smokers, anyone with drugs in their systems, people who don't sleep well, people who don't exercise much, and about a hundred other categories of people who are arguably doing something that "could eventually kill them."  I suspect they do not.  What about people with serious physical problems that affect life expectancy, such as diabetes, cancer, etc.?  Do they kick out people who are HIV positive, because you know, AIDS can kill you?  What about old people on their faculty, who could drop dead at any moment?  Or are they just doing this intrusive bullying to skinny people who aren't even sick?  How dare they threaten her education over her BMI?  It seriously blows my mind.

 

I can't even believe they have a right to force students to have their vital statistics monitored.

 

I will be thinking twice before encouraging anyone to apply to a school that thinks it has that much power over free human beings.

[alef]

I've know young women who are healthy and don't weigh much and I've watched a young woman die saying she was normally low weight. I feel for anyone getting the wrong medical treatment and for health care workers who try to help those that need it and refuse.

This is a big challenge with eating disorders; people who have them don't generally come forward and admit it. It's why I do wonder if there could be more to this story--did all those medical tests turn up evidence that this girl is indeed unhealthy? I don't know. I have had people close to me struggle with eating disorders, the problem is very real.

But if this girl is healthy and does not have an eating disorder, the intrusion would be incredibly frustrating!

[umsami]

Yale is pretty famous in eating disorders/body image arenas for their Rudd Institute. (OK, maybe it's Rudd Center…but you get the idea.)

 

I find the author's story probably is missing some pertinent facts.  Why?

 

She claims they set her up with a nutritionist…and then goes on to say… " In addition to loading up on carbs for each meal, I've eaten 3-4 scoops of ice cream twice a day with chocolate, cookies, or Cheetos at bedtime."

 

No nutritionist is going to suggest gaining weight on 3-4 scoops of ice cream, chocolate, cookies, and Cheetos. I'm sorry.  None--especially not one affiliated with a university (they tend to be more up to date regarding journals, etc.)

 

We also never hear what her electrolyte tests revealed and other tests revealed.

 

I also find it really hard to believe that physicians at Yale, which like all of the Ivies has a large Asian population, would be unfamiliar with lower BMI trends for Asians. (For example, Asians are considered obese often at 27 vs. 30 for a caucasian person.)  If they were going after every Asian girl who was as slim as she reports herself to be, it would be far more well known/reported.

 

​I could be 100% wrong…but her story doesn't add up to me.

 

And I don't see Yale responding precisely because of HIPPAA issues.

[SKL]

As my Chinese classmate/friend was very fond of saying:  the point is not whether they are wrong or right.  The point is that it is not their business.

[SKL]

Another thing.  This forced attention to extreme dieting (to put on weight) has caused a young adult who probably had a normal, healthy relationship with food to now become obsessed about it.  That could lead to health problems, including eating disorders if she is predisposed thereto.

[KungFuPanda]

My daughter is a year from college, 5'3", and 94 lbs. This IS the filled-in version of her. She was a much tinier baby and child. She's just all arms and legs. She's always been well-adjusted and looks healthy, so I can't imagine anyone on a college staff questioning her about her weight. There's GOT to be more to the story than this girl's stats. LOTS of girls are wispy in their late teens.

I had to get a weight waiver and eat bananas to get into the Army at 18. By 19 I'd finally developed hips and stabilized at a 'regulation' weight. I did have a teacher in high school go overboard thinking I had an ED. I had to get tests and everything. It turns out SHE was a recovering bulimic and was out to 'save' everyone. She had issues, so that's another possibility . . . this girl could be the 'project' of someone recovering from an ED.

[Word Nerd]

She claims they set her up with a nutritionist…and then goes on to say… " In addition to loading up on carbs for each meal, I've eaten 3-4 scoops of ice cream twice a day with chocolate, cookies, or Cheetos at bedtime."

No nutritionist is going to suggest gaining weight on 3-4 scoops of ice cream, chocolate, cookies, and Cheetos. I'm sorry. None--especially not one affiliated with a university (they tend to be more up to date regarding journals, etc.)

