The college years can be an exciting time of new opportunities and increased freedom. However, the transition to college can also present challenges as students adjust to living away from family, negotiating new relationships and coping with academic pressures. Another challenge of college life is assuming more responsibility for eating habits, including making choices in the dining hall and dorm and deciding when to eat in the middle of a busy schedule. The transitions of college and the increased autonomy in all of these areas can be very demanding. For those individuals predisposed to developing an eating disorder, the stresses of the college environment can contribute to a troubling sense of a lack of control. Individuals who develop eating disorders often substitute internal control of eating and body weight as a way to deal with feelings of powerlessness over the external environment. In addition, preoccupation with food and body image may serve as a distraction from problems and a way of numbing difficult feelings.
Who is vulnerable to developing an eating disorder?
According to the National Institute of Mental Health (1993), over 5 million Americans suffer from eating disorders. Over ninety percent of these individuals are women, with 1% of adolescent girls developing anorexia and 2-3% of young women developing bulimia. The mortality rate for anorexia is higher than for any other psychological disorder; 1 in 10 anorexics will die from the effects of starvation, including cardiac arrest, or from suicide. Up to ten percent of individuals with eating disorders are male, and many of these men suffer from problems with binge-eating. The mean age of onset of an eating disorder is most common in the college-aged years (age 17 for anorexia; 18-20 for bulimia).
Many college-aged women don’t meet criteria for an eating disorder but are preoccupied with losing weight and dissatisfied with their bodies. Up to a third of college women have “disordered eating” habits, such as using diet pills or laxatives, not eating at all to try to lose weight, or binge-eating .
An important contributing factor to college-aged women’s increased risk of developing eating disorders is young women’s sensitivity to sociocultural messages of the importance of being thin as essential to attractiveness. In reality, the figure of the average college-aged woman is much larger than the cultural ideal as depicted in the media. Yet young women are prone to internalizing societal expectations of the female body and may experience shame and feelings of failure in not “measuring up” to the images seen on television, film, billboards and magazines. In addition, women often struggle with assertiveness and speaking up about feelings and needs. Without a voice to express important aspects of the self, an eating disorder may serve as a form of communication to oneself and to others that something is very wrong. An eating disorder may be a way of expressing frustration and pain without directly talking about underlying feelings and emotional conflicts. Many women with eating disorders may be deeply troubled by the preoccupation with eating and body image, but lack awareness of the emotional struggles that also contribute to the relentless pursuit of thinness.
Athletes represent another subgroup of the population at increased risk of developing eating disorders. Athletic competition and demands for performance may lead to perfectionism in many areas, including the body. Athletes who engage in sports that emphasize slenderness or in which lean body weight is a factor in performance (e.g. track, rowing, gymnastics, diving, wrestling, figure-skating, dance, cheerleading) are particularly vulnerable to developing an eating disorder. Often, moderate weight loss in these sports may improve performance which further reinforces unhealthy eating practices. However, eventually athletic performance becomes compromised by the factors of emotional exhaustion, physical fatigue, poor nutrition and medical problems that are part of an eating disorder.
What are the symptoms of an eating disorder?
Although many individuals worry about food and body image, there are specific criteria used by mental health professionals to diagnose an eating disorder:
- refusal to maintain body weight at or above a minimally normal weight for age and height
- intense fear of gaining weight or becoming fat
- distorted body image, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of low body weight
- amenorrhea in women (absence of at least three consecutive menstrual cycles)
- recurrent episodes of binge eating
- recurrent use of laxatives, diuretics, enemas, fasting or excessive exercise to prevent weight gain
- self-evaluation unduly influenced by body shape and weight
When to seek help
Sometimes, a specific event may trigger the initial onset of eating disorder symptoms (e.g. a diet that gets “out of control,” leaving home, a negative comment about one’s weight, death of a loved one, quitting a sport or other activity, relationship breakup, family problems). Warning signs of a problem with eating may include the following: obsessive preoccupation with food or body image; compulsive exercising; binge eating, purging and/or strict dieting; inability to stop eating; secretiveness or shame about eating; feeling out of control; depression; low self-esteem; social isolation. It is important to seek professional help if you suspect you have a problem with food or weight. Eating disorders can often be prevented if an individual seeks help in the early stages.
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