An estimated 30 million Americans will struggle with an eating disorder in their lifetime, and a significant number of them begin on college campuses.
College is a high-risk period for the onset of eating disorders. Transitioning into a new environment is exciting for young adults, but it also comes with stressors, challenges, and potentially troubling life events that could be triggers for eating disorders. Many college students experience problems such as isolation, homesickness, academic pressure, difficulties negotiating conflicts with roommates, intense peer pressure, or trauma.
For many students, college is also the first time they have the freedom and responsibility to make their own food choices. It can be an anxiety-provoking experience, especially in residence halls where eating is such a public event. People with eating disorders can be affected by social comparison, competition, and self-consciousness when people from such diverse backgrounds live together.
What Can Trigger Eating Disorders in College?
Triggers are stimuli that evoke intense, uncomfortable, and often upsetting emotions. They can “trigger” a negative reaction – social, situational, environmental, psychological, or physiological. When individuals are triggered, they move quickly into a reactive state, ready to find a distraction, relief, or escape. When triggered, those suffering from eating disorders are compelled to act on disordered thoughts and feelings. The campus environment is rife with challenging situations that could potentially trigger students.
Eating disorders are caused by a variety of factors, including biological, psychological, and social ones. These illnesses may be especially prevalent among college students due to the following:
- Change/loss of control: Students will be introduced to newfound independence and increased responsibility in college, along with changes to almost every aspect of their lives. They’re being introduced to multiple unfamiliar environments like living with new roommates, losing personal space and privacy, and having a busy schedule that may be hard to keep up with. When change occurs, humans tend to equate comfort and safety with self-regulation. As a result, if life becomes disordered and erratic, the urge to micromanage increases. To compensate, they might develop rigid rules around one area of their life that they can control – eating. This situation creates a perfect storm for eating disorders to materialize and strengthen, with strict regulation of food, weight, and exercise creating the illusion of control.
- Academics: Naturally, worrying about grades, keeping up with schedules, and the stress of studying affects every student. The main reason students are at college is for their academics, so it’s no shock that this is a huge factor in stress in the college environment. If a class becomes too overwhelming, it can trigger an eating disorder because of the need for control and stability.
- Social circles: Creating a friendship group in college isn’t easy – putting yourself out there and socializing with strangers in search of like-minded people can be daunting. College is about exploring and learning more about yourself, but anxiety can play a factor here for fear of rejection or judgment. Depending on the social circle students create for themselves, their mental health may depend on how friends treat them. It can be stressful if there is significant peer pressure to drink or partake in other activities that may be uncomfortable. There could also be pressure to conform when joining social organizations like sororities and fraternities. All these things could potentially trigger an eating disorder.
- Loneliness: Students, many of whom may feel alone in these struggles, might isolate or withdraw and not get the help they need. Human beings typically need socialization, so spending most of our time alone can cause depression, a drop in self-esteem, and overthinking specific situations. If a student is attending college far from family, homesickness can also affect their state of mind. When separated from parents and a direct support system, struggles may not be noticed immediately, allowing the problem to persist. These emotions and feelings of loneliness can open the door to an eating disorder, and triggers can become hard to ignore.
- Access to food: For the first time for most young adults, college students have to fend for themselves when it comes to eating. They may pay for meals through the school’s cafe, cook on their own, or eat out – regardless, the paradox of choice weighs heavily on someone, especially if they’re dealing with an eating disorder. Choosing what to eat or what not to eat can be incredibly difficult, and with no one there to offer guidance, the choices can be overwhelming. Students may eat more than they want or eat barely enough for nourishment. The food environment is different too – students who had previously been restricted at home may find the availability of food to be a trigger for binge eating. Students who are rigid in their eating may be anxious about the food in the dining hall and their lack of control over their food compared to what they previously had at home.
- Weight loss trends: With social media usage at an all-time high, eating and weight-loss trends have emerged exponentially, putting ideas into people’s heads about nutrition that may not be healthy. The number of weight management options can be staggering. There may also be peer pressure to partake in the latest trends, which is hard to resist. With so many mixed messages about diet and nutrition, there is a risk of making unhealthy choices or following unproven advice – which could lead to bad long-term habits.
