The National Institute of Mental Health estimates that 25 percent of college students have eating disorders.(Photo: photo illustration by Steve Harman/The Tennessean)
NASHVILLE, Tenn. -- As college students are home for winter break, it is an opportunity for parents to notice changes in their college-age children.
Those changes could include eating disorders. The real tip-off to an
eating disorder isn't their appearance, but rather mood and habits.
The National Institute of Mental Health
estimates that 25% 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.
problem's more widespread among women, but men aren't immune. The
association says 10% to 15% of anorexics and bulimics are male.
can pick them out," says Katie McInnis, 32, of college students with
eating problems. At 15, she began an 8-year battle with anorexia when
she resisted eating in a desperate effort to be thin and perfect. "I
gravitated toward them. It's almost this silent club."
a cheerleader who ran track, and once during training, somebody
commented about her "huge thighs." She hid her condition, running the
shower to mask the sound of her vomiting and lying to her mother abut
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.
Broach subject carefully
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?
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," says Holly Fitzhenry, a Mercy Ministries counselor.
students may be eager to unburden themselves, but most are defensive.
Even the most well-meaning questions can prompt denial or anger.
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,
"It's a seed that might grow later," McInnis says.
Counselors urge getting the subject out in the open - however, very carefully. Avoid words such as "heavy," "fat" or "thin."
open-ended, tentative questions," advises Nashville, Tenn.,
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 says.
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
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
If the student resists further treatment,
parents should seek professional help, Simpson says. 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.
On the Web:
www.nationaleatingdisorders.org, National Eating Disorders Association, helpline: 1-800-931-2237
www.anad.org, the National Association of Anorexia Nervosa and Associated Disorders, helpline: 630-577-1330, email email@example.com