She didn't claim that's what she was told to do by a nutritionist.

"'I asked my health-conscious friends what they do to remain slim and did the exact opposite. In addition to loading up on carbs for each meal, I've eaten 3-4 scoops of ice cream twice a day with chocolate, cookies, or Cheetos at bedtime. I take elevators instead of stairs wherever possible,' she wrote."

[alef]

As my Chinese classmate/friend was very fond of saying: the point is not whether they are wrong or right. The point is that it is not their business.

Not whose business? Not the doctor's business? Surely the health of a patient is the business of her doctor. Not the university's business? A university student on university insurance at a university clinic may very well be the university's business. What if a student died of anorexia while a student at Yale and it came out that the university clinic knew about the problem but didn't follow up on it because the student did not want treatment? Would the issue be considered none of the university's business under those circumstances?

[Harriet Vane]

Not whose business? Not the doctor's business? Surely the health of a patient is the business of her doctor. Not the university's business? A university student on university insurance at a university clinic may very well be the university's business. What if a student died of anorexia while a student at Yale and it came out that the university clinic knew about the problem but didn't follow up on it because the student did not want treatment? Would the issue be considered none of the university's business under those circumstances?

 

No. It is not the university's business.

 

We do have the right to refuse medical treatment in this country.

 

As an adult, the student's health is no one's business but her own. Period.

[Word Nerd]

Here is a related 2010 story from The Yale Herald.

[umsami]

She didn't claim that's what she was told to do by a nutritionist.

"'I asked my health-conscious friends what they do to remain slim and did the exact opposite. In addition to loading up on carbs for each meal, I've eaten 3-4 scoops of ice cream twice a day with chocolate, cookies, or Cheetos at bedtime. I take elevators instead of stairs wherever possible,' she wrote."

 

My mistake, and yet why isn't she following their advice, then?  

 

I still say she is not telling the whole truth.  She's seeing a boat load of people for the past what 3-4 months…and they seem to think that she still needs treatment. I don't think they're doing it out of fun.  Her article sounds like to me an effort to force the University to leave her alone…whatever the consequences.  She may not acknowledge that she doesn't menstruate, has lanugo, has electrolyte issues, or whatever.  This is her story, and the university cannot respond due to HIPPAA concerns.  She may not have any issues, but I find it hard to believe they'd still be treating her after 4 months of normal tests and the only issue was a failure to gain weight.  Other health professionals would be speaking up regarding her care in treatment meetings, etc.

 

Yale has tons of Asian students and surely knows BMI variations.  Her BMI is 16.5 (based on the data she gives).  According to WHO that does classify her as underweight--moderately thin. 

http://apps.who.int/bmi/index.jsp?introPage=intro_3.html

 

Under normal BMI charts, someone with a BMI of 16.5 would be classified as anorexic. (Usually it's under 17.5) I cannot find any data that says a BMI that low would not classify her as anorexic even in Asian circles.  WHO still sticks to <18.5 as underweight…I can't find anything that says that because 27 is obese for an Asian, then 15.5 is underweight…for example.

[umsami]

No. It is not the university's business.

 

We do have the right to refuse medical treatment in this country.

 

As an adult, the student's health is no one's business but her own. Period.

 

My guess that a lawyer, especially in the case of a death, would say otherwise…that Yale was her caretaker, etc.  I think if she had something signed by herself and her parents that she was discharging herself AMA (against medical advice), then they might allow it…but I"m betting they'd want her parents to sign as well as a precaution.

[alef]

No. It is not the university's business.

We do have the right to refuse medical treatment in this country.

As an adult, the student's health is no one's business but her own. Period.

From the Yale University catalog:

"Yale College reserves the right to require a student to withdraw for medical reasons when, on recommendation of the director of Yale Health or the chief of the Mental Health and Counseling department, the dean of Yale College determines that the student is a danger to self or others because of a serious medical problem, or that the student has refused to cooperate with efforts deemed necessary by Yale Health to determine if the student is such a danger. An appeal of such a withdrawal must be made in writing to the dean of Yale College no later than seven days from the date of withdrawal."

http://catalog.yale.edu/ycps/academic-regulations/leave-of-absence-withdrawal-readmission/



A private school can make rules regulating the conditions under which students may be enrolled.