Common Eating Disorders in College Students
College students have much higher rates of disordered eating – from 20% to 67%. There are many types of disordered eating, including restrictive, compulsive, and irregular eating. The most commonly diagnosed eating disorders on college campuses are anorexia nervosa, bulimia nervosa, and binge eating disorder.
Anorexia nervosa, characterized by minimal food consumption and weight-related misconceptions, is among the most common. Anorexia nervosa has two types: restrictive and binge-purge. In addition, it is not uncommon for anorexics to exhibit extreme thinness and extreme fear of gaining weight.
Bulimia nervosa is also a common eating disorder characterized by binge-eating episodes, purging, and feeling out of control while maintaining an average weight or being overweight. Common symptoms are gastrointestinal problems, chronically inflamed and sore throat, worn tooth enamel due to stomach acid exposure, and severe dehydration from purging.
Another eating disorder that is becoming increasingly prevalent is binge eating disorder. This condition is characterized by a feeling of lacking control over one’s eating and not following binge episodes with extensive weight loss attempts. There are several symptoms of binge eating disorder, including eating large amounts of food in a short period, eating alone in secret, eating fast during binge episodes, and eating until feeling bloated.
Who is Affected and What Are Some Warning Signs?
Eating disorders can affect people of any age, race, gender, or sexual orientation. Although eating disorders are often diagnosed in teens and young adults, many people are first diagnosed in their adulthood.
Men and Women: Although eating disorders are more prevalent in females than males, the prevalence among males has increased over time.
- In female college students, the problem affects approximately 10% to 20%.
- In male college students, the problem affects approximately 4% to 10%.
Members of LGBTQ+
- The national survey results found an astonishingly high prevalence of eating disorders in young LGBTQ people from varied backgrounds. Of the LGBTQ youth surveyed, 54% have been diagnosed with eating disorders with an additional 21% suspect they had an eating disorder.
- It is estimated that eating disorders are underdiagnosed among LGBTQ youth due to medical professionals misassessing and misunderstanding their presentation.
- Aesthetic sports, such as wrestling, dance, gymnastics, swimming, and track, are at higher risk of eating disorders because they have to follow strict diets to maintain weight requirements. However, eating disorders still affect athletes in all sports and levels of competition because, as in any sport, athletes need to train heavily at the gym, practice their craft, and maintain discipline regarding nutrition and food.
- In collegiate athletes, up to 84% engage in maladaptive weight-control behaviors, such as binge-eating, excessive exercise, strict dieting, fasting, self-induced vomiting, and supplementation with weight loss products.
Symptoms of Eating Disorders in College Students
Symptoms and behaviors of eating disorders may be present in disordered eating but at a lower frequency and severity than in eating disorders. A person with an eating disorder may experience the following symptoms:
- Losing weight by skipping meals or eliminating food groups entirely
- Obsessive thoughts about food and/or body
- Avoidance of eating with peers or in dining halls
- Daily exercise that exceeds one hour (except for sports conditioning) or feeling guilty for taking days off from exercise
- Overeating in a short amount of time and feeling out of control
- Weight loss
- Restricting food before drinking alcohol to reduce drinking’s weight impact
Family and friends may not be able to see these symptoms if students are attending college away from home. As a result, eating disorders can develop and become more severe before others can intervene to offer help. Parents should maintain open, frequent communication with students and closely observe their behavior when home on breaks, seeking immediate help if there are any concerning symptoms.
Trigger Management Tips
Triggers occur when stress begins to accumulate in daily life. Although stress can sometimes be beneficial, producing a boost that provides the drive and energy to help get through challenging situations like studying for exams, it can also trigger disordered eating behaviors.
It is possible to reduce the negative health consequences of stress by finding positive, healthy ways to cope with it when it occurs. For example, eating disorder triggers can be conquered with the help of numerous stress management tools.
Help Them Learn to Identify Their Feelings
By identifying the emotion they’re experiencing, students can figure out the root of the trigger — helping them manage the sudden rush of emotions. When managing eating disorders and triggering events, being in touch with inner feelings is crucial. The next step is deeper introspection. Self-talk can help, such as:
- “Okay, I’m feeling this emotion right now.”
- “What else is going on with me?”
