Eating Disorders in College: Understanding Causes and Support Strategies

College is a transformative time for many students, but the pressure to maintain a certain appearance, combined with the stresses of academic life, can lead to unhealthy eating habits that have negative mental health issues. Understanding the prevalence, signs, and risks of unhealthy eating behaviors during college can help students and families identify, prevent or find professional support.

In this article, we will discuss what eating disorders are, their causes and what types of strategies exist to support college students.

Understanding Eating Disorders

Eating disorders represent serious mental health issues characterized by eating habits and other behaviors that can jeopardize one’s health. These conditions can profoundly impact a college student’s physical and emotional well-being. Recognizing different types and understanding their prevalence and symptoms is essential for learning how to support others or pursue support for yourself.

Types of Eating Disorders

There are several primary types of eating disorders that affect individuals.

1. Anorexia Nervosa: This involves an intense fear of gaining weight, distorted body image, and restriction of food intake resulting in a significantly low body weight.* Contrary to popular belief, anorexia nervosa can involve engagement in binge eating or purging behaviors. 
2. Bulimia Nervosa: Characterized by cycles of binge eating followed by compensatory behaviors, such as vomiting or excessive exercise. Bulimia nervosa also involves evaluating oneself based on body shape or weight (i.e. your self-worth and self-talk are based on how you feel about your body size).
   
3. Binge Eating Disorder: Involves recurrent episodes of eating large quantities of food, often while feeling a lack of control. It also involves distress concerning binge eating episodes.
4. Avoidant/Restrictive Food Intake Disorder: ARFID is an eating disorder where a person struggles to eat enough food, enough food variety, or both—but not because they want to lose weight or change the way their body looks. Instead, people with ARFID struggle to eat because of extreme sensory sensitivities, fear of a bad outcome from eating, or lack of interest in eating. Just like other eating disorders, ARFID can result in serious consequences for mental and physical health.
   
5. Other Specified Feeding or Eating Disorders (OSFED): This category includes atypical symptoms that do not fully meet the criteria for the above disorders but still pose risks.

Understanding eating disorder symptoms and the differences between each disorder is crucial for recognizing the unique challenges each disorder presents.

Epidemiology in The College Population

The prevalence of eating disorders among college students is significantly increasing. One study found that eating disorder risk increased by 13% from 15% in 2013 to 28% in 2020/2021¹.

Key Factors Include:

• Age: Cases arise younger than most people think. A 2023 worldwide study found that 22% of children and adolescents show disordered eating^[2].
• Gender: Although more common in women, men are increasingly affected^[3]. 
• Environmental Influences: Academic pressure, body image perception, and social media impact contribute significantly.

Considering these factors, it is clear there is a need for increased awareness and resources on college campuses.

Common Signs and Symptoms

Recognizing the signs of eating disorders is vital for early intervention. Common symptoms include:

• Physical: Noticeable weight changes, fatigue, irregular menstrual cycles in women, or gastrointestinal issues.
• Behavioral: Avoidance of social situations involving food, excessive exercise, or secretive eating patterns.
• Emotional: Increased anxiety, depression, and preoccupation with body image or weight.

Awareness of these symptoms can assist peers and professionals in supporting individuals struggling with eating disorders to get the help they need.

Risk Factors for College Students

Multiple factors contribute to the risk of developing eating disorders among college students. These include psychological vulnerabilities, sociocultural pressures, and biological influences. Understanding these elements can inform prevention and intervention strategies.

Psychological Factors

Many college students experience significant emotional stress. This stress often stems from academic pressure, limited support system, social expectations, and transitions into adulthood.

Common psychological issues linked to eating disorders include:

• Anxiety: Students may struggle with social anxiety, leading to disordered eating as a coping mechanism.
• Depression: Feelings of hopelessness can manifest in unhealthy eating behaviors or restrictive diets.
• Low Self-Esteem: Poor body image and dissatisfaction with one’s appearance may prompt unhealthy weight control practices.

Counseling services and mental health support are essential for addressing these factors.

Sociocultural Influences

The college environment is rife with messages about body image and physical appearance. In an effort to fit in and build relationships, many college students feel the pressure to meet cultural standards that often idolize thinness. 

