Can Yale Health force underweight students to gain weight or be sent home?

<p><a href="http://www.huffingtonpost.com/frances-chan/yale-eating-disorders_b_4921382.html"&gt;http://www.huffingtonpost.com/frances-chan/yale-eating-disorders_b_4921382.html&lt;/a&gt;&lt;/p>

<p>I'm not sure if we're allowed links. If not, the link was to the Yale University Thinks I Have an Eating Disorder story on Huffington Post. You can google it.</p>

<p>(Full disclosure: I am a Yale student and I love Yale. I highly recommend it. I want to make it completely clear to anyone reading this that Yale is really an awesome place to be, and that my feelings toward Yale Health do not reflect my feelings toward the bulk of my experiences.)</p>

<p>Anyways, I went through/ am still kind of going through the same thing as the girl who wrote this article. Though I no longer have weekly weigh-ins, I've still had more than a few involuntary checks this year to make sure my weight hasn't dropped, and I would very much like to say "No. I'm done. No more."</p>

<p>Do students in this situation have a legal right to say no?</p>

<p>I don’t believe there is anything illegal about this university policy.</p>

<p>I find this disturbing. I have a child who is 5’5" and weighs 100 pounds. She has been the same weight/height for 3 years. She is very active and looks healthy albeit thin. She is a grazer and prefers healthier things, but indulges in ice cream almost daily. We have brought her to the Dr. in the past to make sure everything is fine because she does seem thin, though not bony or gaunt. Everything has checked out fine. I wouldn’t want her to stress anymore about her thinness than I would want my younger daughter to stress about being 5 pounds above the norm for her age height/weight. </p>

<p>It seems to me that this is extreme and I feel for the young lady.</p>

<p>Is Yale doing the same thing for students who are overweight? If not, why not? Or are we missing something here?</p>

<p>Schools often discharge students for seeking health care beyond a certain level.
Their insurance coverage probably prompts them to.</p>

<p>Someone is 5’5" and only 100 lbs may just be young or recently had a growth spurt & their weight hasnt caught up to them yet.
Still, it indicates a lack of musculature since muscle weighs more than fat.
If her endurance is ok, then I wouldnt worry too much, but I might have her thyroid checked.</p>

<p>I think it is responsible for Yale to discharge students who are dangerously thin, but I don’t think 90 lbs for a 5’2" frame meets that definition. </p>

<p>I do think they should do the same for students who are dangerously overweight. I have never seen a morbidly obese student on Yale’s campus, but that doesn’t mean there aren’t any.</p>

<p>No, they don’t have this policy for overweight people. Also we don’t really have any overweight people except the football and hockey guys and I think that’s just muscle.</p>

<p>How does right to refuse treatment (<a href=“https://www.thesullivangroup.com/risk_resources/refusal/refusal_1_constitutional.asp”>https://www.thesullivangroup.com/risk_resources/refusal/refusal_1_constitutional.asp&lt;/a&gt;) factor into this case?</p>

<p>Do we have a right to say no?</p>

<p>If a student has a documented eating disorder (and I am sure they don’t make this decision by calculationg BMI), s/he may be in imminent danger of dying. </p>

<p>“Is Yale doing the same thing for students who are overweight? If not, why not?”</p>

<p>Overweight people aren’t in immediate danger like someone who is starving or purging. (Not saying anything about the author – I know nothing about her.) Even being 500 pounds doesn’t generally kill a college-age person for years and years. Young people with acute eating disorders can die tomorrow. When it’s an emergency, it’s an emergency like a gunshot wound.</p>

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<p>There are no overweight people at Yale? </p>

<p>5’2 and 90 pounds is considered underweight but certainly not an emergency . Often it’s not the weight but the electrolyte problems that come with vomiting that cause the most serious problems (arrhythmias) in people with eating disorders. </p>

<p>It is possible that everything that this young woman wrote is true and that the Yale Health service is following a protocol rather than really looking at and listening to her. If this is the case, one would think that she could enlist her home doctor to provide growth charts verifying that she has always been skinny. </p>

<p>It would not surprise me if there were no morbidly obese undergrads at Yale, or if they are few enough to be counted on one hand. Same goes for Yale’s peers. It says a lot about how different kinds of opportunity go hand in hand in this country.</p>

<p>One thing I noticed on my education trip (all #1 schools) was there were literally no morbidly obese people. I mean I remember only one and that sticks out like a sore thumb. There is a self-selection of some sort definitely going on.</p>

<p>There’s a difference between having a low BMI and having an eating disorder. A friend of mine has a daughter with an eating disorder. Every institution she has been involved with–camp, high school, college, ski team–has done required weight and other health checks for her. This is necessary for anyone with an eating disorder because they can be deadly. In fact, eating disorders have the highest mortality rate of any mental illness. And no school or camp wants a kid in their care to die on their watch. A student with an eating disorder diagnosis whose weight is dropping is in trouble, so it makes perfect sense that a university would send the kid home to receive more intensive care that their health services cannot provide.</p>

<p>Obesity rates are lower among high SES people and among traditional college-age people. So one would expect low obesity rates among students at places like Yale which have predominantly traditional students mostly from high SES backgrounds.</p>

<p>“Low” obesity rates, yes, but "we don’t really have any overweight people " ? That is pretty striking. </p>

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<p>Depends on whether one defines “overweight” by looking at someone, or by some measurement (BMI, waist/height ratio, etc.). Men are often not considered (by themselves or others) “overweight” even if measurements would indicate that they are (and they are not among the small minority who are athletes who are heavy with muscle rather than fat). But the opposite is probably common enough with women that Yale’s student health service is probably convinced that the article writer has an eating disorder even if she does not.</p>

<p>I know a student who takes medication for ADHD, which zaps her appetite; she has always been skinny, and she’s been followed by the same doctors for years, but her new university doctors have been pressuring her to gain weight, too. She eats healthily, and that (paradoxically, and like the woman in the huff post article) makes it hard for her to abandon her normal habits to gain enough weight to satisfy them; meanwhile, they sent her to a nutritionist who honestly doesn’t know what to recommend, never having had to counsel someone to gain weight. Is being too skinny a problem? Of course it could be; but for my friend, the problem is getting people to accept that she is just thin. </p>

<p>Our D is 5’2" and weighs about 100 pounds. When she was in grade school, the teacher would ask her in front of peers if she was eating properly or if she had some eating issue–her pediatrician was fine with her & S–both were 5% for height and weight from birth through the present, consistently. I thought that was pretty awful. Have not heard of Us doing this. </p>

<p>I think if it was a documented health problem, that might be one thing. If it is just the kid’s metabolism and the kid has documented medically that this has been the consistent weight lifelong, that seems like another thing entirely. I don’t think trying to force someone to gain weight is healthy either.</p>

<p>Definitely, BMI is not a gauge of healthy weight for everyone.</p>

<p>On the other hand, women with eating disorders are known to believe that they are perfectly healthy even as they approach catastrophic malnutrition. In the Huffpost article and in the case of the student who posted the article, we only have their word for it that Yale is being unreasonable. I would be curious to hear from Yale’s student health service about their policy in this matter.</p>