This rule may very well have been misapplied in this case, but I do not find the rule itself to be unreasonable.

[umsami]

Here is a related 2010 story from The Yale Herald.

 

In the article, one student had three weeks of weigh-ins, before being discharged. This girl has been doing it for four months…which makes me think that there's something she's not disclosing.

 

The article also says, "But as fellow yalie Stacy* can attest to, this policy of flagging—and potentially penalizing—students with suspiciously low BMIs stretches past the athlete population. For a non-athlete, the BMI cutoff is in the territory of 16 (Stacy’s estimate was 15.5)—considerably harsher than it would be for an athlete."

 

Quite frankly, yes, if they're willing to go as low as 16 or 15.5 before flagging somebody (and the article's author had a BMI of 16.5, if she gave accurate info in the article)…then no, I don't take issue with that.  Those are very low BMIs, even for naturally thin people.  Checking their electrolytes, an EKG,  etc. would be a normal think to do. Making sure that there was no something wrong…especially given the prevalence of eating disorders in college, would not be wrong.

 

I also think that the last few paragraphs make the case for the program, as well as reinforce that the author is perhaps leaving out some details as to why she's been flagged.

[kiwik]

They may have a legal right but I personally think their job is to provide the education the student has paid for. No more no less. They are not loco parentis they are a business providing a service to a paying customer.

[FaithManor]

In college, I was 5"4" and 101 lbs., BMI of 14. Perfectly healthy. When my mom got married she was 5"3" and 94 lbs.

 

This is not the college's business! They do not get to force medical care on anyone, and they do not have a right to insinuate themselves between the student and the doctor, period. This is no different than if your employer demanded access to your medical records, and then threatened to fire you because they didn't like your weight, or the fact that you drive fast cars on the weekend, or you take blood pressure meds, or you were diagnosed with cancer, or diabetes, or you cliff dive on your vacations, or.........

 

It doesn't even matter if there is more to the story nor does it matter if she DID have an eating disorder. Yale administration does not get to decide the medical care and treatment and then FORCE that on any legal adult. If she goes to class, pays her bills, does not get in trouble with the law, and does not violate codes of ethics, etc. they have a legal responsibility to provide her with an education because that is what they were legally contracted to do. My gosh...this is no different than the elementary school down the road deciding that your kid can or cannot have a cookie you sent in his or her lunch because they think he's overweight, underweight, not eating healthy enough, whatever. You'd be all over that like ugly on an ape...how dare they decided that. I'm the parent. Well, this woman is a legal adult.

 

The fact that ANY administrator at Yale knew what her weight and BMI were is very, very disturbing. It doesn't matter if they provide her insurance. That's no different than your employer getting to sit around perusing your medical records because he/she pays part of the premium. So darn illegal and unconstitutional that it staggers the imagination.

 

By the way, my boy who is 5'11" tall weighs 105 lbs. Yes, you read that right. He doesn't have an eating disorder - as a matter of fact her rarely eats less than 5000 calories per day. He does have a metabolic disorder. Is this the business of Cornell, U of MI, U of Rochester, MTU, or whatever institution he contracts with for his education as a legal adult? Absolutely not. He pays his tuition and fees, in case of merit aid abides by the GPA guidelines, and goes to school, period. No one else's business. What goes down between he and his GP or endocrinologist is private information.

 

Yale does not have a legal leg to stand on despite whatever policy they think they have. There are laws in this nation that supercede their policies, and she is a legal adult. They are not her guardians.

[Laura Corin]

I'm really torn on this.  I do think that someone's doctor should flag up a possible problem, but Calvin's BMI is 15.8.  He's completely healthy and hiked for miles through snowy passes a couple of weeks ago, so has plenty of stamina.

 

If the young woman eats like people in Taiwan - she mentions Taiwanese noodles - she eats large portions of savoury mostly healthy foods, but doesn't snack or eat many sweet things.  It's not a mystery why she is slim.

