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

[SKL]

So how many prospective students study all the health policies of every university they apply to?

 

Or is it supposed to be obvious that our university is going to try to engineer our bodies?

 

I'm really shocked that more people don't view this as a severe infringement upon liberty.

[SKL]

If I were a student at such a university, I would immediately stop using any health service connected therewith.

[TechWife]

I totally believe this girls story. I used to be thin as an adult, I am tall but have a very small frame. My doctors never said a word to me, other than to ask me at a physical what my diet was like (they asked me this every year). I can assure you that I ate three healthy meals a day, including healthy snacks. I was also breastfeeding and exercising regularly. 

 

However, the pushback from my friends was amazing. I had people questioning me and implying I was sick all of the time - it was unreal. We would eat out after church and then someone would follow me to the bathroom to see if I was vomiting. Really? 

 

People continue to have an unhealthy fixation on diet and food in this country. Yale isn't helping anything. 

[ThisIsTheDay]

My dd is a college freshman.  She is thin to begin with. A meal plan is mandatory for those in dorm rooms (understandably). She also has a microwave and fridge in her room.  She has access to a full kitchen on her floor but is loathe to use it, and she does not have a car. All of her classes this semester are at the other side of campus, and as a result, she walks a minimum of 7 miles a week just to get to her classes (that doesn't count going back out for food or any other walking that she does around campus).

 

She has lost several pounds this year, and it really bothers her.  Eating meals has been the singular challenge in her adjustment to college.  She doesn't typically eat large meals at one time, but she is now in an effort to eat.  She will pick up food/snacks several times a day.  There are a dozen or so food locations on campus, including a food court--this school has the largest on-campus enrollment in our state, so there's no shortage of food.  But she can only stand so much yogurt parfaits, Chik-Fil-A, burgers, Indian food, etc., and she refuses to do the all you can eat buffet.  We upped her to 19 meals per week early on to make sure she didn't feel like she would "run out" of meal punches, and I've been spending over $100 a month on extra food for her room. I take food up to her once or twice a month and take her out to lunch.  She has never been a big eater, however she's had stomach issues for years, and I'm thankful they've been mostly resolved (praise God).

 

I don't think that the school is lacking in any way, but the way the food works doesn't work for my kid.  If the school ever made any comment as to her weight, I would FLIP.   Out of the things we considered she'd go through as a freshman, trying to eat was never on the list.

 

(Next year, she'll be in an on-campus apartment with a full kitchen, so we'll dump the meal plan, freeing up $3800 for the year to instead pay for the higher room cost and put some of the extra money toward food.  I'll still end up paying less overall, even though the room is $2000/year more.)

 

I don't think we need to hear both "sides" of the Yale student's story to have an opinion.  If that were the case, we'd be hard pressed to form any opinions in news stories, because usually one side isn't talking.

[alef]

I don't think we need to hear both "sides" of the Yale student's story to have an opinion. If that were the case, we'd be hard pressed to form any opinions in news stories, because usually one side isn't talking.

Oh, we can have an opinion, but if it is based on inaccurate information it won't be worth much.

I am sorry the food situation on campus has been frustrating for your daughter.

[Paige]

I am biased in favor of the student because of my experiences, but I know that it is possible she truly has a problem. The thing I don't see mentioned in either article, however, is if any effort has been made to find a physical cause for her being unable to put on weight. If she has a problem, it may not be a psychological one and could be chronic or inherited resulting in her previous low weight and that of her parents. There are many things that can cause someone to not gain weight unrelated to eating disorders. If she has an undiagnosed physical issue, she may not be able to gain weight despite what she eats until the cause is found.

[Arcadia]

She has never been a big eater, however she's had stomach issues for years, and I'm thankful they've been mostly resolved (praise God).

I have food sensitivities and asthma medications lower my appetite. My case file at university was too thick. Luckily the university health service understood that its hard for me to even maintain my weight. I did have frequent blood tests because of anemia and my eosinophils readings being high.

I was and still am 43kg, 1.57m so BMI of 17.4. Classified as underweight in Singapore and here in California.

[umsami]

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.

