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Don't Eat, Don't Tell

Female cadets in the U.S. military are increasingly falling victim to debilitating, silent struggles -- eating disorders. Military officials say that eating disorders aren't problems in their ranks, but cadets and low-profile studies say otherwise.
 
 
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Sheri Becker*, a third-year cadet at the U.S. Coast Guard Academy in New London, Connecticut, gets up at reveille, straightens up her room, puts on her pressed uniform and spit-shined shoes, and stands in stiff formation in the courtyard while an older cadet barks orders. Dismissed, she files into the mess hall to gulp down a hearty breakfast, usually greasy sausages and eggs. Her day is packed with classes -- nautical sciences, leadership, engineering. Then a quick lunch, exercise, a buffet dinner and intensive studying until lights out at midnight.

From the outside, Becker seems like the perfect, ultra-disciplined cadet. Inside, she's in turmoil. Under intense academic stress, she's also fixated on the academy's maximum weight standard for her height and frame (although at five feet six inches tall and 143 pounds, she has room to spare). After meals she searches for an empty communal bathroom where she can vomit undetected. During evening study, feeling stressed, she plows through junk food, then vomits again. The cycle repeats itself up to four times a day.

"A lot of girls are bulimic here," she says. "The whole day is regimented and my one release is what I eat." Becker acknowledges that the habit has eroded her self-esteem and interfered with her studies. Yet she confides in no one. "There's a very competitive edge at the academy. You don't want anybody to see your weaknesses."

***

The introduction of women into America's Navy, Air Force, Coast Guard, and Army academies -- where they make up from 6 to 33 percent of the population -- has been rough going. There are few hard statistics about how many female cadets suffer eating disorders but by all accounts the pressure to succeed, and to compete physically and academically with the country's toughest young men, is intense.

"I was spit on going to class," recalls Major Lissa Young, course director for military leadership at West Point, who was a cadet there in the mid-Eighties. "These girls aren't spit on, but now the weapon used against them is their body size."

The military has been slow to acknowledge eating problems among its ranks. Ignoring bulimia, however, is becoming harder to do. Bulimia nervosa is a disorder characterized by repeated vomiting, laxative use or, less commonly, excessive exercise after binge eating. Its victims are often depressed, under stress and obsessed with body size, although few are actually overweight. Female cadets, some of whom spoke on the condition that their names be changed, describe compulsive eating, bingeing and purging, fasting and overexercising in response to bingeing as rampant at the academies.

Civilian and military psychologists suggest that the intensely competitive atmosphere, coupled with the military's emphasis on body size and physical strength, create the kind of environment that can trigger self-destruct behavior and an unhealthy relationship with food. Both are risk factors for bulimia, even in otherwise healthy women. Despite mounting evidence of an eating disorder crisis in its midst, the military seems unlikely to question, let alone redress, endemic cultural factors that might have contributed to it.

***

The official position on eating disorders at America's military academies is that they are not widespread.

"The magnitude of eating disorders here isn't particularly great," says Air Force Lieutenant Colonel Joe Jackson, a psychologist who counsels cadets. "The problems Air Force women are struggling with are no different from those of women down the street at Colorado College." At West point, however, a 1996 survey of eating disorders among 96 cadets conducted by John Elmwood, a researcher in the academy's department of behavioral science and leadership, found that 83 percent of the women and 20 percent of the men "held potentially dangerous eating perceptions and attitudes." The percentages were significantly higher than national averages.

A glimpse into the rarified world of America's military academies reveals environments less like civilian colleges than top military personnel seem to think. The pressures may be similar, say female cadets, but they are institutionalized -- therefore magnified and inescapable. Where civilian women may aspire to an ideal body, women in the military can lose their careers if they don't meet weight standards. Military women also compete in an environment that was, until recently, exclusively male and where the presence of women is often still resented. Any signs of "femininity" -- painted nails or long hair -- can result in demerits. The military's ethos is one of toughness, individual responsibility and the expectation of absolute perfection.

Admits West Point's Lieutenant Colonel Robert Byrne, a psychologist, "The pursuit of excellence can cause excessive dieting and a pursuit of thinness that's really unattainable." A recent memo on eating problems reveals that their prevalence is "at least the same as, if not greater than, in civilian settings."

Midshipman Konita Kirkeby, a 22-year old naval Academy enlistee, agrees. "I think every female at the academy battles with an eating problem at one point or another, "she says. Other female cadets describe bulimia as "epidemic" and say the secretive act of bingeing and purging is "an art form."

Contributing to the pressure are the academies' varying weight standards, set by the military branches they serve. At the Naval Academy, for example, a five-foot-six-inch woman can weigh up to 153 pounds; at the Coast Guard, depending on her body frame size, up to 177 pounds; at West Point, her maximum is 141 pounds. By contrast, the federal dietary guidelines for "healthy weight" are up to 38 percent higher for women, as long as there are no other medical problems, such as diabetes.

Experts outside the system wonder if the military's standards are too rigid.

"Cadets are like elite athletes, and in athletics there's always a premium on low body fat," says Kathy Hotelling, PhD., a Northern Illinois University psychologist who is consulting with West Point on eating disorders. "But there's no evidence that links peak performance and body fat -- and dieting may hurt performance."

Nonetheless, the weight guidelines are strongly defended and enforced.

"When you raise your right hand and agree you're going to be a soldier, one of the things you have to do is maintain a healthy lifestyle," says Colonel Maureen LeBouef, the first female director of the department of physical education at West Point. "Soldiers have to be in good condition. If you're carrying excess fat, you're going to fatigue faster, and you won't be as effective a soldier."