 

I think colleges are a bit stuck - the students are adults, but the college gets blamed if something dire happens to them, as if it were in loco parentis.

 

L

[ThisIsTheDay]

She is about my size. I was a good 5lbs lighter in college and high school and I am not surprised. Does the campus have the authority to declare someone medically unfit? If so, that's kind of scary. My high school guidance counselor pressured my parents to make me see a nutritionist and psychologist before she'd write recommendations for me. I had to have blood work, an MRI, and an EEG before they left me alone. I was an excellent student. The first psychologist recommended by the school said I was "clearly in denial." I hated her. She said awful things to me and stupid things. She twisted everything I said to make it look bad. She told my parents I was very articulate, intelligent, and mature. I was only 16 or 17, so clearly couldn't really be mature, and it was therefore a symptom of my disorder and I was "pseudo-mature." I was sitting w/my hands in my lap and she asked me if I always liked to touch and rub myself. She asked if I liked to feel my stomach and how thin it was. She said I lied about my food intake and told my parents I must be puking what they saw me eat because there was no way I could eat and be my size. Ugh! I refused to see her again and they found someone else for me to see for ongoing counseling. Thankfully I saw her for only a few times before she wrote a letter saying she could not in good conscious continue seeing me because I had no problems and it would be insurance fraud! I feel for this girl. 5'2 and 90lbs on a thin build can be perfectly fine.

 

Thank you for sharing this.  We've recently been though a couple of disturbing exchanges with a doctor. I have been trying to excuse her behavior in thinking that she's reading my family wrong, but reading this makes me realize that she's a bully. She's never listened, and she won't change. I need to stop thinking I can "win" this one and get a different doc.

 

I'm sorry for what you went through. I can't imagine how painful that would have been as a teenager, and I need to protect my kid from a similar situation.

[FaithManor]

I wonder about this. Is Yale monitoring the beer alcohol consumption of their students? Hmmmm......if not, they are bunch of hypocrites. I've seen far more statistics about bad things happening to students related to binge drinking and drunkenness than I've heard about the dangers of being too skinny on campus!!!

 

 

[umsami]

I wonder about this. Is Yale monitoring the beer alcohol consumption of their students? Hmmmm......if not, they are bunch of hypocrites. I've seen far more statistics about bad things happening to students related to binge drinking and drunkenness than I've heard about the dangers of being too skinny on campus!!!

 

Most universities do have rather strict policies about underage drinking, including expulsion.  How Yale enforces that does not negate the need to also act if they notice something that may be potentially fatal.  I'll also add that the mortality rate for anorexia is 12x higher than the rate of all other causes of death for females 15-24.  No doubt, that includes accident-related and alcohol-related incidents.

 

I think those who say "well, are they doing this to obese kids" or similar arguments are failing to realize that unlike obesity, anorexia can lead to quite a quick death.  People are obese and even morbidly obese or super morbidly obese for years before they face the consequences of that excess weight.  It's rare for somebody to experience a life/death event related to their obesity in their early 20s.  It is not, however, unheard of for somebody with anorexia to die within four years (typical undergrad college length.)

 

There is the assumption that everything she says is taken with face value.  That nothing is wrong with her, she's just healthy skinny.  That seems to be what people object to.  Yet the Yale article pointed out that for girls whom that was the case, they stopped monitoring them quite soon.  This young woman has been under supervision for over 4 months.  There's more there.  Criteria for an eating disorder is not just based on BMI, and my guess is that there are other things that have come out.  Treating somebody for 4+ months who is perfectly healthy, is not the norm.  Trying to get her into see a nutritionist as quick as possible is not normal.

[mamaraby]

There is the assumption that everything she says is taken with face value. That nothing is wrong with her, she's just healthy skinny. That seems to be what people object to. Yet the Yale article pointed out that for girls whom that was the case, they stopped monitoring them quite soon. This young woman has been under supervision for over 4 months. There's more there. Criteria for an eating disorder is not just based on BMI, and my guess is that there are other things that have come out. Treating somebody for 4+ months who is perfectly healthy, is not the norm. Trying to get her into see a nutritionist as quick as possible is not normal.