 

No, doctors are often wrong…but in general, when you have a team of health professionals treating a person (as is in the case with this young woman)… you reduce that risk.  I'll also mention that doctors are sued whether they follow the standard of care or not.  They are sued whether it was their fault or not.  There is, in general, an expectation of a perfect outcome.  Even if risks and benefits are discussed, if a person has a bad outcome, they sue.  It's just the way medicine is in the U.S.

 

Nobody said that all skinny people die young.  BUT, the fact that being anorexic has a 12x increased mortality is not a made up fact.   http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

 

Yes, there is a paper trail…but even with a paper trail…even with evidence to the contrary, the case could still easily end up in court.  I do think that the girl and her parents should be able to sign an AMA thing.  Perhaps that's been offered.  Perhaps her parents don't agree or aren't as supportive. I really have no idea.  BUt the University's policy also seems to say that they can kick her out if they so choose.

 

I'll also add the eating disorders are a big problem in Japan. (Yes, I know…more random Asia stuff….but it's not like just because Asians are naturally thin that eating disorders do not exist.)

http://www.georgiahanias.com/blog/?p=12

 

What stands out from above is that women in Japan now eat fewer calories than they did during WWII.

 

This article is also quite good...http://www.princeton.edu/~aborovoy/fulltext.pdf

 

"In 2001, the National Nutrition Survey (Ministry of Health, Labor and Welfare 2001) reported that the rate of underweight females in early adulthood has increased dramatically in the past 10 years. Specifically, 10% of women in their 20s and 16% of women in their 30s report a body mass index (BMI) of less than 18.5 kg/m,2 a body mass that hovers near the diagnostic weight threshold for anorexia nervosa. These figures represent a 100% increase over the rate of underweight women only one decade ago. "

 

The motivation can also be different..so while she may not fear being fat…there may be other issues at play.

 

"Specifically, from 2002 to 2003, approximately 30% of women with DSM-IV anorexia nervosa and bulimia nervosa accounted for their food refusal with explanations other than weight concern or fat phobia (Pike 2003). Moreover, the meaning of weight and shape concerns appears to have a somewhat different quality from the pursuit of the superwoman beauty ideal in the West. To a great ex- tent, the pursuit of thinness in Japan is linked to the “culture of cute” as described above.

 

Whereas thinness in Western conceptualization is often associated with provid- ing power and control that will, in turn, convey happiness, the Japanese pursuit of thinness is more reminiscent of Crisp’s account (1980) of eating disorders as a strategy for delaying maturation and the pursuant responsibilities. "

 

[catz]

I totally believe this girls story. I used to be thin as an adult, I am tall but have a very small frame. My doctors never said a word to me, other than to ask me at a physical what my diet was like (they asked me this every year). I can assure you that I ate three healthy meals a day, including healthy snacks. I was also breastfeeding and exercising regularly. 
 
However, the pushback from my friends was amazing. I had people questioning me and implying I was sick all of the time - it was unreal. We would eat out after church and then someone would follow me to the bathroom to see if I was vomiting. Really? 
 
People continue to have an unhealthy fixation on diet and food in this country. Yale isn't helping anything.

I actually lost significant weight my first year in college. I didn't buy junk food like was around my parent's house all the time, and I mostly ate snack style meals or salad bar in food service. It is a LARGE campus and walking 5+ miles a day was not unusual for me. I also eventually found running. I had several people hounding me and hinting I had an eating disorder. Ummm ... no. I just lost some of the baby fat I held onto at home. I was 5'2" and over 100 lbs at the time. I have always come up perfectly healthy on physicals. If you saw me today, it's laughable anyone ever accused me of having an eating disorder.

Anyway, due to HIPPA, we don't know if there is some other medical evidence that the facility has other than BMI. If BMI is the ONLY factor involved, I do think they should back off.

[SKL]

But how can it be ethical for a university to tie continued enrollment of an otherwise successful student to her physical condition?

 

I don't deny the existence of underweight-related health problems.  Their existence proves little, though, and even if it did, it would still be unethical for a university to do this.

 

So far nobody has responded to the question of whether they also kick people out for being smokers, having high BMIs, having potentially fatal diseases other than eating disorders, speeding while driving, having unprotected sex, or the many other things that can end up being fatal.

