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

<p>Sorry, you’re all right. There’s no question that there’s definitely a minority of overweight people at my school according to BMI criteria. But think there’s a difference between healthy-overweight and unhealthy-overweight. Yale Health doesn’t see obesity as a problem in students and to be honest it’s not. </p>

<p>Anyways, I get that they’re concerned about eating disorders and the clinicians are often unfailingly kind. But I don’t think that strict BMI cutoffs are the solution. I know that for athletes the BMI policy is even harsher than it is for other students. If an athlete’s BMI falls below 17.5, she is not allowed to practice or compete in accordance with policy. There are no exceptions. It doesn’t matter if you were low-weight your entire life. It doesn’t even matter if you deny any psychological problems, and can honestly fulfill only one of the DSM criteria (the low BMI). You will be accused of anorexia, you will deny it, and you will not practice or compete until you meet their standard. I went through this. They told me that it did not matter if I had an eating disorder or not, 17.5 is the policy, and I would not return to my sport until I met the standard. When I fell below the cutoff again, I was restricted- again.</p>

<p>In my opinion, something needs to change. We’re putting too much emphasis on BMI. The people I know who are mentally/psychologically preoccupied with food and weight tend to be on the lower end of normal or normal weight, above the 16 BMI cutoff for non-athletes and the 17.5 BMI cutoff for athletes. Maybe a more appropriate screening tool would be questions like “Do you eat salad and grapefruit all the time because you want to be skinnier? Do you elliptical for 2 hours straight even though you’re not training for anything? Do you weigh yourself everyday?”</p>

<p>I think the major issue here is any eating disorder is considered mental illness, while standard obesity is not. Therefore, the heightened awareness for treatment.</p>

<p>No, I don’t agree with this. People that purge could answer the questions above “correctly”. Also there are women, who do “use” ADHD drugs to keep weight off which is dangerous. As someone said it is far more dangerous for young girls to maintain an unhealthy weight at that age. If medically it would be advantageous to gain 5-10 pounds then those women should work at that. Muscle weighs more than fat, so if an athlete is underweight it could potentially be a far more serious issue. Being undeweight has as many potential dangerous health issues as someone who is obese. Find a happy ground and be glad someone is watching out for your medical health…is my response to anyone who is complaining about being pushed into a healthy weight. Underweight people in my experience will never, ever admit to being underweight. I think there is some disassociation with the mirror and reality. </p>

<p>“I have a child who is 5’5” and weighs 100 pounds." BMI depends on age. I think people continue to gain bone mass and muscle mass through the teens. That said, the BMI charts are really pretty ridiculous. The government BMI tables don’t even acknowledge that there should be any difference in weight between men and women of the same height. Also, there are clearly differences in build between people of different genetic backgrounds. I don’t think US BMI charts were developed using people of Asian descent. I realized how completely useless the BMI is when I noticed that these charts say I would have had to gain another 10 lb to be considered overweight–that was right before I delivered a rather large baby. </p>

<p>I do see the reason for concern though, 90 lb is awfully low, and could be a health issue or eating disorder. Interestingly, there was another recent thread where an Asian teen complained that her parents called her fat, put her on all kinds of restrictive diets, and she insisted that the super-skinny Asian teen girls aren’t naturally like that but are under a lot of pressure to be thin and work very hard to stay that way. </p>

<p>BMI works reasonably well in population studies, and is presumably used because it is easily calculated from readily available information. For individual assessments, it works less well (muscle/bone versus fat weight and the like), although it still seems to be used out of convenience (since body fat percentage measurements are more difficult to do consistently). Waist/height ratio is probably a better individual measure of obesity-related health risks that is not that difficult to do, though.</p>

<p>I’ve worked with coaches and Deans at several U’s, and they never asked someone to take a medical leave for an unjustified reason. (For the record, I worked in residential and day care programs for E.D.s). It sounds as though Yale is being quite proactive. Too much so? I could not say. IMHO, student health centers hire at least one expert in the field of E.D. I’ve never known BMI to be the deciding factor. I’ve also never known a registered dietician to have difficulty helping someone gain weight in a healthy way. So, I am at a loss to offer an opinion to the OP.</p>

<p>I was 5’ 5" and weighed 195 lb. when I started college. I have never had an eating disorder – except to the extent that snacking at all hours and eating any sort of cookie, cake or junk food put in front of me is clearly not healthy.</p>

<p>I did put on the typical Freshman 15 when eating in the dorms, but then they opened a vegetarian dining hall and I dropped back to my normal, 195 lbs. (I ate at the veggie dining hall just because the food was better quality there – but a lot less carbs). </p>

<p>At the urging of my friends I would try various supplements that were supposed to help me gain weight but they never worked.</p>

<p>My mom, who was quite rotund (due to thyroid condition) used to tell me that she had been skinny as a child and that I would live to regret my eating habits.</p>

<p>I think that by the time I was in law school my weight had stabilized to about 105 lb or so – I believe I weighed 145 lb. at the end of my pregnancy with my son - like the day before he was born - and I took that weight off very quickly after he was born. </p>

<p>I was eventually done in by my second pregnancy – when I was 8 weeks pregnant with my d. I already looked like I was in my second trimester, and I had a hard time taking off that weight – and I</p>

<p>But the point is that some people are naturally skinny, and I can’t see how any responsible doctor would make a diagnosis without taking a full medical history. </p>

<p>As to the BMI issue – I also am very small boned. So I can actually have a lot of fat on my body and still be considered “normal” on those charts. </p>