Exactly. As you mentioned in a previous post, she has the advantage of setting the narrative however she wishes while neither the university nor the medical providers can really comment because of privacy/HIPPA concerns. To me, that alone is cause for tempering the outrage.

[FaithManor]

Most universities do have rather strict policies about underage drinking, including expulsion.  How Yale enforces that does not negate the need to also act if they notice something that may be potentially fatal.  I'll also add that the mortality rate for anorexia is 12x higher than the rate of all other causes of death for females 15-24.  No doubt, that includes accident-related and alcohol-related incidents.

 

I think those who say "well, are they doing this to obese kids" or similar arguments are failing to realize that unlike obesity, anorexia can lead to quite a quick death.  People are obese and even morbidly obese or super morbidly obese for years before they face the consequences of that excess weight.  It's rare for somebody to experience a life/death event related to their obesity in their early 20s.  It is not, however, unheard of for somebody with anorexia to die within four years (typical undergrad college length.)

 

There is the assumption that everything she says is taken with face value.  That nothing is wrong with her, she's just healthy skinny.  That seems to be what people object to.  Yet the Yale article pointed out that for girls whom that was the case, they stopped monitoring them quite soon.  This young woman has been under supervision for over 4 months.  There's more there.  Criteria for an eating disorder is not just based on BMI, and my guess is that there are other things that have come out.  Treating somebody for 4+ months who is perfectly healthy, is not the norm.  Trying to get her into see a nutritionist as quick as possible is not normal.

But, none of this matters. None of it. We have HIPPA laws in this nation. We have doctor/patient confidentiality laws. They do not have a right to her personal medical information, nor do they have a right to force her into any medical treatment. They do not have a right to expel her for NOT getting medical treatment unless her actions are a danger to others, and even then, they can only expel her based on her actions, not on her medical condition. She actually, as sad as this is, has a right to die of anorexia if she so chooses.

 

The fact of the matter remains that for an Asian woman her BMI is normal and so is her weight. So, there just simply is not one thing about this regardless of whether or not we have the whole story, that is okay for Yale to do. It just simply, in America as our laws stand, none of Yale's business. None. Yes, if she did have anorexia and she did die, that would be unfortunate. But, the school is no more at fault for the 22 year old who goes to the local pub, drinks ten taquilla shots, and then drives his car into the telephone pole, than they are for the student who decides to play hockey without a helmet at someone's pond and ends up with a skull fracture. Not their choice. These are legal adults. Not their fault. Therefore, not their business to violate the law in order to force medical decisions on the student. Once over 18, she and any other student on that campus get legal protection of their medical information as well as the right to refuse treatment.

 

Again, do you want your employer to get access to your medical files and then decide what you should and should not do medically, threatening to fire you for failure to comply with his or her demands? If you don't work in a job where your health is a matter of public safety, then are you willing to give them this level of control over you? That is where this is headed. Defending Yale is nothing short of saying that this scenario is also okay. Next up? The IRS tells you that you can't have your tax refund unless you give up smoking and provide proof that you have done so, or lose weight, or gain weight, or stop consuming butter, or demand you take cholesterol drugs, or get chemo and radiation even though you have chosen not to go that route, or .....

 

She has not been declared non campos mentis. Therefore, they do not get a say.

[FaithManor]

Exactly. As you mentioned in a previous post, she has the advantage of setting the narrative however she wishes while neither the university nor the medical providers can really comment because of privacy/HIPPA concerns. To me, that alone is cause for tempering the outrage.

No it's not. The outrage is that she is a legal adult. She has privacy of medical decisions period. She actually has the right to die from anorexia unless she is declared non campos mentis and a guardian appointed.