[SKL]

I also have a brother who used to eat inordinate amounts of food and still remain skinny.  I mean a pound of spaghetti was a normal dinner for him.  And no, he did not puke.  At one point he was trying to gain weight for some sport, and it was about the worst time in his life, because some people just don't put on weight.  And he was extremely healthy and active (still is 25 years later).  And skinny doesn't even run in our family.

 

I also used to have a very high metabolism (before I was 30).  I was never medically underweight, but then I'm a large-boned person of European descent.  At 5'6 the least I weighed was about 115, but that was due to having a physical job that didn't allow me to eat much (at age 18).

 

So I don't automatically disbelieve that a 20yo 5'2 Asian woman could be eating sufficiently and still be 92 lbs.

[umsami]

But how can it be ethical for a university to tie continued enrollment of an otherwise successful student to her physical condition?

 

I don't deny the existence of underweight-related health problems.  Their existence proves little, though, and even if it did, it would still be unethical for a university to do this.

 

So far nobody has responded to the question of whether they also kick people out for being smokers, having high BMIs, having potentially fatal diseases other than eating disorders, speeding while driving, having unprotected sex, or the many other things that can end up being fatal.

 

 

I think the difference is the critical nature of anorexia, and their ability to monitor or treat it.  If they wanted to tackle obesity, the only thing that has been proven to have a long-term (5+ years effect), is bariatric surgery.  I would doubt that Yale's student health insurance would want to undertake that expense…but if they do…more power to them. 

 

My guess is they probably do have the right to kick somebody out of the dorms who is smoking (although I really don't know their smoking policy)…or even expel them if they continue to smoke in non-designated smoking areas on campus.

 

Also, in looking at their specific paragraph, my reading is that it has to do with psychological issues, more than medical. …although somebody having TB or some such thing could be viewed as cause.

 

"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."

 

I

[SKL]

OK but this poor woman has been cooperating for months now and she's still being threatened with expulsion.  She's done more with doctors in the past year than I've done in the past 10.  At her age I never went to a doctor unless I was certain I needed antibiotics or surgery.

[SKL]

This reminds me of what they do to lawyers in my state.  It all goes back to some judge who had an acohol problem.  Because HE was an alcoholic, he made a rule that EVERY attorney in the state has to pay for and attend a class about substance abuse every 2 years.  Even people who don't even take aspirin let alone drink alcohol.  Ridiculous.

[SKL]

By the way, an article I read yesterday stated that the university approved her going to another doctor and that doctor said she could be a low weight because it's normal for her.  I am not sure if that info was in the linked article here or not.

 

So it's not true that (as implied) all the medical professionals involved believe she is starving herself.

[Word Nerd]

According to recent stories (the story she wrote is more than a month old), the university has backed down and she has a new doctor who confirmed that she is healthy. She will no longer be required to do weekly weight checks.

[In The Great White North]

 

 

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. 

 

From the link up thread:

 

 

 

Also, Chan has written to Yale President Peter Salovey to make him aware of her situation.

 

“At Yale, you’re taught to be the change that you want to see in the world,” Chan said. “Well, this seems like an easy thing to change.”

On Friday, she learned just how easy. Chan said her new physician acknowledged that BMI was not the only significant measure of proper health.

“So she trusts that I do not have an eating disorder and admitted that ‘we made a mistake,’” Chan said.

 

Maybe, maybe not.  But all their medical concern seems to have evaporated when a little publicity was applied.  

[SKL]

If so much of one's future happiness didn't ride on staying at Yale, chances are many/most students would have thumbed their nose at any and all of the health-related demands they placed on this woman.  Because a Yale diploma means so much to those who are already established students, the university was in a position to bully her, and did so.  Backing down due to the publicity should not be the end of this.  The policy and the attitude of the university's leaders need to change.

[TeacherZee]

I tend to agree with Umsami.

 

If the headline had been "Yale student dies from anorexia, university knew and did nothing" everyone here would be up in arms too. It is a really difficult situation to be in as an education establishment.

[umsami]

I didn't see that this was a month old…just saw it come up yesterday.

 

I find these things interesting from the article http://www.nhregister.com/general-news/20140406/yale-student-92-lbs-stuffed-her-face-with-cheetos-ice-cream-to-pacify-school-officials

"Chan said she’s contacted Yale Health officials many times, bringing up the idea that BMI may not be the best indicator of overall health for every person. She said a Yale doctor told her that while BMI is, indeed, only one factor, it is highly important."  

