Ira Sacker, M.D.
Students Dying To Be Thin

Ira M. Sacker, M.D. is an acknowledged expert in the field of eating disorders. He is author of Dying To Be Thin and founder and president of HEED (Helping End Eating Disorders) a program with offices in Manhattan, Brooklyn, Upstate New York, and Long Island.

Karen Scherr

Hey, Wasn't I Supposed to be the Valedictorian?

Karen Scherr graduated from Kingwood High School in 2005 as Honorary Valedictorian.  She was diagnosed with anorexia nervosa in her sophomore year and subsequent hospitalization and inpatient treatment caused her to miss the first six weeks of her junior year.  Due to a school policy, she was unable to be valedictorian despite her number-one class ranking.  She has been in the recovery process for two years now and hopes to increase awareness of the seriousness of eating disorders and encourage their prevention by sharing her experience with others. She will participate in a joint program between New England Conservatory and Tufts beginning this fall, where she plans to major in vocal performance and biopsychology. Karen will share her story about the trade-offs between scholastic performance and treatment. Read more online now at http://www.msnbc.msn.com/id/7884243/. (Photo by MSNBC)

Hey, Wasn't I Supposed to be the Valedictorian?

Good afternoon. I would like to thank Senator Clinton for sponsoring this briefing; what an inspiration to see a female so active and successful in the United States government. As a 2005 graduate of Kingwood High School in Kingwood, Texas, I believe I have a different perspective than many people here in this room. I have spent the last 13 years of my life in the public school system; eight hours a day, five days a week I sat in a classroom taking notes, tests, and final exams. I feel connected with today’s students and am honored to share my experience of dealing with anorexia nervosa while attending a public high school.

From a young age, I was blessed to be the recipient of numerous school awards, complements from adults, and solos in the church choir. Unfortunately, this experience led me to rely on others’ approval for my sense of self worth rather than inside myself. When I reached tenth grade, I suddenly found myself competing against seniors for places in the varsity orchestra and choir, roles in theatre productions, and a spot on the tennis team. My self-esteem began to waver as I struggled with not begin the absolute best. Like many people in our culture today, I decided I would feel better about myself if I lost a few pounds. I lost ten pounds and was excited about the sense of control I had experienced over my weight. This feeling of control came at a time when I began to realize that many aspects of my life were out of my control: sick grandparents and other people’s opinions, for example. Adults, teachers, peers, friends-everyone seemed to be saying how good I looked. If only I’d learned to rely on myself for my sense of self-worth, perhaps these complements wouldn’t have had such a strong effect on me.
I quickly knew that something wasn’t quite right with my new eating habits, and every night I’d write the following sentence in my journal: “Dear God, please help me with this weight thing.” I didn’t even know what to call it; it’d only be after the anorexic mindset was deeply entrenched that I was officially diagnosed with anorexia nervosa.
For the next four months, I underwent intensive outpatient treatment with a therapist, dietician, and psychiatrist. I worked hard and learned a lot about myself and my needs as a human being. My family and I hoped that an upcoming trip to Scotland with the KHS theatre would provide an incentive for me to gain weight and fight the anorexia. However, when the departure date arrived, it was clear that I was neither physically nor emotionally capable of traveling overseas. At that time, my parents, treatment team, and I made the difficult decision to admit me to an inpatient eating disorder treatment program at Laureate Hospital in Tulsa, Oklahoma.

We knew that school would start while I was receiving treatment, but we also knew that more intensive treatment was necessary for my recovery. Laureate had a certified school teacher who worked as a liaison with girls’ hometown schools to continue their education during treatment. My mom and dad met with my counselor, assistant principal, and the majority of my teachers to explain that I was in a hospital receiving treatment for anorexia nervosa. My mom shipped me my books, and she went to the school at least twice a week to obtain assignments that she then faxed to me in Oklahoma. My math teacher even gave me her home phone number so I could call her to discuss my work. My treatment progressed well, and I continued to discover why I had developed anorexia and learn how to now fight it.

Four weeks into my seven-week stay, I learned that according to state law the school had un-enrolled my since I had not physically attended school during the 2003-04 school year. I was also informed of a school policy which stated that the class valedictorian and salutatorian “must be enrolled by the 20th day of his/her junior year.” As I had been ranked number one in my class since freshman year, this was a valid concern for my family and me. The school suggested I return to sit in school for a day so that I would be eligible for valedictorian should I retain my number-one ranking through senior year.
When my family told my doctors of the school’s request, they thought the idea was ridiculous and leaving the hospital could definitely jeopardize my recovery. And important part of my recovery involved learning that my health and well-being was more important than my accomplishments and awards; flying me back to Texas so I could be eligible for the title of valedictorian two years later was in direct opposition to this idea. My family and I knew that I had come too far in the recovery process to risk a relapse at that point. Additionally, we understood that the rule was established to prevent a student from moving into the district late in their high school career and becoming the valedictorian or salutatorian. I just couldn’t imagine they’d enforce the rule in my situation.
 

