Eating disorders can develop at any time in a person’s life, but there are some developmental periods with higher rates of eating disorders. Late adolescence and early adulthood are significant seasons of transition and are often marked with worsening disordered eating patterns. The 18 to 20 year old will likely move away from family meal patterns. Some will go to campus dining, others will move out alone and some will go to work full time. Each of these examples is a disruption to mealtime patterns that can be an opportunity for past urges, such as binging, purging, and restricting, to resurface. In addition, this period of late adolescence is marked with increased social pressure. The desire to be thin, strong, athletic, sexy, ripped, etc. is a primary concern for most in this stage of life. This puts further pressure upon the individual and further exacerbates the disordered eating and exercise habits.
What are some of the warning signs indicating that someone might be struggling in their ability to feed themselves and balance their exercise? How might you approach this person with curiosity and kindness? How might support be offered? This article will address these questions and more in hopes that more adolescents may move through the milestones of young adulthood without the unwanted disruption of an eating disorder.
As a young adult transitions to independent living, food behaviors are often disrupted. For some, this disruption is welcomed as a unique aspect of their college experience. Middle of the night Dunkin Donuts with friends, university dining facilities and Uber eats are just as much a part of the college experience as exams and parties. Unfortunately, for some individuals, these eating experiences are seen as frightening and threatening. This can develop into avoidance behaviors, such as declining invitations to go out, claiming to be “not hungry,” and eating alone or differently than others. Some may be more overt in their avoidance and will start on specific diets, meal plans or “clean eating” regiments in order to have an excuse to not participate in the normal rhythms of college eating.
Other warning signs that someone is struggling to care for themselves during the college transition will be clear in their exercise routines. The threat of the “freshman fifteen” will cause some to adapt rigorous exercise schedules. Exercising for more than an hour per day, exercising more than one time per day or skipping meals because of lack of exercise are all indicators of someone struggling. In some cases, this drive to exercise may even become compulsive, pushing the individual to workout for hours even when they are sick, injured or are busy with other responsibilities. When speaking of exercise, it is important to mention collegiate sports. High level sports can often be a means of masking a disordered relationship with food and exercise. Dieting, restricting, compulsive weighing and exercising outside of supervised training can all be indicators that the collegiate athlete is not doing well.
In addition to disrupting an individual’s eating and exercise patterns, the college environment introduces an increased opportunity and pressure to experiment with drugs and alcohol. According to the National Eating Disorder Association, up to 50% of individuals with eating disorders use alcohol or illicit drugs. Signs that substance abuse may be interfering with someone’s relationship to food include:
- Using Adderall or other prescription drugs to suppress appetite
- Skipping meals early in the day in order to “save up” calories for heavy drinking in the evening
- Missing meals because of irregular sleeping patterns or feeling “too busy to eat”
- High intake of energy drinks as meal replacements and appetite suppressants
Engaging a College Student with a Suspected Eating Disorder
What if you have noticed first hand some of the behaviors listed above? What if a classmate or a family member begins to show signs of the initial onset of an eating disorder, or the recurrence of old behaviors that have been a problem in the past? First and foremost, the fact that you notice and are feeling the urge to express concern is a gift to the sufferer. Many who are concerned about the behaviors of a friend or family member are afraid to express their thoughts. They assume that mentioning the “elephant in the room” will threaten the relationship or make the disordered behavior worse. If this is you, don’t be afraid to speak up. As long as you are expressing your concern with curiosity and kindness, you are doing a service to the sufferer regardless of their response. Try some of the of the following phrases:
- “I have noticed that you have not been coming home for weekends and have declined my invitations to meet for lunch. I also see that you have not been using the college meal credits. I would like to understand how this transition to eating at university is going for you? Is there something I can do to better support you?”
- “Hey, you never seem to eat dinner with us when we go out. You keep talking about all of these foods you don’t eat anymore. Foods you used to eat all the time! Wondering what is going on with you. Have you gone to a doctor to get your concerns checked out? Or are you following a diet that you found on the internet?”
- “I have noticed you waking up earlier than usual to go to the gym, in addition to practice in the afternoon. Is this something your coach has asked you to do? Why do you feel like you need to do these extra workouts?”
If you or a loved one are looking for care, the best place to start is with mental health counseling. Most universities offer free or discounted services for students. University counselors are skilled in the assessment of eating disorders and will be able to set recommendations. If there are no services offered at school, then the best option is to conduct a search for eating disorder certified therapists in your area. Additionally, there are virtual and in person support groups offered for family members and sufferers in most major cities. The details for these groups can be found at the National Alliance for Eating Disorders website. With appropriate support, young adults and college students can learn to navigate the food environment with balance and ease.