Eating Disorders on Campus
My palms were sweating, my heart rate was increasing, and my eyes darted back and forth scanning row after row of all-you-can-eat catering trays overflowing with food options. A self-serve stir fry station, BBQ staples on another island of trays, a mile-long salad bar, desserts with a soft serve ice cream machine, and (just in case nothing else appealed) clear tubes of stale cereal, accessible by turning a small wheel to distribute into bowls. A couple girls at the dessert station lamented over the infamous “giant cookies” for which this dining hall was known.
“Did you know just one of those cookies has almost 1000 calories?!” states one.
“Omg no way- of course I had one WITH ICE CREAM last night at dinner. I’m definitely hitting the rec center after class for some cardio-compensation”, replies her friend.
“You know you can check the calories for all dining halls online?? I would be LOST without the meal calculator”, reminds the first.
An abundance of food choices (not to mention food-centered activities on campus) was just not something I was used to prior to starting college and living in a residence hall with buffet-style dining, and for the first time I was left examining the conflict of all-you-can-eat vs what-should-I-eat? Add that to culturally normalized diet talk of the mid 2000s, university-sanctioned calorie and nutrition information posted for all food offerings, and a hyperfixation on the dreaded “freshman 15”, and I found myself searching for information that would help me feel “in control” of what felt like a very out of control situation.
For many young adults, on-campus college enrollment is a time of tremendous transition and change, offering new freedoms, responsibility, and valuable education in and outside of the classroom. These abrupt lifestyle and environmental changes can be associated with the onset or exacerbation of mental health issues, including eating disorders (EDs) such as anorexia nervosa, bulimia nervosa, binge eating disorder, and orthorexia. On college campuses, students grapple with increased academic pressure, less structure, and peer-focused activities related to new social dynamics and developing friendships. For these reasons, it is perhaps not surprising that multiple studies have found that the median age-of-onset of eating disorders (EDs) occurs from age 18 to 21 years, coinciding with common years of college enrollment and newfound independence from one’s family of origin. Many college students report disordered eating habits- everything from eating minimally before consuming alcohol (either due to appearance-related anxiety or to increase the effect of drinking), skipping meals to study during exam season, or compulsive exercise habits. But when these behaviors and anxiety around food and appearance become all-consuming, they can have serious impacts on the quality of life for college students and even transform into diagnosable eating disorders with the potential for harmful, potentially fatal side effects.
It is worth including a reminder that eating disorders do not discriminate and there is no one “look” or certain type of person who is likely to develop eating disorders. In fact, harmful misconceptions that only thin, white women develop EDs contribute to disparities in care that disproportionately harm non-white students, members of the LBGTQ+ community, men, and individuals in larger bodies- who all deserve access to high quality care and prevention efforts.
There are many ways to support young adults navigating the independence and pressures of life on a college campus that could help mitigate the emerging threat of disordered eating and appearance-related challenges. University officials, families, peers, and mental health professionals all can play a role in educating, preventing, or intervening early for students who are struggling, including sharing helpful resources to make care more accessible.
If you notice yourself or peers around you engaging in common signs of disordered eating, don’t be afraid to address your concerns in a compassionate and non-judgemental way. The Center for Change offers great tips for what to say (and what NOT to say) when engaging a friend or loved one in a courageous conversation around changes you may be noticing.
Thanks to research conducted by local universities in collaboration with the Missouri Eating Disorders Council, adults age 18 or older in Missouri can access free screenings, resources, and education related to disordered eating through an online program called Body U. After taking a 5 minute survey, respondents will receive access to free, tailored online programs to meet their needs and, when appropriate, users will receive referrals to health providers. This local effort by colleges and universities demonstrates an effort to better connect students to resources, especially when counseling centers may not have adequate staff to meet growing demand.
Working with a multi-disciplinary team of professionals, including a therapist and dietician who specialize in eating disorders, can offer life changing support for those who are struggling with disordered eating and body image concerns.
For individuals struggling with an ED or newly in recovery from an ED, there may be concerns over whether to go away for college/university and risk jeopardizing recovery efforts. Putting a plan in place for expected recovery behaviors, allowing students to complete a trial run with increasing independence and control at home before going away to school, and scheduling regular check-ins can be helpful. For those struggling to make a decision regarding going away to school, here is a list of questions to ask to determine if now is the right time to enroll. Also worth remembering- if you need support or treatment, college isn’t going anywhere and it’s worth prioritizing your health and wellness to get the most out of this experience.
For students, it is important to surround yourself with body-positive resources and role models, avoid social media promoting disordered behaviors (just say no to #skinnytok ><), use compliments that don’t focus on physical appearance, avoid diet talk, and most importantly, be patient and supportive towards those who may be struggling.
College can be such an exciting time of discovery and growth, but such a dramatic transition does not come without risks and challenges. It is important to be aware of the unique risk factors that impact young adults and leave them vulnerable to disordered eating and offer compassion and support at the first sign of struggle. This is a unique phase of life where young people have the opportunity to invest in themselves, and hopefully start building an independent life full of joy, new experiences, and resilient self assurance and worth that makes life worth living.