Implying that perhaps it was more than just her BMI which lead them to monitor her.

 

"Chan, for her part, agreed to continue coming to Yale Health for monitoring — but only once a semester."

 

I'm glad it was resolved…and it seems like they're taking other steps to improve how they handle these things..but both of these things imply to me that perhaps there is still more to her story than she's letting on.  Why is she agreeing to continue to be monitored ?  

 

We'll never hear from the health officials involved, they cite privacy concerns…and will continue to.

[SKL]

 Why is she agreeing to continue to be monitored ?  

 

 

Because she has to in order to graduate from Yale.
 

[SKL]

If the headline had been "Yale student dies from anorexia, university knew and did nothing" everyone here would be up in arms too. It is a really difficult situation to be in as an education establishment.

 

I don't disagree that the university would have a problem if the media said the bolded.  However, there is a very large space between "university knew and did nothing" and "university kicked woman out since she failed to gain weight."  The university could show that it had an active, accessible, well-advertised, confidential program to provide comprehensive (physical and psychological) assistance and that this was offered to the student upon referral from a medical professional.  Very few people would hold the university accountable for not going to the point of coercing a student to accept this help.

 

By the way, if they had kicked her out as they threatened (which may have happened if she'd kept quiet), and she did have anorexia, why does anyone believe that would save her life?
 

[umsami]

I don't think kicking her out would save her life… I don't think anybody does…for Yale it's an issue of liability…but I don't think that's why they threaten to do so.

 

As for her refusing to get help, that's actually quite the norm w/anorexics.  Usually there is some coercion required because most do not believe that there is anything wrong with them.  It's a lot like addiction, although I think actually addicts probably have a better likelihood to voluntarily seek help.  My guess is that Yale uses the threat of expulsion as a way to compel those that they truly believe have eating disorders to get help.  Remember, it is extremely common in college, especially among upper middle class overachievers.  No doubt the threat also leads to parental pressure as well, as the impact of being kicked out would not only be future-career/life, but also financial for the parents.  

 

My honest guess is that she probably was far thinner than 90 pounds as she claimed…80…85….could be from stress…could be from other issues…which triggered the intervention.  Her EKG or electrolytes may have had issues…and/or in talking with her…there was stuff that came up…be it coping issues, or other things.  She may/may not have disordered eating, but perhaps a tendency to drop weight when stressed, which could easily happen during college.  Five pounds on somebody her size is a big drop.  Ten pounds is huge.  Coupled together they didn't feel it was safe to discharge her…especially as she didn't seem to be able to maintain any weight gain. Thus, the continuing monitoring to ensure that if her weight does drop, it can be addressed.

 

Of course, I could be 100% wrong too.

[SKL]

I just keep coming back to, I am an adult, and nobody gets to intrude into my personal life without my permission.  What is it about Yale that gives it this right, which is not normally assumed by any organization (other than maybe a prison or mental hospital) with respect to adults?

[Harriet Vane]

Umsami, the potential for lawsuit does not negate a person's legal or constitutional rights. In other words, Yale's concern about liability just does NOT trump an adult's rights to medical privacy and to make their own decisions regarding health care.

[In The Great White North]

 

 

Maybe I'm not understanding you, but universities certainly can intrude into students' personal lives. Are you only taking about health issues?

 

 

HIPPA only applies to health issues.

 

But, not having attended a "normal" university, I'm curious as to what other  areas of students' personalities do universities intrude into?  

[alef]

HIPPA only applies to health issues.

But, not having attended a "normal" university, I'm curious as to what other areas of students' personalities do universities intrude into?

A university does not have to enroll a student nor keep them enrolled; a student enrolled contingent upon their willingness to abide by university policies. Policies at the university I attended (which as a school tied to a religious institution were more stringent than most) happily dictated where I could live, what it could wear, visiting hours for the opposite sex, sexual behavior, acceptable beverages, and more. Unwillingness to abide by any of these regulations could have terminated my status as a student.

