Help me help them understand.

March 1, 2012 9:57 AM

I'm looking for an experience to help a small group of college students understand what it's like to have an eating disorder.

Long story short, as part of a larger project about empathy and nutrition, I am trying to create an immersive, eye-opening experience to help a small group of college students understand what it's like to live with an eating disorder from a physical, mental, and emotional perspective. This should be something that really challenges their existing opinions, and makes them feel a bit uncomfortable.

We were originally going to partner with a local organization who has some programming that does this for families of individuals with eating disorders, but that arrangement fell through. So now we are trying to brainstorm for new ideas, and we're at a loss. Hive mind, can you help?

posted by thejanna to education (25 answers total)

There're those trick mirrors that make you look wider than actuality. Might help shed insight on the delusions of a sick mind
posted by MangyCarface at 10:00 AM on March 1, 2012 [2 favorites]

Well, studies have shown that caloric restriction and dramatic weight-loss makes people act and think like they have an eating disorder.

Maybe tell them they should eat 1500 calories a day for three days and record everything they eat, all the movements they make, etc., and report it to the group at the end?
posted by SMPA at 10:02 AM on March 1, 2012

Frankly, this ongonig autobigoraphical webcomic really stayed with me. I would absolutely call it immersive and eye-opening, even if it's not the interactive kind of experience you were imagining.
posted by PercussivePaul at 10:07 AM on March 1, 2012 [4 favorites]

Maybe tell them they should eat 1500 calories a day

That would be generous for a lot of young women, sadly enough. Most diet plans you see in popular magazines recommend calorie intakes that would be considered dangerously low by the WHO, etc., and a lot of women follow programs like that for years. (The interview with Joan Rivers where she said "I don't diet, I just try to eat around 600 calories a day" has stayed in my mind for decades.)

The other thing that would be risky about telling a group of college students to engage in eating-disordered behavior is that the statistical odds that none of them have ever experienced eating disorders are rather small, and I wouldn't want to take the responsibility of triggering a relapse in any of the students.
posted by Sidhedevil at 10:08 AM on March 1, 2012 [22 favorites]

I think the funhouse mirrors Mangy Carface suggested is a good idea.

From my own experience, the constant intrusive thoughts about food and why I shouldn't eat it were a really definitive aspect. Maybe if you could get someone to intercut an interesting movie with images of food and then other images of people at the extremes of the weight spectrum and just blare self-excoriating messages over the soundtrack at random intervals, and put the students in a darkened screening room to watch it, that would in some way mirror the experience of trying to concentrate on the world around you while getting all of these horrible signals from your self-sabotaging eating-disordered brain.

I am still concerned about how you are screening this group to be sure that none of them have active or dormant eating disorders that could be triggered by the experience, though.
posted by Sidhedevil at 10:13 AM on March 1, 2012 [4 favorites]

Just want to reiterate what sidhedevil mentioned...In my (anecdotal) experience at least 1/3 of my female friends have some form of eating disorder or disordered eating. Recommending an exercise with limited calorie intake and journaling would be extremely triggering.
posted by thankyouforyourconsideration at 10:18 AM on March 1, 2012 [5 favorites]

The movie Thin helped me to better understand the mental illness aspects of eating disorders. It's not exactly immersive, but it was eye-opening for me.
posted by valeries at 10:20 AM on March 1, 2012

OT perhaps, but if you are faculty or staff at said college, you will almost certainly need IRB approval.
posted by Wordwoman at 10:21 AM on March 1, 2012 [1 favorite]

When I think back on my experience 14 years ago, what resonates most with me was how exhausting and mentally-draining an ED can be. I was thinking about my body/food/other people's bodies All. The. Time. Even while I was sleeping!

I don't think anyone can ever really understand what that's like, but here are my ideas:

First, because everyone is "connected" nowadays through technology, I was thinking that you could send random text messages to the students, along with maybe cell phone alarms that would ring and deliver messages like: "I am not enough." "I am not worthy." "I am ugly." However, reading Wordwoman's comment makes me acknowledge that it could be harmful or potentially damaging to a college student and I'm doubtful that you would get the green light from supervisors.

