At first glance, Paul '07 looks like a model student. He is successful academically, boasts an athletic build and handsome features and is a key player on a varsity sports team.
Like an estimated 150,000 other college men, however, Paul has darker secrets than meet the eye. Paul, whose story is so personal that he prefers not to use his real name, is a recovering bulimic.
Nationally, the appearance of eating disorders in men is a growing phenomenon. The nonprofit organization Eating Disorders Awareness and Prevention, Inc., estimates that five to 10 million women and one million men in the United States suffer from eating disorders and borderline conditions.
Health officials say instances of male eating disorders have increased 30 percent since 1972.
The trend might be especially prevalent at schools such as Princeton.
Harvard Medical School's Dr. Roberto Olivardia, coauthor of "The Adonis Complex: The Secret Crisis of Male Body Obsession," said the rate of male eating disorders might be higher in Ivy League schools than other colleges.
"While it is unclear exactly how many men develop eating disorders in college, we do know that eating disorders tend to affect college men versus men who do not attend college," Olivardia said.
He speculated the rate might be even higher in Ivy League schools "partly because these problems tend to affect men in the middle to higher class socioeconomic groups" and partly because of the pressure students at selective schools feel to project an image of success.
"Unless they seek treatment, men with eating disorders do not fare well after college," Olivardia said. "In fact, their problem can get worse, as the stressors of life, work, relationships and the real world lead them to use food — or lack of it — as a coping strategy."
A problem at home
The University's Task Force on Health and Well-Being reported in its April 2004 interim report that "the number of students suffering from eating disorders, men as well as women, [is] apparently large and growing."
University Health Services (UHS) Eating Disorders Team coordinator Robin Boudette concurred, saying male eating disorders have been on the rise at Princeton for the past five to eight years.
She said UHS is therefore "working to dispel the belief that [eating disorders] are a women's problem" and to identify men in need of assistance and encourage them to seek help.
The effort might prove arduous. Olivardia said men constitute one in six eating disorder sufferers but only one in 15 patients in treatment.
He ascribed this disparity to personal guilt and men's reluctance to seek help for a disease often associated with women.
Paul's story
Paul began wrestling competitively in high school. Endowed with an athletic build, he didn't worry much about his looks. Still, he knew that wrestling would make him stronger and more muscular.
"Guys are raised with Ninja Turtles and G.I. Joes and pro wrestling," he said. "My whole life I wanted to look like that."
Experts have linked the rise in eating disorders among men with increasingly unrealistic portrayals of the male body in pop culture.
Olivardia's research documents how magazine spreads, testosterone-fueled movies and muscular action figures promote a male ideal of thick biceps, a V-shaped back, a broad chest and clearly defined abdominal muscles.
In addition to these unrealistic images of the male body, Paul faced other pressures in high school, where he was on the varsity wrestling team.
By his junior year, Paul encountered the pressure on wrestlers to lose weight rapidly before competitions so they could wrestle in a lower weight category.
"In wrestling, it's called 'cutting weight.' Some guys cut weight by dehydrating, but I did it legit," Paul said, explaining that while some wrestlers tried to lose water weight quickly, he decreased his body fat.
He wasn't yet forcing himself to vomit; he was severely restricting his food intake and exercising vigorously.
"There's this mentality that I'm gonna be at a disadvantage if I don't [wrestle in a lower weight category]," Paul said.
But, he said, not all competition among men is sports-related.
"It's a guy thing," he said. "Guys are so territorial. You go into the weight room and everyone's eyeing each other . . . You see a difference between the way your body looks during season and out of season."
Paul worked himself down to 5 percent body fat in high school. (According to the U.S. Olympic Committee Sports Medicine Division, the healthy range for body fat is 13 to 16 percent for men and 20 to 25 percent for women.)
Paul's starvation diet and constant fixation on food, however, eventually drove him to bouts of uncontrolled "binge" eating.
"I was just so obsessed with food because I couldn't have it," Paul said. "Then one day I went home, and I just gorged myself on food. And I was like, well, I could burn all this off, or I could stick my finger down my throat."
Paul continued to binge and purge regularly, using a toothbrush or a pen to force himself to vomit his meals. He also got up at 5:40 every morning to run two miles, train two hours every day and lift weights at night.
"I told myself, 'This isn't bulimia, because I'm doing it for wrestling,'" Paul said.
But even after wrestling season ended, the cycle continued. "It wasn't wrestling season, but I kept on gorging and throwing up," Paul said.
He kept his illness a secret through his senior year. The bulimia continued into university, where he joined the varsity wrestling team.
At Princeton, Paul met many other athletes who also felt pressured to maintain an unnaturally low weight.
"I'd say about 95 percent of the wrestlers (at Princeton) have had an eating disorder at one time," said Frank '07, another member of the University wrestling team who also said his story was too personal to use his real name.
Frank takes diet pills regularly to help curb his appetite.