[Lovingparent]

This story disturbed me and I can empathize with the young woman. I am 5'7" and until my 30's I weighed around 102-105 pounds. I ate, was healthy, but that was my weight. Frankly, I wish I could eat now what I was eating then. Now my son is 5'4"-5'5" and he weights about 90-92 lbs. I have to say I observe that with the passing of the years there is an increased hostility toward skinny people. Nobody would walk to an obese person and ask them to stop eating, but a lot of people think it's OK to tell me "Why don't you feed him" or "Give him some food". When I was young, people still teased me for my weight, but they were not nearly this vicious or mean. It has been pretty traumatic to my son, he weighs himself regularly and he makes an effort to put on weight by eating chocolate and other high calorie foods.

 

It also disturbs me that people assume that being skinny equals anorexia. It doesn't. And there is tons of articles out recently that argue BMI is not a be all indicator and it should not be the only indicator or even an important indicator to determine proper health.

 

And it's sad that if Yale put an obese person through this and threatened to expel them, unless they lost weight, there now would be a firestorm in the media and not just merely a couple of articles.

[Kathryn]

I've read but avoided posting thus far as this is one of my hot button issues. I'm a small person. I'm slightly taller than the woman we're discussing and have at times in my adult life weighed only slightly more than her. As a teen, I was even thinner. And I've dealt with other people's comments and misguided healthcare worker's obsession about my weight. I've had to pay more for health insurance because my BMI puts me at underweight on their handy little charts. I'm surprised I haven't ever had an eating disorder as much as people feel free to comment on my weight. I have always eaten whatever I wanted besides when dealing with nursing allergic children or now with gestational diabetes. I've never counted calories or looked at nutritional content to find out about fat or carbs. I just don't care. I expect that someone with a different body type who ate the way I do would weigh two to three times what I do. If I ate the way my 300-pound friend eats, I'd waste away and die. I'm tired of people thinking that everyone has to have the same body. We don't. We are individuals and our health is individual also. I'm not at all surprised at what this woman has dealt with and I don't see any reason to believe that she's not telling the entire story, based on my own experiences.

[Paige]

As for her refusing to get help, that's actually quite the norm w/anorexics.  Usually there is some coercion required because most do not believe that there is anything wrong with them.

The problem is, if she truly didn't have a problem, wouldn't she say she didn't have a problem? There's no way to win. Denial of the problem is considered confirmation of a problem by some physicians.

[livetoread]

It is a mess and it sounds like the university overstepped. Having said that though, anorexia is a very tricky and very dangerous disease. Many who have it will lie about it, hide it, and use all sorts of manipulation to avoid getting help for it. I have a friend whose anorexic daughter was being seen by a physician. She was low weight but not dangerously low according to her last visit. Two weeks later she was hospitalized and almost died after quickly losing weight and then catching a stomach bug. Even then the girl refused to acknowledge she had a problem.Things can go south very quickly when you are teetering on the edge of low weight.

 

That isn't to say you can't be healthy and be low weight. But it can be hard to distinguish between someone who is simply low weight and someone who is in the grip of anorexia and very adept at hiding it. When I say they can be masters at it, I'm not kidding. Pair that with the understanding that when you are already low weight, losing a few more over a short amount of time can take you from ok to dead, it's scary stuff. It is the most lethal of all mental illnesses, 4x the death risk of major depression according to Webmd.

[Guest submarines]

I agree that the university overstepped, but I was also surprised by her essay. She's either a not very articulate writer, or she went out of her way to avoid confirming that she in fact didn't have anorexia.

[Word Nerd]

I agree that the university overstepped, but I was also surprised by her essay. She's either a not very articulate writer, or she went out of her way to avoid confirming that she in fact didn't have anorexia.

"I don't have an eating disorder" ...

[SKL]

A university does not have to enroll a student nor keep them enrolled; a student enrolled contingent upon their willingness to abide by university policies. Policies at the university I attended (which as a school tied to a religious institution were more stringent than most) happily dictated where I could live, what it could wear, visiting hours for the opposite sex, sexual behavior, acceptable beverages, and more. Unwillingness to abide by any of these regulations could have terminated my status as a student.

 

Risky, illegal, and (in some contexts) morally questionable conduct on school property is one thing.  Dress code etc. is fine as long as the information is out there for prospective applicants.  Going to a school with a known dress code equals giving the school permission to restrict what you can wear.