So, to make the above more benign: what about painting toenails? Say, 5 times a day, students have to paint their toenails. You text them to do it and they need to text a response when it's been completed. It's a "task" that needs to be completed, much like how having an ED mimics OCD tendencies and one's mind cannot rest until the thought/action has been processed to completion. Plus, painting toenails is bothersome to do, annoying, and slightly embarrassing (so you'd want to do it in private, like so many ED habits).

Just a (way-super-out-there) thought ...
posted by athena2255 at 10:33 AM on March 1, 2012 [1 favorite]

I had an ED (lost about 25% of my healthy weight), and still struggle with under-eating.

Some things that I wish there were more awareness of is that the major EDs we hear about - anorexia nervosa and bulimia - are very different from each other, and not always accompanied by body dysmorphic disorder. And that there are other EDs - binge eating and a straightforward depressed appetite (which often accompanies depression). And that people can be overweight or look healthy and still have full blown EDs, or at the very least, highly disordered eating. That men as well as women can have EDs.

And that as easy it is for some people to have knee-jerk reaction to the effect of "how vain for them to starve themselves for their looks when people in poorer countries can't afford to feed themselves" (I have heard a lot of this), our body- and looks-obsessed culture still enables and rewards this behavior. That time I lost a quarter of my weight? A couple girls at my school kept telling me how great I looked.
posted by fireflies at 10:49 AM on March 1, 2012 [3 favorites]

I'm a little worried about how you are going to accomplish the immersive element of this task. I think that calorie restriction is not a way to go- other people have mentioned the possibility of triggering behaviors. What I worry about is that it might actually reduce empathy for people with eating disorders. Someone without a disorder who fasts for a day might see the solution for eating disorders might reduce the solution to "eat a sandwich." Fasting in an of itself does not help students to understand the element of compulsion in these disorders.
I like the idea of having students experience of having to imitate compulsive behaviors- like they have to touch the lightswitch of every room that they enter. Again, I worry about triggering behaviors or marking people who might struggle with such behaviors.
This is a case in which empathy might best be produced by looking someone in the eye and talking: can you get a speaker for your class? Might a local group or therapist come and talk to your class? Someone talking honestly about their personal struggle might be very powerful, more powerful than trying to get students to make this kind of struggle into a personal experience.
posted by pickypicky at 10:56 AM on March 1, 2012 [2 favorites]

Maybe if you could get someone to intercut an interesting movie with images of food and then other images of people at the extremes of the weight spectrum and just blare self-excoriating messages over the soundtrack at random intervals

My mother does something like this to teach her students about schizophrenia. She has a student stand in front of the class to give a lecture about something, but then stands behind the student, whispering criticism. Incredibly uncomfortable and effective.
posted by MrMoonPie at 11:13 AM on March 1, 2012 [3 favorites]

I think you've got yourself quite a challenge. Eating Disorders and other destructive OCD "addictive" behaviors, for me, have quantified an "insanity" resulting in a completely skewed ability to perceive stimuli in an accurate and proportional manner. As often referred to in Anonymous circles: "the insanity of addiction is a problem of perception and proportion."

Basically, with respect to an eating disorder, addiction, and just normal life events, I was unable to determine the difference between a mountain and a molehill, and thus may be accurate in my appraisals of such or mistakenly perceive one for the other, with a seemingly "crazy" randomness.

If you can artificially construct (without damaging or triggering your students) to this skewed perception, and somehow make them insatiably and egocentrically self centered while simultaneously lowering their self-esteem to nil, you'd probably win some award in Psychology Today.