It's hard, cadets say, to meet weight standards in mess halls where the high-fat, calorie-dense food is tailored to super active young men who want to bulk up.

"We have mandatory meals, and even if you're not hungry, you have to go sit at the table, so of course you eat," says one Coast Guard cadet. Women complain of menus with pork chops, mashed potatoes, beans and gravy, and usually no lighter options such as steamed vegetables.

"There's nothing healthy to eat," says West Point cadet Leah Haberer, 21, who says she never struggled with her weight before joining the military.

In the mess hall, mealtime rituals contribute to food anxieties. First-year cadets at the Coast Guard have to eat braced up, sitting at attention and bringing their fork to their faces, rarely looking down at their plates to examine their food. Even worse are the regular weigh-ins, where a scale is brought into the hall, cadets are weighed, and their stats -- "Five feet six inches and 151 pounds" -- are called out.

"You want to die," says Haberer. Those who are overweight are told to lose and subjected to more frequent weigh-ins, while those who fail can be put on probation or discharged.

Hotelling says the military uses negative incentives to get overweight cadets to lose weight, stigmatizing and punishing those who fail. One cadet describes how she was nearly kicked out of West Point for being only 2 percent over her body fat allowance.

"I bought my own food, exercised like crazy, and after six months I was still over the limit by 1 percent," she says. "It was my dream from fifth grade to be a female officer in the Army, and I faced expulsion for three pounds." She ended up losing the weight -- and staying in the military -- by drastically curtailing her food intake.

Female cadets at West Point report being teased -- usually by male cadets -- for having "Hudson hips" in their uniforms, being told to work out more, and being constantly scrutinized at the dining table.

"The military academy is one of the last places in America where masculine identity can be validated," says Young. Byrne, the cadet counselor at West Point, responds that, although every effort is made to encourage an atmosphere of respect, "There's a high premium on appearance and fitness here. There's no doubt in my mind that some cadets can be harsh toward one another in their comments about appearance."

***

Academic standards at America's military academies are high -- comparable to the standards at elite colleges. Eating disorders often become a way of relieving academic tension at both. One bulimic Coast Guard cadet describes grueling all-nighters and junk food binges -- with the threat of the weight standard providing an added incentive to vomit. Another tells of purging six times a night during finals, then, exhausted, crawling back to her room from the toilet.

"Bulimia was the only way I could get this paper done," she says. She confided her secret crutch to no one at the academy.

Even when cadets aren't studying for a test, there's little room for the women to let off steam. A male cadet might be able to go out and get wild with his buddies, drinking beer and carousing with local girls. Bulimia becomes one way for women who want to protect their reputations to act out, says David Herzog, M.D., founder and president of the Harvard Eating Disorders Clinic, who has counseled cadets.

"It's the super-good-girl's way of being bad," he says.

Many of the cadets recognize they have a serious problem with eating, but they're reluctant to get help for fear of being booted out. At the Coast Guard, if a cadet goes for counseling voluntarily, it won't go on her record -- unless the problem appears to be interfering with her health or abilities to lead. That's the big catch -- and it's the same at all the academies.

"The fear is that self-referral will lead to dismissal," says Young. "Technically, that's not what happens, but that's what the rumor mill teaches." They're also afraid that their secret will get out. "if you turn a friend in for an eating disorder, every cadet in charge of her knows, all the way up the chain of command," says Haberer. "There's no privacy."

Last year, Angela Keane*, a first-year student at one of the service academies, resigned because of an eating disorder. She was at the academy only two weeks before she began purging in response to the extreme stress of the rigorous schedule.

"It started off as a once a day, then moved to twice a day, then at every convenience." She said she tried to get help, but was turned over to medical staff, who recommended she be discharged. She said she was given no opportunity to get better. Other cadets consider this case unrepresentative of their circumstances; they say Keane's disorder was so extreme it made her unfit for duty. But for many, her resignation confirmed the belief that seeking help is a sign of weakness that the military simply won't tolerate.

"The academy is demanding," says the Air force's Jackson. "If you're struggling with an eating disorder, you can't keep up with the academic, military and character demands of the place."

***

In the past two years, military academies have begun to address the issue of eating disorders. West Point has developed and Eating Disorders Task Force to educate officers and cadets about preventing, detecting and treating eating disorders.

"Now that West Point has acknowledged the problem, we're on our way to healing it," Young says. At the naval academy there's now a support group for eating disorders. In late 1998, the military held its first annual interacademy human relations seminar with a discussion devoted to eating disorders. The fact that the military held such a meeting is a sign that many inside are starting to take this problem seriously.

But cadets wonder how much will really change if the military continues to put a premium, for good or bad, on physical strength and competitiveness.

"How do you implement a change in this culture that is so fixated on weight, physical fitness and body image?" asks Dena Ridenour, 21, a West Point cadet. Asks one bulimic Coast Guard cadet, "We've volunteered for this. But the way military academies are structured, some women can't be productive without developing an eating disorder."

Meanwhile, Becker struggles to keep her secret under wraps -- trying not to eat too much or steal food from her roommates, trying not to let anybody notice when she vomits.

"I've challenged myself to become strong enough to get over this or leave," she says. "If I left, it would be hard to see the disappointment on my mom's face. But I think I'm doing okay. I'm fighting it. I just wish there was someone to help me through this. It's very lonely."

* Names changed to protect confidentiality

Laura Fraser is a freelance journalist and author of "Losing It: False Hopes and Fat Profits in the Diet Industry" (Penguin).