Pigging out on Domino’s and digging into a tub of Ben and Jerry’s on a Friday-night- in with the girls was normal for Rachel Rifkin and her friends.

But for Rifkin, the binge eating continued behind closed doors. During the week when her roommate left for class in the morning she would grab a jar of Nutella and “numb out.” She was never noticeably overweight, so no one would have suspected anything.

Rifkin struggled with binging, purging and over-exercising for the first two years of college. She finally she went to a treatment center to get help after her sophomore year and returned to Syracuse University the spring semester of her junior year. National Eating Disorder Awareness week has inspired Rifkin to share her story and help other people suffering with body image issues and eating disorders.

Freshman year at SU was a difficult transition for Rifkin. Being from Indiana, she knew no one and wasn’t making the friends she wanted. The friends she did have bonded over those late-night binges of ice cream and pizza. Eating became a way for her to cope.

She joined the SU dance team her freshman year, so eating more than most girls was fine because she was dancing all the time — or at least that’s how she justified it.

With everything she ate, she calculated what she would have to do to burn it off. At the gym, she stayed on a machine until she hit a certain number of calories burned. By her sophomore year, she began purging as a way to keep the extra calories from counting.

Rifkin would go through phases in which she focused on eating healthy, and she would cook vegetables and grilled chicken. But she found herself binging even on the healthy food. She would binge eat after a night out, but justified throwing up by saying she was drunk, even when she knew exactly what she was doing. No one ever thought twice about it. She ate whatever she wanted and as much as she wanted. Eventually, she couldn’t count the number of times she purged each day.

A couple hundred students, both male and female, go to the SU Counseling Center each year to seek help about eating concerns, said Dr. Cory Wallack, director of the SU Counseling Center.

But Rifkin didn’t think she had an eating disorder. Her mother suffered from anorexia and bulimia, and had told her when she was about 10 years old. Her mother wanted to make sure it would never happen to Rifkin.

“I think she kind of explained to me so much of the extremes that I never realized that a lot of the little things can still escalate to the same disorder,” Rifkin said.

Rifkin constantly compared her habits to her mother’s experience. She justified what she was doing because it differed from the stereotypes of anorexia and bulimia she had learned about.

More than one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting and taking laxatives, according to the National Association of Anorexia Nervosa and Associated Disorders website. Such behaviors can be classified as an eating disorder, or be the signs of an onset to a disorder.

Rifkin knew what she was doing was wrong, but people complimented her weight loss. She didn’t look sick. She wasn’t underweight. She couldn’t have an eating disorder.

“I knew it wasn’t OK. It was everything I learned not to do, but at the same time it’s OK because everyone is telling me I looked good,” she said.

It wasn’t until Winter Break of her sophomore year that anyone realized she had
an eating disorder. She drunkenly told her best friend in the heat of an argument that she was struggling with binging and purging. Rifkin knew right away her friend wasn’t going to just let it go.

Rifkin had to tell her mother, who wasn’t shocked to hear Rifkin’s confession.

“She was not taken by surprise at all and I think she knows that my mannerisms are a lot like hers, and it made a lot of sense,” Rifkin said.

Rifkin saw a therapist during break and continued to call her when she went back to SU for the spring semester. But Rifkin still struggled. She found that relying on other people made her condition worse.

“It was like ‘Oh it’s out of my hands other people are going to help me so I don’t have to take care of myself,’” she said.

Kelli Uhlberg was one of the first people she confided in at SU. Although Uhlberg said tried to help Rifkin, she couldn’t understand exactly what she was going through and how to help her.

“After a while, when it really became an issue, I lent my advice; however, it got to a point where she needed to seek serious treatment,” Uhlberg, a senior fashion design major said.

During Spring Break, Rifkin’s mother set up an appointment to talk to a woman from the Alliance for Eating Disorders. Rifkin said if it fit into her schedule, she would consider going — she still didn’t think she needed help.

Her mom pushed her to go to treatment and Rifkin agreed to go to the Oliver-Pyatt Center in Miami. She liked that it looked like a resort, not a hospital. She figured it would be nice to get away and go on a mini-vacation.

Getting into the center was difficult. She went through an initial interview. She completed an admission application and intake questionnaire which is reviewed by Dr. Wendy Oliver-Pyatt and a clinical director, according to the Oliver-Pyatt website. Medical evaluations and an intake assessment by a clinician are also required. Her insurance needed to be able to cover it. And she would only know seven days in advance if there was a spot for her to take.

Rifkin got a call in the beginning of the summer and seven days later, staff members at the Oliver-Pyatt Center were searching her suitcase for anything with which she could hurt herself.