That said, the first thing that popped into my head is to award 20 free points to a quiz or other exam (which may or may not have real bearing on a final grade) to the student who can prove through receipts (and an honor system obviously) that he or she has eaten at nothing but fast food joints for a solid week, but also has the lowest caloric intake of the class. The person(s) who drops out of the "program" or has the most calories has to sit apart from the class for the duration of the exercise, and is not allowed to talk. All while having all students keep a journal of thoughts and actions regarding food and their views on fairness, and self-esteem. Basically present a near impossible situation to succeed at with a normal diet, make it based on some quantifiable reward/punishment system, which hinges on what others think of them.
posted by Debaser626 at 11:27 AM on March 1, 2012

Have students make a list of positive and negative things about their personalities and abilities. Then a list of the positive and negative things about their bodies. (individual private lists, or one big group list depending on which is more suitable for the group) Then scratch out the first list entirely and retitle the bodies list 'personalities'. Then discuss how these body traits connotate personality traits. (fatness = lazy. Unattractive = boring. Basically the worst assumptions involving seeing someone like 'body trait') Then discuss the resulting fallout of obsession/depression/anxiety and other info about eating disorders. (Here would be a great place to read some anecdotes from the perspectives of people who have had eating disorders, what they did, how they felt. Stories are great connectors) At the end lead the discussion back to what creates a healthy sense of self worth (maybe using the positive personality lists).

This might be a bit difficult to pull off, but people who get it will really get it and see that they are not really so different. I'd also be willing to bet a number of students are already quietly suffering from some amount of body and/or eating issues.

Also the students would understand it is at heart, disordered conceptions about substituting one's body traits for the achievement and worth of their personality.
posted by everyday_naturalist at 11:29 AM on March 1, 2012

I had an ED in college, too. It's going to be hard to capture the experience and mentality, since it's different for everyone. And it's about a lot more than appearance and feeling "fat."

Here's an idea totally off the top of my head: for one day, each student should keep track of how many words they say or write, and record the number in a notebook. Their total word count must be under 1000 words for the day. Written class assignments (including the recording of the day's words) are exempt, but everything else counts towards the total: class participation (let other instructors know about this), phone calls, text messages, Facebook, emails, singing, journaling, talking to yourself, saying hi to friends in the hallway, everything. If it's language-based, it counts.

For added challenge: tell them that the average 20-year-old says/writes about 900 words a day, so this should be easy, or that other students have done this exercise in previous years and all of them found it easy to stay under 800 words. (Both of these are totally made up.) Perhaps offer a prize to whoever says the least.

The next day, have a discussion with the students: how hard was it to stay under the limit? How much of their day was spent counting words or thinking of what to say? Did they avoid certain situations or people? How did they explain it to their friends? What strategies did they use to keep themselves under the limit? If they couldn't manage to get under the limit, how did they feel about that?

The idea is to give them an idea of the constant preoccupation with food/calories that ED sufferers can have, as well as how isolating it can be and how "different" it makes you feel. And to get across the point that it's not really about food.

And I'm nthing the concern about how you'll ensure that none of your students are at risk of being triggered. Some ED sufferers actively seek out discussing/learning about EDs as a means of self-triggering.
posted by Metroid Baby at 11:41 AM on March 1, 2012 [33 favorites]

These are all fantastic ideas and great feedback. Thank you so much, and keep it coming. And special thanks to those who have suffered with eating disorders for your input.

To answer a few questions:

We are looking for a speaker to come in and talk to the kids - unfortunately, that was one of the things that recently fell through.

There is no grade associated with this. It's not for a class, but a special project, and the students are aware that they will be put in uncomfortable and challenging situations. We will definitely be keeping their mental wellbeing in mind.

They have already been tasked with keeping a food journal for a week, so it can continue on with that experience, but we can't ask them to do anything that might jeopardize their health.
posted by thejanna at 12:04 PM on March 1, 2012

Given the obsessive nature of EDs, addiction, etc., I think it's really hard to dramatize it for a group of people using only one example. If they can't relate, they can't relate. I'd be tempted to ask them to look inside themselves. "Has there ever been a time when something took over your brain to the point where it overshadowed all your other activities? Maybe it was a failed love affair or job insecurities or the idea that your parents didn't love you, or just anything that looked so large it took over your life?" Because if you have never been inside that space you are just not going to get it.

