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Eating disorders boom as kids enter college

4:24 PM, Dec 27, 2012   |    comments
The National Institute of Mental Health estimates that 25 percent of college students have eating disorders.(Photo: photo illustration by Steve Harman/The Tennessean)
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Written by Maura Ammenheuser, The Tennessean

Katie McInnis grew up hearing what a "perfect" Nashville family she had.

"There was a lot I felt I had to live up to in terms of image," says McInnis, now 32 and living in Bristol, Tenn. At 15, she was a cheerleader who ran track, and once during training, somebody remarked upon her "huge thighs."

That triggered an 8-year battle with anorexia, when McInnis resisted eating in a desperate effort to be thin and perfect. "I thought, 'I have to fix that. I can't have anybody thinking I have big thighs.' "

McInnis hid her condition, running the shower to mask the sound of her vomiting and lying to her mother about meals. She duped counselors by water-loading and stuffing her pockets with coins before weigh-ins.

"Girls and guys with eating disorders can manipulate with the best of them," McInnis said. "They will lie."

Parents, remember that. Though McInnis' anorexia began in high school, the average age for the onset of anorexia and bulimia is between 18 and 20, depending on the study - just as teens begin college.

Once there, they have plenty of company.

The National Institute of Mental Health estimates that 25 percent of college students have eating disorders. The same percent of college women report managing weight by binging and purging, says the National Association of Anorexia Nervosa and Associated Disorders.

The problem's more widespread among women, but men aren't immune. The association says

10 percent to 15 percent of anorexics and bulimics are male.

"You can pick them out," McInnis said, of college students with eating problems. "I gravitated toward them. It's almost this silent club."

Broach subject carefully

Winter break is an opportunity for parents to notice changes in their college-age children. The real tip-off to an eating disorder isn't their appearance, but rather mood and habits.

Counselors describe many signs of an eating disorder:

• Is the student depressed, anxious?

• Is he isolating himself?

• Does she seem obsessed with her appearance, size or food?

• Does he avoid eating with people, perhaps saying, "I ate earlier?"

• Is he scrutinizing food labels, counting calories?

• Is she so dissatisfied by her appearance or clothes that she avoids social activities?

• Is food disappearing?

• Does she suddenly favor loose, baggy clothes?

• Does she disappear after meals, particularly to the bathroom? (That's a sign of purging, either through induced vomiting or laxative abuse.)

• Are there sudden problems with the home's plumbing?

Parents should discuss observations with their child, but this conversation is extraordinarily delicate.

"There is a lot of secrecy and a lot of shame," said Holly Fitzhenry, a Mercy Ministries counselor.

Some students may be eager to unburden themselves, but most are defensive. Even the most well-meaning questions can prompt denial or anger.

McInnis actually advises avoiding confronting this until the student's about to return to school. Then, suggest meeting with a counselor or nutritionist together, and leave the student with a list of resources, she said.

"It's a seed that might grow later," McInnis said.

Counselors urge getting the subject out in the open - however, very carefully. Avoid words such as "heavy," "fat" or "thin."

"Ask open-ended, tentative questions," advised Nashville psychotherapist Kim Simpson. Say: "I notice your eating habits changed. Want to talk about that?"

Fitzhenry suggests even more subtlety. "Don't come at it from an eating angle," she said.

Try a casual review of the semester, touching on college in general. Parents can ask, "What went well for you this semester? What are you disappointed with?" That could include friends to grades to food, a natural segue to the campus meal plan. Ask, "Did your plan include too much food? Not enough?" That's the time to say, "You seem anxious/sad/preoccupied with food. I'm concerned. Anything you want to talk about?"

When to seek help

Regardless of how these chats go, parents can follow up by scheduling an appointment for their student with the family doctor. This can rule out any medical issues, such as thyroid problems. The parent can say the appointment's for a flu shot or physical, then warn the doctor in advance about eating-disorder worries.

If the student resists further treatment, parents should seek professional help, Simpson said. McInnis says the student needs some control, so give options: "Who do you trust to talk to about this?"

Finally, don't expect communication from your child's university about her eating habits or mental health. While most colleges have on-campus counseling available, it's generally up to students to seek it out, and privacy laws prevent campus-based counselors from discussing students' health with parents.

Reach Maura Ammenheuser at 615-259-8253 or

The Tennessean

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