 

No college, no employer should be allowed to have access to private medical information on a student or employer and then black mail them - which is exactly what this is - "comply or be expelled" with that medical information. Occupations in which an employee's health directly affects public safety have a notable exception but the employee signs a statement saying they understand that certain information will have to be made privy to the employer and STILL, there are limits on that as well. Anorexia doesn't actually endanger anyone else on campus. Yes, it would be tragic if she died from the disorder, however, that is still her choice and as soon as we decide that Yale gets to railroad legal adults into medical treatment they do not want or provide medical information that the law says they are not legally privy to, then there is a big problem.

 

I am really kind of shocked that people think that just because she might have had an eating disorder, her legal rights in the matter are of no concern. Wait until your employer decides to raid your medical files and decides to fire you because they don't like that you checked yourself out of the hospital AMA, or that you refused cholesterol drugs and decided to make lifestyle changes instead, or that you are still smoking at home, or that .... Big, Huge, BAD, red flag here. This is not a trend that should be supported.

 

I was BADLY injured in college, and yet kept attending classes. It was not the faculty's business nor the adminstration's to make any determination of what medical care I should receive, nor force me into any medical care. As a matter of fact, the attending physician at the ER made a very damning mistake that could have caused me to have to walk the rest of my life with a cane. I sought a second opinion. I shudder to think that IF Yale's position is defensible, then it would also have been defensible for some administrator at my college to force me to follow the advice of doctor number one. Not their business. There just isn't any other way to say it and it really doesn't matter what the back story is on this girl. It just simply does not matter. They should not be given the right to force medical care on her or make medical decisions for her.

[Word Nerd]

 

There is the assumption that everything she says is taken with face value.  That nothing is wrong with her, she's just healthy skinny.  That seems to be what people object to.  Yet the Yale article pointed out that for girls whom that was the case, they stopped monitoring them quite soon.  This young woman has been under supervision for over 4 months.  There's more there.  Criteria for an eating disorder is not just based on BMI, and my guess is that there are other things that have come out.  Treating somebody for 4+ months who is perfectly healthy, is not the norm.  Trying to get her into see a nutritionist as quick as possible is not normal.

 

And your assumption seems to be that nothing she says can be taken at face value because the university can't possibly have overstepped or made a judgment error.

 

 

[mamaraby]

No it's not. The outrage is that she is a legal adult. She has privacy of medical decisions period. She actually has the right to die from anorexia unless she is declared non campos mentis and a guardian appointed.

First, it's not a "trend" as if it's something new. Secondly, the title of the thread "If you're skinny, don't go to Yale" is rather over the top. And yes, before passing judgement on Yale I think one would need to hear their side of the story which we will not get because of privacy concerns/HIPPA. I can't agree with the idea of "being railroaded" because we don't actually know this to be true. Sorry, but there's plenty the student could have lied about (including what the university did or did not do) that it makes it difficult, I think, to justify outrage. You disagree, fine. We'll agree to disagree.

Is the University wrong in what they did? It's possible. Is the student's version of the events accurate? It's possible. My assumption is not that the university could do no wrong. My assumption is that it's likely more complicated than the student is admitting to. To me, that alone is reason enough to temper the outrage.

You've got a host of unrelated issues in your post, imo, some of which I can agree with and some of which I can't. I really have no interest in arguing about those we disagree with.

[umsami]

From the Yale University catalog:

"Yale College reserves the right to require a student to withdraw for medical reasons when, on recommendation of the director of Yale Health or the chief of the Mental Health and Counseling department, the dean of Yale College determines that the student is a danger to self or others because of a serious medical problem, or that the student has refused to cooperate with efforts deemed necessary by Yale Health to determine if the student is such a danger. An appeal of such a withdrawal must be made in writing to the dean of Yale College no later than seven days from the date of withdrawal."

http://catalog.yale.edu/ycps/academic-regulations/leave-of-absence-withdrawal-readmission/



A private school can make rules regulating the conditions under which students may be enrolled.

This rule may very well have been misapplied in this case, but I do not find the rule itself to be unreasonable.