<p>I can understand rules about weight for athletes playing team sports – isn’t there some minimum weight requirement for a coxswain? (I know that isn’t about the health of the player so much as the weight of the boat). </p>

<p>But the rest? I guess I’m lucky I went to a big state U. with an indifferent health center. </p>

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<p>Ummmm, 195 -> 210 (Freshman 15) -> 195 -> 105 ???</p>

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<p>Why do you think this? Why is this your opinion? </p>

<p>I fail to see why this is any business at all of Yale. To me this seems like if Walmart weighed everyone coming in and decided that people outside a certain BMI range weren’t allowed in the store. Doesn’t make much sense to me. </p>

<p>5’5" and 195 pounds for a female is not very light in my world. Now 95 pounds would be on the lighter side for 5’5". </p>

<p>I’ve been 5’5" and 120-135 from the time I was 12 years old and now many decades later (originally nearer the lower end–now the higher end). </p>

<p>I’m not familiar with any Us which sanction students based on BMI or weight. None of the Us I or my relatives attended attended such Us. </p>

<p>On a related note, my S2 (freshman voice performance major) has been told to gain weight by his voice teacher. He has always been thin and lost quite a bit of weight during his first semester. I had to buy him new jeans at Christmas because his size 29 were falling off. So, S2’s solution? McDonalds every night. I am not happy about this, as we’ve never been big fast-food eaters. I am trying to get him to go to the health center to talk to a nutritionist about healthy ways to gain weight. However, I think that this “requirement” to gain weight has more to do with the physiology of voice than worry about an eating disorder. </p>

<p>This article didn’t mention the denial associated with eating disorders. The author of this article is outraged that the university didn’t believe her, but they may be used to students denying that they are trying to lose weight. This might also explain why they seem to be going overboard according to the OP and author, with students who are naturally small.
We don’t have all the information at hand to know, but the author’s response to Yale’s concerns does not rule out the possibility. With the consequences of eating disorders being so serious, perhaps they are choosing to be on the side of overdoing it- requiring healthy and smaller students to get weight checks- than missing someone. </p>

<p>@megpmom, I think it is important to find out what he attributes the weight loss to. Not liking the food, a lot more walking or more activity in general, or something else. Talking to a nutritionist is a great idea! </p>

<p>“I fail to see why this is any business at all of Yale.”</p>

<p>This is the world we live in. Yale is the health care provider for its undergrads. When a student dies of mental illness, parents sue the university and often win. Again, I don’t know what happened in this case specifically or whether it was proper, but residential universities have no choice about being in the business of monitoring and treating students’ mental illness.</p>

<p>From the rest of the post, I am pretty sure that calmom meant that she was 5"5" and 95 lbs. when she started college!</p>

<p>I’m having a really hard time understanding this. I get why the low BMI would alert the health practitioners to a potential problem and I actually applaud them for paying attention. I lose them at the next step: not getting a medical history, not looking at family patterns, not asking questions about eating habits. Forcing a 90 pound kid to gain weight simply because it looks better on a chart that isn’t sensitive to differences in physiology and body types is absurd.</p>

<p>We encountered a situation like this when H and I took our daughter into emergency care clinic one weekend two years ago. Her BMI was very low and the doctor who came in to talk to us about strep brushed that aside to home in on D’s weight. Really? Luckily, she wasn’t dealing with this alone and we were able to discuss her medical history. She’d been below the mainstream in weight since the month she was born but her curve showed a steady increase in weight (and height) each year. She is now about 5’3" and has just passed the 90 pound mark. She continues to grow and gain and the last thing I’d want is for someone to introduce an unhealthy relationship with food to this girl. She eats well and combines her share of good foods and junk, just like any other teen. I would expect Yale to use sound medical judgment if she showed up at their door.</p>

<p>I’d also like to point out that this young woman is Asian and that some Asian body types can be slender. There is nothing unhealthy or wrong in that. </p>

<p>I’m a little confused. Is the author saying that Yale is trying to remove her from the University or just prevent her from playing her sport? Based on her follow up comment here, and also the article she liked to in her own article, it seems the latter. I would more quickly support a college trying to make sure an athlete, who likely puts more stress on her body and also does so at the behest of that college, is healthy enough to play. </p>

<p>I can confirm that Yale does send kids home if they are dangerously thin, and that they can’t return until they put on some weight. In the case I know about, the person was extremely thin, but I don’t know anything about the cause. She went home, ate a lot, and returned quite soon after.</p>

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<p>Burgers, fries, and soda seem to be a rather unhealthy way to consume more calories.</p>

<p>In Super Size Me, Morgan Spurlock’s fast food diet resulted not only in gaining body fat, but depression, lethargy, headaches, fatty liver, heart palpitations, and worsening blood cholesterol levels.</p>

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<p>I think people need to get used to this kind of “paternal” behavior as it is slowly making it’s way into business and industry. If you smoke, or if your BMI is too high or too low, or your lipid panel is off, or your glucose too high, in the future you may either pay alot more for your insurance for being non-compliance with health standards OR you will be given a period of time to “fix it.” This is happening right now. Your company will not care about the circumstances or ask you about it, they will send you to providers or leave you to your own devices…at least Yale connects students who are outside the norm with a health care team. </p>

<p>For several years the media has been focused on the problem of obesity. This is good, but we cannot forget there is also a horrible problem within the entertainment world and fashion world of very poor body condition being portrayed as desirable. To some extent this has allowed women to falsely feel that everything is just dandy when in fact they are placing a huge burden on their heart, their joints, their bones etc.</p>