The freshman 15 is something of lore on most college campuses. Rumor has it that students gain 15 pounds once they go to college. Weight gain is often attributed to what food selections students make, stress, and alcohol consumption. While the freshman 15 doesn’t always happen, weight gain is something many students are concerned about, especially if they have a past history of struggling with body image.
As of 2005, the National Institute of Health estimated that over 10 million people suffer from eating disorders. Though there are a variety of eating disorders, the two most commonly talked about are anorexia and bulimia. Anorexia is typically characterized as self starvation and an extreme fear of weight gain. Bulimia usually consists of binge eating over a short period of time followed by purging (usually in the form of vomiting, laxatives, diuretics, or excessive exercising). Despite that anorexia and bulimia are the two most commonly talked about eating disorders, there are numerous other practices that fall into a spectrum of disordered body image or eating that are equally as unhealthy and dangerous.
One concern parents often express is how they can tell the difference between an eating disorder and a diet. Here are a few ways that may begin to help parents consider the differences:
|Dieting is about losing a little bit of weight in a healthy way.||Eating disorders are about trying to make your whole life better through controlling food and eating (or lack of).
|Dieting is about doing something healthy for yourself.||Eating disorders are about how life won’t be good until a bit (or a lot) of weight is lost, and there’s no concern for what kind of damage you do to yourself to get there.|
|Dieting is about losing some weight in a healthy way so how you feel on the outside will match how good you already feel on the inside.||Eating disorders are about being convinced that your whole self-esteem is hinged on what you weigh and how you look.|
|Eating disorders are about attempting to control your life and emotions through food/lack of food.|
The trickiest thing about eating disorders is that they are about control. The person struggling with the eating disorder believes that he or she is completely under control by controlling the amount of food eaten, exercising until all of the calories consumed are burned, and other control mechanisms. This fallacy of control is one of the reasons that when confronted about an eating disorder, the person may get defensive, angry, or reassert how in control they feel they are. This false sense of control is also why it is hard for anyone suffering with an eating disorder to get help until they truly want help.
What Signs Might You See?
Eating disorders are often very secretive. Part of this goes back to control—if others know that someone has an eating disorder, they may try to stop it, which would result in a loss of control. Parents may suspect that their student is struggling, but may not know what to look for. Here are a few signs you may see:
- Excessive layering of clothing, either because the person is trying to hide their body shape and/or they are cold all of the time due to low body weight.
- Exercising constantly to burn off the calories consumed that day; people will tell you how frequently someone goes to the gym or runs.
- Odd food rituals such as eating only certain types of foods, cutting food into tiny, tiny pieces and moving them around a lot, but not actually eat anything, hiding food to avoid eating it (dropping into a napkin, etc), refusing to eat in public places or with other people, chewing and then spitting out food, cooking a lot of food for others but refusing to eat any of it, etc.
- Lowered immune system due to the body’s systems slow down as a result of a lack of fuel in addition to self preservation. The body loses the ability to fight off diseases and illness, resulting in people getting sick all of the time. Blood pressure also gets lowered, which sometimes results in frequent fainting.
- Exhaustion because of a lack of food to fuel and energize the body. Often times, even though a person is exhausted, they still struggle to sleep.
- Thinning hair or hair loss as a result of a lack of nutrients.
- Some women may lose their menstrual cycle
- Large fluctuations in their weight due to binging and purging.
- Because of the purging that often follows eating, people will try to find a bathroom that is secluded, away from others, so no one will know what they are doing. Throwing up in the shower is another method as the sound of running water hides the sound of vomiting. If this happens, you may see something that looks like kitty litter over the top of the drain. This is the undigested food that was not washed down.
- Food may disappear or be hidden so they can binge with it at a later time. A sufferer will often hide or “store” food for later binges, will often eat secretly.
- Throwing up frequently exposes teeth to stomach acid that can strip the enamel off of teeth, which often results in staining.
- Frequent sore throats/swollen glands/blood shot eyes as a result of purging.