 

 

But, none of this matters. None of it. We have HIPPA laws in this nation. We have doctor/patient confidentiality laws. They do not have a right to her personal medical information, nor do they have a right to force her into any medical treatment. They do not have a right to expel her for NOT getting medical treatment unless her actions are a danger to others, and even then, they can only expel her based on her actions, not on her medical condition. She actually, as sad as this is, has a right to die of anorexia if she so chooses.

 

The fact of the matter remains that for an Asian woman her BMI is normal and so is her weight. So, there just simply is not one thing about this regardless of whether or not we have the whole story, that is okay for Yale to do. It just simply, in America as our laws stand, none of Yale's business. None. Yes, if she did have anorexia and she did die, that would be unfortunate. But, the school is no more at fault for the 22 year old who goes to the local pub, drinks ten taquilla shots, and then drives his car into the telephone pole, than they are for the student who decides to play hockey without a helmet at someone's pond and ends up with a skull fracture. Not their choice. These are legal adults. Not their fault. Therefore, not their business to violate the law in order to force medical decisions on the student. Once over 18, she and any other student on that campus get legal protection of their medical information as well as the right to refuse treatment.

 

Again, do you want your employer to get access to your medical files and then decide what you should and should not do medically, threatening to fire you for failure to comply with his or her demands? If you don't work in a job where your health is a matter of public safety, then are you willing to give them this level of control over you? That is where this is headed. Defending Yale is nothing short of saying that this scenario is also okay. Next up? The IRS tells you that you can't have your tax refund unless you give up smoking and provide proof that you have done so, or lose weight, or gain weight, or stop consuming butter, or demand you take cholesterol drugs, or get chemo and radiation even though you have chosen not to go that route, or .....

 

She has not been declared non campos mentis. Therefore, they do not get a say.

You're kidding yourself if you do not believe that parents would sue the school if she died, they knew she had a low BMI, and the school did nothing about it.  Schools are sued also for alcohol-related accidents on campus…even if their kids were over 18.  Doesn't matter if it should happen, if it's justified, if they are sued, they need to defend themselves. The costs could be significant….and they may very well decide to settle to avoid such costs.  Thus, either way, they lose if they do not treat her.

 

Also, if she agreed to Yale's policy regarding health/admissions policy as quoted above, then it's not the case of a slippery slope, but rather something she agreed to.  

 

You said that "for an Asian woman her BMI is normal and so is her weight."  That's not actually true.  According to the WHO, she is still considered underweight.  According to journal articles on anorexia in Hong Kong, Taiwan, and China, she is still underweight.  Her BMI is low enough to require in-patient treatment for anorexia.  She's not just healthy thin.  It's beyond that.  Once again, if she was healthy thin, they still wouldn't be treating her.  There have not been reports of a mass group of Asian females being kicked out, or forced to gain weight or be expelled.  The article in the Yale newspaper did not support that, sorry.

[umsami]

And your assumption seems to be that nothing she says can be taken at face value because the university can't possibly have overstepped or made a judgment error.

 

No…but my assumption is based on the article in the Yale Herald on how others were treated, my knowledge of Yale's medical staff, and my knowledge regarding eating disorders that we are not getting the full story from her.

 

Could she be perfectly 100% healthy thin and Yale is treating her regardless? Yes, but that is highly unlikely. If that was the case, we'd see more naturally thin Asian women going through months of treatment or being forced to resign.  That was not supported by the Yale Herald article.  Her length of treatment itself is a red-flag.

[Word Nerd]

There have not been reports of a mass group of Asian females being kicked out, or forced to gain weight or be expelled.  The article in the Yale newspaper did not support that, sorry.

 

Where did you get the impression that was an argument I was attempting to support?

[umsami]

Here's one article on eating disorders in Asia…. http://www.med.nus.edu.sg/pcm/book/17.pdf

 

"In a pilot study of 26 female medical students in Singapore 58% reported feeling moderately or very fat, despite a mean Body Mass Index (BMI) of 18.7. Alarmingly, four out of the 10 whose BMI was below 18 reported feeling very fat. In a study of Singapore Chinese schoolgirls with a mean age of

1

16.5 years, 56% felt overweight despite a mean BMI of 18.89 in the sample and 40% expressed a wish to be either a model, dancer or aerobics teacher. "

 

The article also talks about the electrolyte, EKG, and other issues that can result from anorexia.  From her article, it sounds like these things are still being tracked, which implies that even if she thinks her weight is OK, she may be experiencing issues from being underweight.