Although, paradoxically I will also say that almost anyone who has "dieted" for any period of time probably has SOME idea. Between say following the Weight Watchers plan and becoming anorexic or bulimic is probably more of a continuum than a stark divide. (I speak as someone who has had at least two extended bouts with unhealthy weight loss as well as one successful moderate weight loss. But I was scared to start a diet of any kind because I was all too well aware that both anorexic periods were kicked off with what seemed like normal dieting.)
posted by BibiRose at 12:10 PM on March 1, 2012

I would have them wear clothes that they felt horribly uncomfortable with- even go out in pyjamas or something... or fat suits... the feeling of not looking right, that people are staring, not FEELING right and that you want to take "these things!" off would not be dissimilar to someone who feels that way in their body and wants to take off the fat.
posted by misspony at 12:26 PM on March 1, 2012 [1 favorite]

Something else you might want to try to get at here is the struggle between needing and wanting to eat, badly, and not being able to allow yourself to do it. I am trying and failing to come up with a suggestion that I wouldn't find triggering... I can't do food journals, or diets, or even exercise for its own sake.

My first thought was to have them look at the recommended serving size on a food they want to eat, and then imagine being allowed to have only half of that. And that's once you've found something that you'll allow yourself to eat in the first place. Making decisions about food becomes a hassle -- there's nothing you can eat -- and it's easier just not to worry about it at all. Then imagine having to do that all day long. Then imagine trying to go grocery shopping and make decisions about foods when everything has something wrong with it (too much sugar, too much fat).

That's the worst part about ED for me. And think of all that needless time and energy wasted, with obsessing about food choices. The suggestions of disruptions during a movie or a task might be on to something.
posted by fiercecupcake at 12:40 PM on March 1, 2012 [2 favorites]

[Folks, OP is not anonymous, feel free to MeMail them directly if you have concerns about this project that aren't answering the question]
posted by jessamyn at 1:13 PM on March 1, 2012

Bring a really beautiful cake to class. Bonus if it smells amazing. Maybe instead of a cake it should be some fresh bacon. Make it as desirable as possible. Set it up front and give everybody forks and paper plates. Then give a lecture. Talk for a long time. Two hours or more. Stand behind the cake/bacon so the students are forced to look at it. If they ask about it, brush them off. Bonus if you hold the class at a time when students are likely to be hungry.

After your lecture, ask them how they felt about the cake. They wanted it pretty badly, they would be ashamed to just run up and grab some, but they couldn't stop thinking about it. It made paying attention to the lecture difficult. It made everything more difficult.

This is how eating disordered people feel all the time, every day.

After you talk about that, give your poor students some cake.

Here's a favorite site of mine with lots of great firsthand accounts of what it's like to have an eating disorder: http://famine.brokensanity.org/
posted by milk white peacock at 1:36 PM on March 1, 2012 [3 favorites]

I work with teenage girls who have eating disorders, and I would just be very careful about pursuing any type of exercise that has them mimic one because it could be very triggering and possibly damaging.

For that reason, maybe something that doesn't have them try to feel as though they have an eating disorder, like a good movie or a speaker?
posted by kinetic at 2:01 PM on March 1, 2012 [1 favorite]

Bring in some family members of folks that had eating disorders. If you want to have a gut wrenching and honest view of the disease, give a family member the floor. Then you will get an account of the insidious and destructive nature of the disease.
posted by Nanukthedog at 3:08 PM on March 1, 2012 [2 favorites]

I had an assignment in a gender studies class which had similar goals to this. For that class, we had to browse blogs and "pro-ana" websites, and write a reflection paper. (Many of the blogs read like private diaries, and give very raw insight into what those with eating disorders are feeling.)

It was 4 years ago, but I still remember because it was THE MOST depressing homework I've ever done.
posted by tinymegalo at 4:37 PM on March 1, 2012 [1 favorite]

Ask the students to hold a ziplock bag of ice. Tell them not to think about it. See how long they can hold it. That's like asking someone with OCD or an eating disorder to just snap out of it.
posted by Chaussette and the Pussy Cats at 5:03 PM on March 1, 2012