Key sociocultural factors include:

• Peer Pressure: Desire to fit in can lead individuals who dislike their body to adopt harmful eating habits.
• Social Media: Continuous exposure to idealized body images can distort self-perception and promote unhealthy behaviors. Bombardment with people promoting diets, exercise routines, or other weightloss products can also lead people to develop an unhealthy relationship with food. 

Athletic Culture: Students involved in sports may feel compelled to maintain strict diets or weight control for performance.

Biological and Genetic Contributions

Genetic predisposition plays a role in the development of eating disorders and family history can indicate a higher risk [4] [5]. Students with relatives who have also struggled with disordered eating or with the issues below may be more vulnerable.

Understanding these biological underpinnings is vital for developing targeted treatment approaches. It can also help individuals understand their own risk for developing an eating disorder. 

Impacts on Health and Academic Performance

Eating disorders in college students can lead to significant consequences for both physical and mental health. These issues can directly affect academic success and overall campus life experiences.

Physical Health Consequences

Eating disorders can result in severe physical health issues. Nutritional deficiencies may develop due to inadequate intake of essential vitamins and minerals. This can lead to fatigue, weakened immune systems, and increased susceptibility to illnesses.

Other consequences include:

• Weight fluctuations: Unintentional weight loss or gain can impact physical well-being.
• Gastrointestinal issues: Disorders can cause severe digestive problems, including bloating and constipation.
• Cardiac complications: Strain on the heart may arise, especially in extreme cases of anorexia or binge eating.

Long-term effects can be serious, requiring medical intervention.

Mental Health Challenges

The toll on mental health is often profound. Students with eating disorders frequently experience anxiety, depression, and low self-esteem. These psychological issues can exacerbate the eating disorder and contribute to a cycle of negative thoughts and behaviors.

Key mental health challenges include:

• Social withdrawal: Individuals may isolate themselves from peers, decreasing support networks. At times, this isolation begins as individuals avoid events where food is present or will be a focus of spending time with others. 
• Cognitive impairments: Focus and concentration may suffer, affecting problem-solving abilities and one’s ability to study. 
• Increased stress: Constantly managing food-related thoughts can lead to chronic stress and burnout.

Effects on Learning and Campus Life

Academic performance often suffers due to the impact of eating disorders. Students may struggle to attend classes regularly or complete assignments on time. Their ability to participate in group projects or campus activities can be limited.

The effects on learning include:

• Poor grades: College can be a formidable challenge for many students, even with adequate nutrition. Electrolyte imbalances, malnutrition, and other physical symptoms can impact a student’s ability to focus and efficiently memorize material. 
• Campus engagement: Participation in social events may decline, leading to a sense of isolation. This can also impact the presence or building of friendships, which are an important protective factor. 

Involvement in campus life is vital for a well-rounded college experience. Eating disorders can hinder this facet of student life.

Prevention and Education

Educating college students about eating disorders and promoting a healthy environment is crucial. Implementing awareness campaigns, early intervention strategies, and fostering a positive body image can significantly reduce the incidence of these disorders.

Awareness Campaigns on Campus

Awareness campaigns serve as a vital tool for educating students about eating disorders. Colleges can organize workshops, seminars, and information booths that focus on signs, symptoms, and resources for help.

Posters and social media campaigns can effectively disseminate crucial information. Using compelling statistics and personal stories can create connections and motivate students to engage.

Additionally, involving student organizations can enhance outreach efforts. Encouraging peer-led initiatives helps in reaching more students and fostering a supportive community.

Early Intervention Strategies

Early intervention plays a key role in addressing eating disorders before they escalate. Colleges should establish confidential counseling services where students can seek help without fear of stigma.

Training faculty and staff to recognize warning signs is essential. They can serve as first responders who guide students toward professional help. It is recommended that student workers who help manage student housing should be included in these trainings.

Creating a network of support is also important. Peer support groups can provide a safe space for students to share their experiences. These groups can help normalize conversations around mental health and eating concerns.