"We don't talk much about it. It's just like, 'I feel your pain, man,'" he said.
Men's wrestling coach Michael New disagreed with Frank's estimate, saying there is a difference between eating habits that are abnormal and those that truly endanger one's health and lifestyle.
"I think there's a lot of disordered eating here [on the team], but not eating disorders," New said. "Of all the years that I've been associated with wrestling, there were only three people who I was aware of who I felt had an eating disorder."
He added, "Disorderly eating, that would be 90 percent of the time."
New said the wrestling program is "trying to stay on top of" nutritional issues, and that dieticians visit to counsel the team on proper nutrition. But he said ultimately dieting has less to do with the wrestling mat than it does with the outside world.
"It's more of a control issue outside of wrestling," New said. "It's about trying to be in control of your surroundings."
Sports and success
Boudette said that although athletics and eating disorders are not inherently linked, students are at higher risk of disordered eating when they play sports where weight is seen as a factor in success, such as wrestling, running and crew.
New said he was not aware of the presence of eating-disordered behavior on the current wrestling team. While acknowledging that wrestlers often feel special pressure to maintain a low weight, New said Princeton students in general tend toward "obsessive-compulsive" tendencies that prompt them to carry their drive to success to extremes.
New said he hoped any team members with disordered eating would seek medical help, but also said he felt team support was "very important" in recovery and that he would not ask a struggling wrestler to leave the team unless his disorder began interfering with performance.
He also said weight-loss measures like temporary fasting and dehydration, though not perfect, are "safer alternatives" than vomiting, adding: "It's like shooting yourself with a BB gun instead of a shotgun. The [larger] question is, should you be shooting yourself in the first place?"
New said high school and intercollegiate wrestling communities have been struggling with the problem of cutting weight for some time.
Yet research shows that these athletes are likely to ultimately harm their performance on and off the athletic field. Case studies show it is virtually impossible to maintain an eating disorder without compromising social life, health or academic function.
The starvation mode forced on the body by an eating disorder prompts patients to neglect physically nonessential activities — a practice which leads to reclusiveness, low sex drive, declining hygiene and plummeting grades.
"You just feel disgusted with yourself," Paul said. "I had, like, no sex drive. And my wrestling started going completely downhill."
Paul became increasingly withdrawn, shielding himself beneath large hooded sweatshirts and snapping at people who commented on his diet. At night, Paul and Frank used to break into the Forbes dining hall and eat ice cream with their bare hands.
"I used to eat food off the floor," Paul said. ""Those were some f—-ed-up times."
Finally, Paul decided he couldn't take it anymore.
"There's a point where you just say, 'The hell with this,'" he said. Although he said change required work and discipline, he also said success ultimately came more from changing his feelings about food than anything else.
"This was an aspect of my life that I always felt guilty about and that I didn't feel reflected the real me," said Paul, who gave himself permission to eat reasonable portions of "whatever I wanted" without guilt.
Without the food obsessions and constant deprivation of his starvation cycles, Paul has found it easier to stick to a healthy diet. His wrestling has improved dramatically, and he is socially active again.
Paul acknowledged his recovery would have been easier if he had shared the secret of his illness with others, but he was afraid the admission would make him ostracized.
"People who don't have eating disorders look at people with eating disorders like, 'what's wrong with you?'" he explained.
Paul also said he might have found it easier if he had sought help from University resources.
When a reporter asked whether Paul knew the University has programs available to help men with eating disorders, Paul looked surprised.
"I wasn't aware of that," he said. "I mean, I'm sure they have something to offer, because they offer a lot of things."
He said he had not considered the possibility that a program might be geared to his particular problem.
Yet such programs do exist.
Compared with local schools such as Ryder, Rutgers and the New Jersey Institute of Technology, the University offers expansive eating concerns services.
Through its Eating Disorders team, UHS provides confidential eating disorder evaluations, as well as short-term individual psychotherapy, nutrition counseling, exercise consultation and referral to treatment off-campus when needed.
The UHS-trained Eating Concerns Peer Educators group, composed of students, also includes two men.
Peter Tedesco '05 said he became a peer educator specifically to help with men's issues, which he said are "not really talked about" in the male community.
"The conception is that [low body image] is not something that guys should be dealing with and therefore they cannot talk about it — that it makes them effeminate or gay," Tedesco said. "Guys would have less [hesitancy] using our resources if there wasn't this stereotype."
For the past two years, the University has also held a support group specifically for males with eating disorders.
While the group's continuation this year is undecided, Boudette said such groups are helpful because they break the "sense of isolation" that goes along with eating disorders and because members help each other "see aspects of themselves."
Paul, who still wrestles for Princeton, has never shared his experience with a counselor. He knows bulimia is not just a necessary feature of athletics. He also knows the price that eating disorders can exact on one's life.
But he believes it is all behind him now.
Staff writer Christian Burset contributed reporting to this story.
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