- “What do I need right now?”
- “How can I best take care of myself right now?”
- “How do I address this?”
Share a Self-Help Strategy such as the ACCEPTS Approach
By following each letter of the word and trying different options, students can help soothe themselves and dilute the innate fear induced by their eating disorder.
- A – Activities: Try coloring, hanging out with someone they trust, taking a walk around campus, watching a movie, doing dishes, or reading something they’re interested in.
- C – Contributing: Whether they’re volunteering at a shelter, helping a friend, or opening a door, making a difference around them can help their mental state.
- C – Comparison: Allow them to notice how much better they are now compared with other stressful or triggering situations they’ve had to deal with before.
- E – Emotions: Elicit a new emotion. Have them put their feelings into words or art by writing in a journal, painting, drawing, coloring, or listening to inspirational music.
- P – Pushing Away: Shelve it. They can revisit the distressing thoughts and emotions later when they are calmer or around someone they trust.
- T – Thoughts: Direct thoughts away from the trigger by counting something, writing helpful affirmations down, thinking about something that makes them happy, or reading a self-help article or book.
- S – Sensations: Try and immerse them in the sensations that the Earth provides. Enjoying a warm bath, placing their face in ice water, trying aromatherapy, getting a massage, going outside and smelling the fresh air, and feeling the grass between their toes are all helpful options.
Offer Options for Eating a Balanced Diet
Students having difficulty deciding what to eat should start with small changes and strive for a healthy balance. Remind them to grab a snack that includes protein, carbs, and essential vitamins. Apples, peanut butter, blueberries, turkey slices, eggs, yogurt, rice, avocado, and fish are great places to start.
Aid in Reframing Negative Thoughts
To combat negative thinking patterns, coming up with specific examples to counter stressful thoughts can be beneficial. When there is a negative thought, have them write it down and try to find a more positive way to express how they’re currently feeling. By allowing their mind to establish new habits, they’ll overcome negative thought patterns more effectively.
- Instead of, “I am not worth anything.” Try saying, “I am valuable, and I have plenty to give this world.”
- Instead of, “I want to give up.” Try saying, “I need to try a new strategy.”
- Instead of, “This is as good as I’m going to get.” Try saying, “I can always get better if I keep at it.”
- Instead of, “I’m fat and ugly, and no one will love me.” Try saying, “I am learning to love and accept myself just as I am.”
- Instead of, “I’m never going to be good enough.” Try, “I’m finding this hard right now, so I need to be especially gentle with myself today.”
- Instead of, “I’m damaged and broken.” Try saying, “I’m healing and rediscovering myself.”
Become A Reliable Support Network For Them
When triggered, this is a crucial time for them to reach out to someone in their support network. No one should have to battle their eating disorder alone. If students are feeling particularly vulnerable, reaching out to someone could alleviate some of the shame and isolation they’re feeling. It helps if family or friends share with students how they may want to help them, whether they need someone to just listen, engage in fun activities to distract them, or help them find an alternative coping skill.
Offer Compassion and Understanding
Students can prevent themselves from dwelling on school pressures to such a paralyzing extent by taking time away from the relentless pace of academic life and focusing on their health. Engaging in a self-care activity is one of the best things they can do if they’re feeling triggered. Often, when people feel triggered, they blame themselves for their feelings. It is at this point that self-compassion becomes especially important. Instead of watching your child avoid unhealthy coping behaviors, consider ways to show them kindness today. Working towards recovery from an eating disorder takes strength, courage, and commitment, so they deserve to honor themselves for the hard work they’re putting in.
Early Intervention is Essential
If you or someone you know may be struggling with an eating disorder, especially if they’re in a developmental stage in their life such as college, getting help right now is the best way to ensure it doesn’t get more severe. If you have any questions, need more information, or just need someone to talk to, please don’t hesitate to call us at 855-808-4213 or contact us online.
- The Trevor Project, National Eating Disorders Association, & Reasons Eating Disorder Center (2018). Eating Disorders Among LGBTQ Youth: A 2018 National Assessment.
- Clifford, T., & Blyth, C. (2018). A pilot study comparing the prevalence of orthorexia nervosa in regular students and those in university sports teams. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 24(3), 473-480.