 

NEJM says that a BMI of less than 16.5 is considered reason for aggressive treatment.   Many facilities require an in-patient facility when a BMI falls below that.  (The author qualifies, BTW.)

 

 

Honestly, I hope she's right. I hope she's perfectly fine and healthy and that Yale has overstepped.  I don't wish an eating disorder on anybody, especially as it is often a life long struggle.

[alef]

But, none of this matters. None of it. We have HIPPA laws in this nation. We have doctor/patient confidentiality laws. They do not have a right to her personal medical information, nor do they have a right to force her into any medical treatment. They do not have a right to expel her for NOT getting medical treatment unless her actions are a danger to others, and even then, they can only expel her based on her actions, not on her medical condition. She actually, as sad as this is, has a right to die of anorexia if she so chooses.

The fact of the matter remains that for an Asian woman her BMI is normal and so is her weight. So, there just simply is not one thing about this regardless of whether or not we have the whole story, that is okay for Yale to do. It just simply, in America as our laws stand, none of Yale's business. None. Yes, if she did have anorexia and she did die, that would be unfortunate. But, the school is no more at fault for the 22 year old who goes to the local pub, drinks ten taquilla shots, and then drives his car into the telephone pole, than they are for the student who decides to play hockey without a helmet at someone's pond and ends up with a skull fracture. Not their choice. These are legal adults. Not their fault. Therefore, not their business to violate the law in order to force medical decisions on the student. Once over 18, she and any other student on that campus get legal protection of their medical information as well as the right to refuse treatment.

Again, do you want your employer to get access to your medical files and then decide what you should and should not do medically, threatening to fire you for failure to comply with his or her demands? If you don't work in a job where your health is a matter of public safety, then are you willing to give them this level of control over you? That is where this is headed. Defending Yale is nothing short of saying that this scenario is also okay. Next up? The IRS tells you that you can't have your tax refund unless you give up smoking and provide proof that you have done so, or lose weight, or gain weight, or stop consuming butter, or demand you take cholesterol drugs, or get chemo and radiation even though you have chosen not to go that route, or .....

She has not been declared non campos mentis. Therefore, they do not get a say.

When you enroll in a university, you agree to abide by their regulations and procedures. I am sure lawyers are involved in the crafting of such regulations.

Yale's policy is far from unique. Here is Columbia's: http://www.essential-policies.columbia.edu/morningside-campus-required-medical-leave-students-eating-disorders

And Harvard: http://isites.harvard.edu/icb/icb.do?keyword=k69286&pageid=icb.page356069

http://isites.harvard.edu/icb/icb.do?keyword=k69286&pageid=icb.page356070

[SKL]

Because we all know that doctors are never wrong.

 

And all skinny people die young.

 

And universities regularly make large payouts to parents of young adults who die because of their own choices.

 

But even if all that is true, why not have her sign a waiver?  It's obvious her parents are in her court on this because they have been in communication with the school about it, pushing them to get off this girl's back.  They have a fine paper trail in the unlikely event that the girl starves herself to death.

[SKL]

OK, Singapore is not all of Asia.  Please go to Tai Yuan and see if you can find any clothes in their stores that fit you.

[Pawz4me]

I can't summon up any strong feeling about this one way or another given that we're only hearing one side of the story.

 

I think many of you have made good points for both sides.

 

I do know from personal experience (both with myself, a close relative, and the daughter of a close friend) the lengths that someone who has an eating disorder will go to deny and hide it.  I would not assume that just because this young lady is of Asian descent that her low weight/BMI is natural.  Sure it may be.  But it also may not be.

 

I think BMI is an absolutely useless measurement.

 

I believe that as a private business Yale has the right to decide who they will serve (barring discrimination against a protected class of people, of course).

 

So . . . I'm pretty much on the fence on this one.