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Diet or Eating Disorder?

By: Nicola Miller, Center for Cura Personalis

The “freshman 15” is something of lore on most college campuses, referring to weight gain experienced by many new college students.  This weight gain is often attributed to stress, alcohol consumption, and the new and unlimited food selections available to many students.  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 ten 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 by 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.

Because eating disorders are often very secretive, concerned parents can have difficulty telling the difference between an eating disorder and a diet.

What Signs Might You See?

Anorexia:

  • 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.
  • 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 eating anything; hiding food to avoid eating it, such as secreting it into a napkin; or refusing to eat in public places or with other people.
  • Lowered immune system due to a slowing down of the body’s systems; this slowing down is the body’s way to preserve what little fuel it is receiving.
  • Frequent fainting, which is sometimes a side effect of decreased blood pressure.
  • Exhaustion due to a lack of food to fuel and energize the body.
  • Thinning hair or hair loss as a result of a lack of nutrients.
  • Loss of menstrual cycle (or delayed onset) in some girls and women.

Bulimia:

  • Large fluctuations in weight.
  • Because of the purging that often follows eating, bulimics will try to find a bathroom that is secluded, away from others, so no one will hear what they are doing.  Throwing up in the shower, where the sound of running water masks the sound of vomiting, is another method of maintaining secrecy.
  • Unaccounted disappearing of food, which can be stockpiled for binging at a later time.
  • Stained or decaying teeth, caused by frequent vomiting which exposes teeth to stomach acid that can strip enamel off teeth.
  • 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.  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.

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 to frame this conversation is to talk about body shape or weight in terms of health rather than in terms of weight loss.  Be compassionate in bringing up the topic.  A good conversation starter could be to mention that you are concerned about their health, and couple that with specific examples of behaviors that you have noticed.  Be prepared for an angry response.  Give the person time to digest what you’re saying, while also being patient and supportive.   While it may be easy to fall into a pattern of careful watching, be cautious not to constantly hover or monitor their eating practices, as this often causes greater anxiety and more secrecy.

Getting Help
Eating disorders often require ongoing work to help the person struggling develop the self-care and coping skills necessary to be successful long term. Even 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.

Treatment for eating disorders often employs a multipronged approach, as the issue itself is often multi-faceted.  The physical health aspect requires medical treatment by a doctor or nurse practitioner, while therapists, psychologists and/or psychiatrists are vital to helping students deal with the mental health issues and thought patterns that accompany eating disorders.  Dieticians and nutritionists are crucial to helping students develop healthy eating habits. The active involvement of family members in the treatment process has been shown to increase success rates for “recovery.”

Eating disorders are rarely “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 a relationship with practitioners in Spokane who can aid students during the many stresses and changes that college brings. The Center for Cura Personalis on campus is available to help students identify resources available to them on and off campus, and the DREAM office can talk with students about the appropriateness of an accommodation plan.  ZagDining also has a registered dietician on staff that can help any student consider the nutritional value of the food choices they are making on campus.

Resources regarding eating disorders:

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