Tuesday 27 2024

Eating Disorders: Is Your Institution Doing Enough to Help Prevent Them?

by Leah Jackson

Purple Anvil/ Shutterstock

Starting college is often viewed and portrayed as an exciting, fun-filled time -- a rite of passage for young adults. While this is true in many cases, as Erin Birely, LCPC of The Renfrew Center, reminds us, "this period is really marked by transition" as well.

Birely, a licensed clinical professional counselor who specializes in treating clients struggling with eating disorders, reminds us that transition is a known risk factor for eating disorders, which are common among college students. "A study from the National Eating Disorders Association found that between 10-20% of women and 4-10% of men in college suffer from an eating disorder," she says.

Eating disorders, according to the National Institute of Mental Health, are "serious and often fatal illnesses that are associated with severe disturbances in people's eating behaviors and related thoughts and emotions."

They can have serious effects on a student's mental and physical health, academic performance, and social engagement.

As colleges and universities grapple with the student mental health crisis, eating disorders are another related concern to watch out for. Let's examine how transitioning into a college environment can be a trigger for eating disorders and how you can aim to prevent and address them among your student population -- on both an institutional and individual level.

The Perfect Storm

"College can create a perfect storm of biological, social, and cultural factors that contribute to the development and maintenance of eating disorders," Birely explains. "On an individual level, many students have left home for the first time or have made some of the biggest decisions of their lives. There are also new social constructs and 'rules' to get used to."

As students shape identities apart from their families and friends at home and seek social connections with their new peers, they can experience a great deal of stress. There is also pressure from social media to maintain a certain appearance as well as the fear of gaining the 'Freshman 15' -- an idea perpetuated by our culture that most new students gain 15 pounds during their first year in college due to poor eating habits and food management.

"A student's identity, such as race, ethnicity, gender expression, gender identity, sexual orientation, body size, are also risk factors to eating disorders," shares Birely. "In fact, a 2019 study found that gender minority students exhibit a significantly higher prevalence of eating disorder symptoms than their cisgender peers, and another study from 2015 found that transgender college students are four times more likely to develop an eating disorder."

Deborah J. Cohan, Professor of Sociology at the University of South Carolina Beaufort and author of "The Big Book of College" (New World Library 2024), says it's also important to recognize that trauma and eating disorders often intersect.

"For example," she says, "a student who has survived sexual and domestic violence, including incest, rape, or assault, may engage in the following: binging and purging as a way to claim control of what goes in and out of one's own body; binge drinking; and using alcohol and other drugs to numb out pain and trauma or to avoid eating and gaining weight."

Helping Students

Cohan emphasizes the importance of tackling these issues early. "Just like with binge drinking on campus, which can set in motion habits that are hard to break after college, so too, disorderly eating can lead people down a path from which it is hard to recover, even years beyond graduation," she shares.

Eating disorders can present in various ways and can be hard to identify. Yet, there are some warning signs that could indicate a student is struggling with one. Birley and Cohan say that faculty members, administrative staff close to the student, and peers can watch for:

  • Increased focus on exercise, specifically prioritizing this above all else (schoolwork, time with friends, etc.).
  • Secretive behaviors specifically around food, going to the bathroom, showering, etc.
  • Markings on fingers and knuckles.
  • Grade fluctuations.
  • Social withdrawal from family and friends.
  • Mood changes, such as increased anxiety or depression.
  • Low energy/motivation.
  • Increased distress about body image, such as consistent negative body talk.
  • Failure to take care of basic daily needs.

These are certainly not the only signs, and they may not be indicative of an eating disorder, but rather another struggle. If you notice these signs, avoid any direct references to the student's weight or appearance. Instead, channel empathy and compassion, Birley recommends.

"Ask questions," she says, "such as, 'I noticed you didn't do as well on this test as some of your others, are you feeling OK?' or 'You seem a bit withdrawn, is something going on?'"

Prevention and Intervention

Colleges and universities can play an instrumental role in not just identifying/treating existing disorders but preventing them among their students. Building awareness is the first step, and education for faculty, staff, and students is critical.

"With students, I've been part of creating wonderfully inspiring campaigns on campuses about body image," Cohan says. "At my last college, we sponsored an 'Every BODY is beautiful' campaign with murals inviting people's contributions, stories, and comments. Several years ago, my sociology of the body class started writing affirmations on Post-it™ notes about body love and self-acceptance and sticking them all around campus, in hallways and classrooms and on bathroom doors, mirrors, and kiosks. Who knew a trip to the bathroom could become so affirming? It really did make people smile and spread good, healthy energy. When kind sentiments about the body radiate outward into the community, it can be a powerful, uplifting experience."

Engaging students, faculty, and staff in a campaign is just one way to build a positive culture around body image and prevent eating disorders on campus. You may also consider:

  • Creating and sharing content online related to healthy eating habits and nourishing our bodies.
  • Hosting a panel discussion, bringing experts to campus to discuss eating disorder signs, symptoms, and how to intervene.
  • Staffing counseling and health centers with professionals trained to treat eating disorders.
  • Partnering with local clinicians or treatment centers to provide additional or more intensive support.
  • Thoughtfully considering and adjusting dining hall factors that could contribute to eating disorders, such as removing displays listing calories and ensuring dining hall hours align with most students' schedules (and ensuring grab-and-go options are in place).

Remember

Unfortunately, college-aged students are particularly susceptible to developing eating disorders, which can be life-threatening if not treated. Colleges and universities can do better by their students by evaluating their roles in both prevention and treatment. As we observe Eating Disorders Awareness Week (February 28-March 5), it's the perfect time to consider sustained, year-long efforts that can support students in developing healthy eating and exercise habits and positive body image.

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