Promoting Healthy Eating and Body Image

Promoting healthy eating and a positive body image can mitigate the risk of eating disorders. Colleges should offer nutrition workshops that teach students about balanced diets and mindful eating practices. 

Incorporating wellness programs that focus on mental health can create a more holistic campus environment. Activities such as yoga, exercise classes, and stress management sessions are beneficial.

Encouraging diverse representations of body types in media and campus events is also important. This approach fosters acceptance and positivity, helping students embrace their individuality while promoting health.

Treatment and Support Options

Access to treatment and support is crucial for students facing eating disorders. This section outlines the key resources available both on and off campus, as well as peer support options that can facilitate recovery.

On-Campus Resources

Many colleges offer on-campus resources specifically designed to address eating disorders. These typically include counseling services where students can receive therapy tailored to their needs.

Counselors often provide:

• Individual Therapy: Personalized sessions focusing on emotional and psychological aspects.
• Group Therapy: Supportive environments where students share experiences and coping strategies.
• Nutrition Counseling: Guidance from registered dietitians on developing healthy eating habits.

Most campuses also host workshops and seminars that promote awareness and education about eating disorders, creating a supportive community.

Off-Campus Healthcare Services

In addition to on-campus offerings, students can seek off-campus healthcare services for more specialized treatment. This often includes outpatient clinics or private practices that specialize in eating disorders. Many healthcare providers also accept insurance, making these treatments more accessible.

Key services available might include:

• Inpatient Treatment: For those needing intensive care to address medical instability, often provided in a hospital setting.
• Residential Programs: For those who are medically stable, but struggling to manage eating disorder behaviors in a way that places them at risk for becoming medically unstable.
• Partial Hospital and Outpatient Programs: Allow students to participate in therapy while continuing their studies. Gives individuals the opportunity to practice coping skills and manage eating disorder behaviors in a more independent manner. 
• Support Groups: Regular meetings with peers and facilitators to share experiences and strategies.

Peer Support and Student Organizations

Peer support plays a vital role in recovery from eating disorders. Many universities have student organizations dedicated to mental health and wellness, providing a platform for students to connect.

These organizations offer:

• Support Networks: Students can find companionship and understanding through shared experiences.
• Events & Workshops: Educational events focused on body positivity and mental health awareness.
• Peer Mentoring: Opportunities to be paired with mentors who have successfully navigated similar challenges.

Engagement in these groups fosters a sense of belonging and can significantly alleviate the struggles faced by students.

Recovery and Management

Recovery from eating disorders in college involves establishing a balanced approach to nutrition, implementing effective strategies, and engaging a support system. These elements are crucial for a sustainable recovery journey.

Developing a Healthy Relationship with Food

Establishing a healthy relationship with food is essential for recovery. This involves changing one’s mindset about food and nutrition. Individuals are encouraged to adopt intuitive eating^[6], which focuses on listening to bodily hunger cues rather than strict dieting.

Learning to cope with and reduce anxiety related to specific foods or groups of foods is an important part of the recovery process. This can often look like working alongside a mental health professional and registered dietician in exposure exercises; during these exercises, individuals practice managing their anxiety with specific foods until it is no longer stressful to consume. An ongoing attitude of self-compassion and mindfulness during meals can be beneficial in this process. 

Role of Family and Friends in Recovery

Family and friends play a pivotal role in the recovery process. Their support can create a safe environment for discussing challenges. Open lines of communication are critical; peers should feel empowered to express concerns about eating habits without causing additional stress.

Encouragement to participate in uplifting activities or healthy meals can foster a supportive atmosphere. Families can educate themselves on eating disorders to understand what their loved ones are experiencing. Establishing regular check-ins can help maintain connection and support, making recovery feel less isolating.

Advocacy and Policy

Advocacy and policy play crucial roles in addressing eating disorders within college campuses. By establishing supportive frameworks, institutions can better protect and assist students facing these challenges. The following aspects are vital to understanding campus approaches to this issue.

Campus Policies on Eating Disorders

Many colleges and universities are implementing specific policies aimed at addressing eating disorders. These policies often include guidelines for prevention, intervention, and treatment. Institutions may create task forces to monitor the prevalence of eating disorders and assess the effectiveness of current resources.