I completed my treatment at Laureate and returned home after missing the first six weeks of school. I met with each of my teachers individually to set up a schedule so I could complete my remaining make-up work by the end of the semester. After my return, nothing was ever mentioned to me personally about the 20th day policy or that the school considered me ineligible to be valedictorian. For two years, when every report card came out and I was still ranked number one out of approximately 900 students, I became more and more hopeful that the school would look at the intent of the rule instead of just enforcing the policy blindly. Then, during 7th period the day before the top ten students would be officially announced, I happened to be in my assistant principal’s office. He sat me down to ensure that I understood that although I was indeed ranked number one academically, I could not be valedictorian because rank was “only one criterion for being named valedictorian.” And in case I was “hoping against hope” that the 20th day rule would not be enforced, he wanted to make sure I new the administration’s decision before it was publicly announced.
 

By the next day, news of my ineligibility to be valedictorian had spread and the students of KHS were taking action. The student council started a petition, and the students ranked #2-9 called our superintendent to set up a meeting. They wished to discuss the administration’s decision and assert their desire for me to be named valedictorian. Parents called my house nonstop and sent e-mails and letters to our superintendent, the Kingwood Observer newspaper, and the Houston Chronicle. The encouragement from my fellow students and entire Kingwood community was incredible; I never could have imagined the outpouring of support that I received.
 

When my parents and I were invited to meet with my principal and assistant principal, we were told the following information: the school was not required to work with me while I was in the hospital two years ago. In fact, they said that there were schools in our district that would have refused to give me work, and I should just be grateful that I received credit at all. My principal also told me that my teachers didn’t have to take me into their honors classes, and made me feel as though I was a burden to my junior teachers. However, I think that the multiple awards I received from my junior teachers at honors night that year shows that they considered me an asset to their classrooms, not a burden. Finally, she told me that the 20th day policy was designed to ensure that the class valedictorian and salutatorian had the Kingwood experience, and that my experience was different and therefore unequal to that of my classmates. I did not think this was a fair statement, however, as the school’s policy required that a valedictorian or salutatorian was enrolled for at least his/her junior and senior year; in essence, four semesters. I’d been enrolled for 7 2/3 semesters, yet was denied the title of valedictorian because of the time frame during which I needed treatment for an eating disorder.
 

It was only after the media began to tell my story and the other top ten students met with the superintendent that I was offered the title of ‘honorary valedictorian.’ This allowed me to give a speech at graduation, and for that I am sincerely grateful. But for me, my concern was never about whether I received the title of valedictorian, honorary valedictorian, or even nothing. It was about the attitude that the administration had while making their decision; they failed to recognize an eating disorder at a life-threatening disease and penalized me for receiving the treatment I so desperately needed. I am aware of people who have heard my story and become discouraged from seeking impatient treatment because of the negative consequences it may have on their school ranking. However, I believe that this should not have to be a concern for these people; our public schools should provide the benefit of an education to any student who wishes to continue their education during hospitalization for any medical illness, including an eating disorder.

S. Bryn Austin, ScD

Balancing Obesity, Eating Disorders, and Physical Activity

S. Bryn Austin, ScD, is Director of Fellowship Research Training in the Division of Adolescent and Young Adult Medicine at Children’s Hospital in Boston. She is also Assistant Professor in Pediatrics at Harvard Medical School and Assistant Professor in Society, Human Development, and Health at the Harvard School of Public Health. Her primary research is in the behavioral sciences and social epidemiology, addressing social and physical environmental influences on eating disorders, physical activity, and nutritional behaviors in school and community settings. In addition, her research interests include media and health communications and gay, lesbian, bisexual, and transgender adolescent health. She received her doctorate from the Department of Health and Social Behavior at the Harvard School of Public Health. Her research on eating disorders, nutrition, and the environment includes work with the Planet Health study, a school-based intervention study to promote healthful nutrition and physical activity and reduce overweight; the Growing Up Today Study, a national prospective cohort study of over 16,000 adolescents; and the National Eating Disorders Screening Program, a screening initiative conducted in over 100 high schools nationwide to promote early identification and treatment for adolescents with eating disorder symptoms.

Margo Maine, Ph.D.
Moderator

Dr. Maine, co-founder of the Maine & Weinstein Specialty Group, is a clinical psychologist who has specialized in the treatment of eating disorders for over 20 years and serves as the Consulting Director of Eating Disorders at the Institute of Living in Hartford, Connecticut. Author of two groundbreaking books, Body Wars: Making Peace With Women’s Bodies (2000) and Father Hunger: Fathers, Daughters and Food (1991), she is a senior editor of Eating Disorders: The Journal of Treatment and Prevention and board member and past president of Eating Disorders Awareness and Prevention, now the National Eating Disorder Association, and trustee of the Eating Disorder Coalition for Research, Policy and Action. Dr. Maine is an Assistant Clinical Professor at the University of Connecticut, Department of Psychiatry and an adjunct faculty member at the University of Hartford, Graduate Institute of Professional Psychology. As well as sitting on numerous advisory boards, including Dads and Daughters, she has presented at numerous state, national and international conferences on a variety of topics related to the treatment and prevention of eating disorders, women’s health, and associated issues.