 

Being required to submit to medical tests and procedures is a very different level of intrusiveness.  In addition, it is discriminatory.  They are not making all the students do this, only skinny people.  What would the student body do if the university decided that everyone had to attend a weigh-in every week and see a shrink about their eating habits?

 

And also, nobody is claiming that there was a BMI cutoff made clear when this woman applied to / entered the university.  This woman is already a student, not an applicant.  Once someone is in the middle of a multi-year program, it's unconscionable to raise this kind of issue.  The generic rule that "you have to get help if we determine you're dangerous to yourself or others" only applies if it can be proven that the woman is dangerously frail.  Skinny does not equal frail.

[alef]

"I don't have an eating disorder" ...

Says every person with a eating disorder.


That's why it's tricky. I'm sure most skinny people don't have eating disorders, but most people who do have eating disorders go out of their way to hide them.

[alef]

Risky [...] conduct on school property is one thing.

An eating disorder is risky conduct.

[SKL]

An eating disorder is risky conduct.

 

No, a disorder is not "conduct."  And even if it is risky, an eating disorder is not established by BMI.  Fat and average people can have risky eating (and drinking) disorders.  The only way to "prove" an eating disorder without the individual's agreement is to violate the individual's privacy rights to the point of following them to the bathroom after meals, having a camera on them all night, etc.

 

How about we let adults take responsibility for their own health at Yale, like they do everywhere else.  People go there to get an education, evidenced by a diploma.  That is what they should get if they get accepted and meet the academic requirements without harming anyone else.

[SKL]

Says every person with a eating disorder.


That's why it's tricky. I'm sure most skinny people don't have eating disorders, but most people who do have eating disorders go out of their way to hide them.

 

This woman has no way of proving that she does not have an eating disorder. 

 

Therefore the normal presumption of innocence until proven guilty is not available to her. 

 

Perfectly logical.

[Guest submarines]

This woman has no way of proving that she does not have an eating disorder. 

 

Therefore the normal presumption of innocence until proven guilty is not available to her. 

 

Perfectly logical.

 

I'm just saying that she didn't write a very convincing, coherent argument to prove her statement that she doesn't have an eating disorder. The essay was all over the place. I wanted to know the following:

 

1. What was nutritionist's advice?

2. Did she follow it? For how long? If not, why not?

3. What were the results of her other tests?

4. What does she normally eat on the daily basis?

5. Has she tried seeing another doctor and why not?

6. Did the nutritionist offer alternatives to her ice cream and chips solution?

 

and so on.

 

 

 

 

 

 

 

 

[Jean in Newcastle]

I'm just saying that she didn't write a very convincing, coherent argument to prove her statement that she doesn't have an eating disorder. The essay was all over the place. I wanted to know the following:

 

1. What was nutritionist's advice?

2. Did she follow it? For how long? If not, why not?

3. What were the results of her other tests?

4. What does she normally eat on the daily basis?

5. Has she tried seeing another doctor and why not?

6. Did the nutritionist offer alternatives to her ice cream and chips solution?

 

and so on.

And this is your business because?  It isn't Yale's business and it certainly isn't anyone else's.  

[Guest submarines]

And this is your business because?  It isn't Yale's business and it certainly isn't anyone else's.  

 

It isn't Yale's business and certainly not my business. My only comment is that she didn't make a good case for anything in that essay.

 

My first comment in this thread was that she was very careful to neither confirm of deny her having an eating disorder. Yet she didn't make a strong argument for this is not being Yale's business. That's all. :shrug

[SKL]

I'm just saying that she didn't write a very convincing, coherent argument to prove her statement that she doesn't have an eating disorder. The essay was all over the place. I wanted to know the following:

 

1. What was nutritionist's advice?

2. Did she follow it? For how long? If not, why not?

3. What were the results of her other tests?

4. What does she normally eat on the daily basis?

5. Has she tried seeing another doctor and why not?

6. Did the nutritionist offer alternatives to her ice cream and chips solution?

 

and so on.

 

The purpose of the essay was not to argue or prove the state of her personal, private health situation.  It was to highlight/protest the way Yale is infringing on her personal liberty and privacy and bullying her with the unreasonable threat of expulsion.