Policies should outline the roles of counselors, faculty, and peers in supporting affected students. Colleges should provide training programs for staff to recognize signs of eating disorders, aimed at facilitating early intervention. By having clear reporting mechanisms, students can access necessary help without stigma or fear of repercussions.

Student Rights and Accommodations

Students struggling with eating disorders are entitled to certain rights and accommodations under disability law. Institutions must provide necessary support to ensure equal access to education. This can include modified meal plans, flexible scheduling for classes, or mental health services tailored to individual needs.

Colleges are required to provide reasonable accommodations that do not fundamentally alter programs. Students can advocate for their rights through disability services. Awareness of available services is essential; students should be encouraged to seek assistance without fear of discrimination or judgment.

Fostering Inclusive Environments

Creating an inclusive environment is essential in combating eating disorders on campus. Colleges should promote body positivity and mental health awareness through workshops, campaigns, and events. Engaging student organizations can foster peer support networks that empower individuals to share their experiences and challenges.

Education about healthy body image should start early, integrating these discussions into orientations or first-year courses. Institutions can partner with local organizations that specialize in eating disorder awareness. By creating an open dialogue, colleges can diminish the stigma surrounding eating disorders, encouraging more students to seek help.

CONCLUSION

College students face body image issues exacerbated by societal expectations and the campus environment. This struggle can manifest in various ways, including restrictive eating, binge eating, excessive exercise, and/or purging. Awareness of these behaviors is crucial for peers, faculty, and administrators who can play a role in supporting those in need. Knowledge of eating disorders can also foster a culture of support and understanding among the student body.

If you or someone you know seems to be struggling with disordered eating, it is helpful to know what on-campus resources you can refer them to. Campus resources, like counseling services and support groups, are vital in addressing these challenges as they provide a supportive setting to start the recovery journey. Knowing there are nearby resources can also empower students to seek assistance early, promoting both mental and physical well-being. 

*If you are concerned you might meet diagnostic criteria for anorexia nervosa, specifically related to if your weight loss is “significant,” please meet with a doctor, a dietician, or a therapist who specializes in eating disorders to discuss further. 

When to Seek Help 

Destination Therapy provides a safe space to communicate openly, address challenges, and revisit past experiences that lead to generational trauma. Whether you are a busy professional dealing with perfectionism, trauma, burnout, and anxiety or looking to explore if therapy can help you have a happier life, we can match you with one of our therapists, who will be able to help with your concerns. 

If you’re ready to explore therapy, we offer a free 15-minute consultation call to discuss your needs and see if couple therapy is right for you.

Resources

National Eating Disorders Association

Confidential eating disorder screening tool from NEDA

Homepage

Sources

[1] Daly, M., & Costigan, E. (2022). Trends in eating disorder risk among U.S. college students, 2013-2021. Psychiatry Research, 317, 114882. https://doi.org/10.1016/j.psychres.2022.114882

[2] López-Gil, J. F., García-Hermoso, A., Smith, L., Firth, J., Trott, M., Mesas, A. E., Jiménez-López, E., Gutiérrez-Espinoza, H., Tárraga-López, P. J., & Victoria-Montesinos, D. (2023). Global Proportion of Disordered Eating in Children and Adolescents. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2022.5848

[3] Gorrell, S.,& Murray, S. B. (2019). Eating disorders in males. Child and Adolescent Psychiatric Clinics of North America, 28(4), 641–651. https://doi.org/10.1016/j.chc.2019.05.012

[4] Westwater, M.L., Mallard, T.T., Warrier, V. et al. Assessing a multivariate model of brain-mediated genetic influences on disordered eating in the ABCD cohort. Nat. Mental Health 1, 573–585 (2023). https://doi.org/10.1038/s44220-023-00101-4

[5] H. J. Watson et al., “Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa,” Nature Genet., vol. 51, no. 8, pp. 1207–1214, online Jul. 15, 2019, https://doi.org/10.1038/s41588-019-0439-2.
[6] https://www.intuitiveeating.org/about-us/10-principles-of-intuitive-eating/