The hidden health crisis on campus: Eating disorders

Jennifer A. Smith, LICSW, Walden Behavioral Care. Copyright 2010 The MetroWest Daily News. Some rights reserved

Fewer than 50,000 cases of H1N1 were reported last year, according to the Centers for Disease Control and Prevention, yet this potentially deadly strain of flu was treated as a national emergency. In contrast, millions of college students have eating disorders, yet most of them receive little or no medical attention or psychological intervention.

When left untreated, eating disorders can lead to permanent physical damage ranging from hair loss to damage to the heart, osteoporosis and the inability to conceive. They can even result in death. In fact, eating disorders have the highest mortality rate of any psychiatric disorder, and a suicide rate that is 50 times higher than that of the general population.  Many people recover from eating disorders when they are treated at an early stage. Unfortunately, the longer eating disorders are left untreated, the more likely they are to cause serious medical and psychiatric damage symptoms.

College students – mostly women, but also a growing number of men – do not seek treatment for many reasons. They may be trying to hide their disorder due to shame. They may cope with the disorder by avoiding treatment. They may not even realize that they have a serious health problem or may mistakenly regard their disorder as something they will grow out of.  Many individuals may believe that treatment is not covered by their insurance, or they may not seek treatment because there are no treatment facilities on or near campus.

A 2010 survey of college counselors and other professionals by the Eating Disorders Recovery Center found that students did not seek treatment for the following reasons:

– Unwilling to seek treatment (82 percent)

– Do not know that they have an eating disorder (48 percent)

– Lack of awareness of treatment resources (34 percent)

– Embarrassed to seek treatment (28 percent)

– Lack of treatment resources (28 percent)

– Perceived lack of anonymity in treatment (23 percent)

– Lack of knowledge by staff about where to refer students (18 percent)

– No need for treatment (8 percent)

Because so few students seek treatment, it’s difficult to say just how serious the problem is on campus. Studies in the 1980s indicated that 4 percent to 5 percent of college students have eating disorders, but a 2006 survey by the National Eating Disorders Association (NEDA) found that nearly 20 percent of the more than 1,000 college students surveyed – both male and female – said they had or previously had eating disorders.

What to Look For

Eating disorders affect both women and men, young and old, rich and poor, yet they are especially common among women on campus. Major life transitions, such as the onset of puberty and going away to college are believed to be among the most vulnerable times for the onset of eating disorders.  To recognize whether you or a friend have an eating disorder, you’ll need to know enough to identify the most common disorders – anorexia nervosa, bulimia nervosa and binge-eating disorder.

College students with anorexia take extreme measures to avoid eating. They typically become abnormally thin, but still talk about feeling fat. They have a distorted image of their body and continue to diet, even when they are severely underweight. Other signs of anorexia include rituals around preparing food and eating, social withdrawal and pronounced emotional changes, such as irritability, depression and anxiety.  College students with bulimia typically “binge and purge.” A binge is the consumption of a large amount of food in a short time. Purging is forced vomiting, but students with bulimia may compensate for binging in other ways, such as excessive exercise, or use of laxatives or diet pills.  Binge-eating disorder is characterized by uncontrollable, excessive eating, followed by feelings of shame and guilt. Unlike those with bulimia, college students with binge-eating disorder typically do not purge their food. College students with binge-eating disorder typically are overweight or obese.

Those with eating disorders are more apt to have other psychiatric disorders and they have a higher incidence of substance abuse than the general population. A growing trend on campus, for example, is “drunkorexia,” in which coeds starve themselves during the day so they can consume large amounts of alcohol at night without gaining weight.

If you think you have an eating disorder or know someone who does, be sure to seek professional counseling immediately. Your health, or your friend’s health, may depend on it.

H1N1 is no longer a problem because it was treated as a crisis and action was taken. Given the impact they have on millions of college students, its time to treat eating disorders as a crisis, too.