Sarah Madaus always wanted to be perfect.
It started in elementary school, she said. She always had to have perfect grades. But as she got older, Madaus said her perfectionism “[turned] into something more.”
“That aspect of being perfect leads into everything else,” Madaus said. “I wanted to be perfect in academics, but I also wanted to have the perfect body and eat the perfect diet so I could just be this really fascinating, well-rounded person.”
Madaus, now a sophomore journalism major, developed orthorexia nervosa — an “unhealthy obsession” with healthy eating and exercise, according to the National Eating Disorders Association — during her junior year of high school.
According to the Multi-Service Eating Disorders Association, a nonprofit based in Massachusetts, 20 percent of college students said they have or previously had an eating disorder. National Eating Disorders Awareness Week ended on Saturday, and groups around Main Campus held events to raise awareness.
Temple’s Delta Phi Epsilon chapter hosted its annual National Association of Anorexia Nervosa and Associated Disorders awareness week with body positive events like “No Makeup Monday.” Last week, the Wellness Resource Center set up tables to distribute information about resources for students struggling with eating disorders.
Despite outreach efforts by different groups, Lauren Napolitano, the coordinator of the eating disorders unit at Tuttleman Counseling Services, said it’s difficult to keep students who struggle with eating disorders in treatment — whether that means individual therapy, group therapy, meeting with the nutritionist at Student Health Services or a combination of those methods.
Madaus said during her senior year, she packed the exact same lunch every day because she knew exactly how many calories it had. She followed “fitspiration” accounts, which idealize exercise and dieting on Instagram. She also spent hours at the gym each day. She suffered panic attacks if anything interrupted her exercise, like a text from her parents asking her to leave the gym early or unexpected dinner plans.
Her family eventually noticed her struggling and she began to see a therapist, but when she came to college, she did not continue her therapy. During her first semester, Madaus gained some weight and began to struggle more, so she decided to try to seek counseling at Tuttleman in Spring 2016.
With only a few months left in the academic year, Madaus found it difficult to start counseling due to long wait times. She only had two appointments, she said, and they were with different people, so she felt like she didn’t get anything out of it besides “telling [her] sob story.”
“It was hard because I didn’t really find a connection with someone and I didn’t really make that relationship,” Madaus said.
The eating disorders unit at Tuttleman is comprised of Napolitano, three other full-time therapists and one part-time therapist. In addition to individual counseling services, Napolitano leads an Eating and Body Image Concerns group at Tuttleman on Wednesday afternoons. She said the group is open at the beginning of each semester, but after a few weeks it closes in order for the group to remain consistent for the rest of the semester.
Students who struggle with eating disorders are also often referred to Lori Lorditch, the only dietitian on Main Campus. Lorditch works at Student Health Services and said about 25 percent of the students she works with struggle with eating disorders.
In Fall 2015, Lorditch and the eating disorder unit started meeting once per month to discuss cases and treatment plans for the students with whom they work.
Both Lorditch and Napolitano previously worked at The Renfrew Center, a national eating disorder residential facility. Lorditch said at Renfrew, it was easier to communicate with therapists and give more comprehensive care because they all shared a space.
“It’s a little more difficult now,” she said. “With scheduling it’s hard to communicate sometimes directly with therapists. They also have a lot of part-time therapists up there too, so sometimes their hours don’t line up with mine.”
Madaus said she would like to see a comprehensive center dedicated to eating disorder recovery on Main Campus.
“It’s important to have … a nutritionist that’s also talking to you as well,” Madaus said. “And maybe a personal trainer … just incorporating all of the elements, because I think you can’t just have a counselor when it’s an eating disorder. They’ll talk you through it, absolutely, but you also need [more] help.”
Drexel University and the University of Pennsylvania both have eating disorder centers to train doctoral students and to conduct research projects. Outpatient care and other services at the centers are not free and usually do not accept insurance.
Lorditch said she sometimes posts fliers for paid research studies at Drexel’s Delta Clinic. She is also in the process of working with Drexel to collaborate on updating the Body Project, a four-week body positivity program last offered to Temple students in Fall 2016 through the Wellness Resource Center.
Temple Eating Disorders, a research center in the psychology department, conducts similar research projects, but Lorditch said the center does not work closely with her or the eating disorders unit.
Lorditch said she thinks Temple has great resources for students struggling with eating disorders, but the team is talking about ways to bring the resources together. She said an ideal “next step” would be a six- to eight-week program during which students have access to the full eating disorder team and other doctors from SHS.
“It just makes a world of a difference when [students are] able to feel physically better in their bodies based on eating well and eating the right amount,” Lorditch said. “That kind of satisfaction is really rewarding.”
“We prioritize so many other things before ourselves,” Madaus said. “Yourself is what’s most important, and not your physique. It’s more about how your mind is doing, how your soul is doing and then that’s when your body will follow.”
Erin Moran can be reached at firstname.lastname@example.org or on Twitter @ernmrntweets.