A Gender Neutral Issue
Of the 10 million cases of eating disorders in the US, an estimated 1 million are in men. While some cases of eating disorders in males may mirror the systems and thought patterns of females with eating disorders, one difference may be that rather than thinking in terms of “thin” and “fat”, males may think in terms of “strong” and “weak” with fat being representing someone that is weak or unmanly. Men who compete in sports where body shape or size are important such as figure skating, crew, gymnastics, dance, wrestling and others may be at a greater risk for eating disorders. A major challenge for men with eating disorders may be that health professionals do not recognize the signs in men. This is compounded by the fact that men may be reluctant to seek treatment due to embarrassment or social stigmas about seeking help or “manning up” when faced with issues. Another challenge is that treatment programs are often focused on females, so men who do seek help may struggle to find a facility that can help them.
Signs of eating disorders in men often include:
- Obsessive preoccupations with body size or shape.
- Binging or purging.
- Restricting the types of foods consumed.
- Frequent over exercising.
- Using products or supplements to bulk up.
- Frequent fluctuations in weight.
Talking to Your Student
If you are concerned that your student may be struggling with an eating disorder, finding the right words to express your concerns is often challenging. One of the best ways of framing this conversation is to talk about body shape or weight loss in terms of health rather than in terms of weight loss. Because eating disorders are a twisted way of manifesting control, when a person hears that you have noticed weight loss, he or she may see this as a sign of success rather than unhealthiness. Be compassionate in bringing up the topic. Mentioning that you are concerned about their health while coupling the statement with specific examples of behaviors that you have noticed is a good way to start the conversation. For example, “I’m concerned about your health. I have seen your weight decrease to what appears to be an unhealthy level over the last month. I also noticed that you eat less and less all of the time.” Be prepared for an angry response. Because eating disorders are about control, confronting someone may feel like you are trying to take control. Let the person know that you are open to talking more about this. Give the person time while also being patient and supportive. Constant monitoring or policing of food will often cause more secrecy. While it may be easy to fall into a pattern of careful watching, be cautious about hovering, constant monitoring, or policing of eating practices as this often causes greater anxiety and more secrecy.
Eating disorders are not something that simply are “cured” or “go away.” They often require owning work to help the person struggling develop the self-care and coping skills necessary to be successful long term. For those who have taken steps to learn healthy coping mechanisms, times of life transition or stress can often trigger students to revert to old patterns.
Treating eating disorders is often a multipronged approach, as the issue itself is often faceted. The physical health aspect often requires medical treatment by a doctor or nurse practitioner. Therapists, psychologists and/or psychiatrists are vital to helping students deal with the mental health issues, thought patterns, and triggers that accompany eating disorders. Dieticians and nutritionists are crucial to helping students develop healthy eating patterns that will fuel their bodies. Persons with eating disorders often feel more confident finding practitioners that have previous experience with eating disorders rather than clinicians who do not specialize in the disorders. Treatment of eating disorders frequently involves family members also. Active engagement on the part of family can often promote much more success than non-engagement.
Eating disorders rarely are something that is “cured.” Rather, they are controlled and managed throughout a person’s lifetime. For students who come to college having already battled an eating disorder, it may be important to establish practitioners in Spokane who can aid students during the many stresses and changes that college often brings. The DREAM office on campus is available to help students identify resources available to them on and off campus, and talk with students about if an accommodation plan may be appropriate. Sodexo also has a registered dietician on staff who can help any student consider the nutritional value of the food choices they are making on campus. Students who are planning to study abroad may also benefit from seeing past practitioners prior to their departure as the types of food, eating patterns and treatment of eating disorders are often very different in other countries.
For various resources regarding eating disorders, please see any of the resources below:
- CHER Spokane, Eating Disorder Resource Guide
- Inland Northwest Coalition on Eating Disorders (INCED)
- In Health Northwest magazine, Treating Eating article
- National Eating Disorders Association
- Something Fishy Website on Eating Disorders
- National Institute on Mental Health
- Mayo Clinic