She wasn’t allowed to have a water bottle in her room at night. She could only shower in the morning. The bathroom was locked at all times. Someone had to flush the toilet for her. Every rule they had was because someone figured out a way to use that to their advantage and not their health.

Rifkin compared herself to the other girls at the treatment center. They couldn’t finish the food on their plate. They wouldn’t eat the pizza or the turkey burgers. She remembers girls doing push ups in the corner to try to burn off what they just ate.

“I was like ‘Oh I’m not as sick as them — they can’t even eat their food,’” she said. “I didn’t think I was sick because little things like that didn’t bother me.”

Finally, after a month into the program, Rifkin realized she had a problem. After meeting so many people in the treatment center that were there for the second or third time really affected her. She didn’t want to have to be at a treatment center more than once in her life. She didn’t’ want her future family to be affected by her disorder. She knew she would need to stay in treatment to make sure she didn’t relapse months or even years down the road. She had missed the fall semester of her junior year and spent a total of eight months working on her recovery.

“I realized I’d rather plan my life around my recovery, than my recovery around my life,” she said.

Knowing she wouldn’t return for the spring semester, Rifkin was going to have to open up to her sorority sisters in Kappa Alpha Theta. At first she told them she was getting help for anxiety and depression because she was ashamed. She didn’t want to make a big deal out of it. Eventually, she told them exactly what was happening.

“People reacted positively. It wasn’t gossipy or strange; it was very supportive and loving. A lot of people sent her care packages and letters throughout the year,” Uhlberg said.

During the next seven months in treatment, Rifkin found out a lot more about herself. She credits her therapist with uncovering problems Rifkin didn’t know were related to her eating disorder. She discovered anxiety and depression — two things her family struggled with — were issues for her and connected back to her eating disorder.

Much of the focus of her therapy was on mindful living and everyday thinking, not strictly about eating. It was those tools that allowed her to see how food related back to depression and anxiety. The Oliver-Pyatt Center helped her discover the root of the problem, rather than just treat the symptoms.

“I learned about obvious scientific connections with eating disorders, the genetic ties of depression, anxiety and OCD in my family never appeared in me because it manifested through food instead of being depressed,” she said.

During her treatment, Uhlberg went to visit Rifkin. Her visit was a piece of home for Rifkin, but it was also so Uhlberg could fully understand what she was going through.

“When she was towards the middle of treatment I flew down to Miami and spent a couple days with her. I had meals with her, attended a therapy session and got a full experience of what she was going through,” she said.

In the spring, Rifkin was ready to head back to SU. She knew that everything that put her at risk for relapse was part of the college lifestyle — drinking, lack of sleep, an inconsistent schedule, food — but she knew she couldn’t avoid these elements for the rest of her life.

“Disorders are so delicate that almost anything can be a trigger. College campuses are populated by triggers,” Uhlberg said.

Back on campus, Rifkin continued to lead a more mindful, healthy lifestyle. She talked with her friends to tell them what was normal behavior and what wasn’t. She had meetings with her therapist from the treatment center via Skype. She practiced meditation and she journaled weekly goals to keep her on track.

But she was missing a true support group, because the SU Counseling Center didn’t offer any.

“I came here looking for a support group when I got back to campus and there was nothing and I was livid,” she said. “I went from a group where I was always with five to 10 girls to nothing. I needed to be with at least someone that understood.”

Wallack, of the SU Counseling Center, said he recognizes the need for a support group on campus. The Counseling Center and SU Health Services partnered together for eating disorder treatment on campus about a year ago and they are currently trying to implement a support group, he said.

“The challenging part about folks who are struggling with eating concerns, though, is as a group, generally speaking, they’re less likely to seek out therapy services and are people with other mental health stuff like depression and anxiety,” he said.

Rifkin has been extremely open about her experience. She has talked to a lot of other women on campus who have confided in her for support. She serves as the vice president of program for Students Helping Acquire, Promote and Enhance Self- Esteem at SU (SHAPES) — an organization that raises awareness about body image issues and eating disorders.

Rifkin interns and attends support group meetings at Ophelia’s Place — a support and treatment center for eating disorders in Liverpool, N.Y. Each week, the group sets “weekly intentions” of things they’d like to work on. Then they share with each other why they did or didn’t reach these goals.

Following through and continuing practices she learned at Oliver-Pyatt Center with other women who have struggled with the same issues makes it easier for Rifkin.

Rifkin said she no longer thinks about food in the way she used to. She can have a slice of Domino’s pizza or a bowl of Ben and Jerry’s when she wants it, and no longer “numbs out.”

“I’m better,” she said. “I’m as well as I’ve ever been but it doesn’t mean I need to stop the effort.”

Published on February 25, 2014 at 1:51 am

Contact Jocelyn: jdelaney@syr.edu