As students go off to college, they are beset with new responsibilities, which become the source of added stress. Many students have to balance jobs with school work and may additionally have family responsibilities. There is the pressure to receive good grades and keep up with the academic work load.

Those who leave home for the first time suddenly are responsible for buying and cooking for themselves or choosing what to eat from college cafeterias or kiosks. They may restrict their eating or over eat or make poor food choices. They may develop unhealthy attitudes and behaviors over food and dieting.

Adolescents and young adults are especially self-conscious of what their appearance at a time in their life when they are looking for a lifelong mate. Their obsession with appearance and fitness may lead them to develop eating disorders and obsessions with exercising.

RECOGNIZING EATING DISORDERS

It is difficult to notice the physical signs of people with eating disorders from a casual observation, unless the person is underweight due to anorexia nervosa. Bulimics tend to fluctuate 10 – 20 pounds within a normal weight range, and binge eaters usually are overweight.

See the “Symptoms” page of this website for a detailed description of the signs of an eating disorder. The symptoms presented here are the physical, behavioral, and attitudinal characteristics that will be most observable.

Physical Symptoms:

• Anorexics appear underweight and bingers may be overweight
• Anorexics may complain of being cold when temperature is comfortable
• An anorexic's skin may appear dry and their hair and nails brittle
• Bulimics may have puffiness in the cheeks resulting from swollen salivary glands, broken blood vessels under the eyes, and bruises on the knuckles from forced and frequent vomiting
• Bulimics may complain of sore throat, chest pain, muscle ache, and fatigue
• The teeth of bulimics who vomit will appear yellowish, grayish, and spotted due to tooth decay

Attitudinal and Behavioral Symptoms:

• Experience wide range of negative emotions, including depression, anxiety, guilt, self-loathing, irritability, etc.
• Avoid social events involving food
• Constantly talk about food, calories, weight, exercise and/or appearance
• Anorexics tend to be perfectionists
• Anorexics usually withdraw and isolate themselves from others
• Anorexics will restrict their food intake and make excuses for not eating or only eating small amounts
• Anorexics may exhibit odd food rituals, such as moving food around on plate without eating it or refusing to eat certain foods
• Anorexics may dress in baggy or layered clothes to keep warm and to hide their thinness despite taking pride in it
• Anorexics and bulimics may take diuretics and laxatives, fast, and may obsessively exercise
• Bulimics will frequent the bathroom after meals
• While anorexics have difficulty making decisions, bulimics tend to be impulsive, so there is an increased risk to act out sexually and to abuse alcohol and drugs
• Bulimics may hoard food for later binges
• Bingers who are overweight typically avoid recreational activities that may involve physical activity or that may expose parts of their body (such as swimming)
• Bingers usually binge in private, and may eat only small amounts in public
  
  

1. Be informed about eating disorders and be prepared to refer a student to an eating disorder therapist.
2. Be willing to ask a student if he or she has an eating disorder, assuring him or her that your discussion is confidential. If a student admits to an eating disorder, reassure the person that he is not alone with the illness, show understanding and empathy, provide him informational handouts, encourage the person to seek treatment, and provide referrals. Explain that you want to have a follow- up appointment with the student during which time you will find out if he or she has scheduled an appointment with a treatment provider. If not, continue to encourage the student to seek treatment. When approaching someone with an eating disorder, be sure to have reasons to back up your suspicions about the person having an eating disorder. Express this in a tone of caring and concern. Rather than directly asking the student if he or she has an eating disorder, you may initially want to ask an anorexic, for example, "Do you restrict your calories or diet?" or a bulimic, "Do you use compensatory techniques to lose weight or prevent weigfht gain after eating?"
3. Have handouts and brochures available for students in your counseling center, such as brochures by N.A.M.E.D. Also, have videos on eating disorders available for viewing.
4. Invite an eating disorder therapist to facilitate an “Eating Disorders Therapy Support Group” or a presentation on eating disorders at the college.
   
   

Family and friends tend to feel helpless when it comes to helping a person with an eating disorder. You may ask yourself, "Should I talk to him or her about it? What should I say? What should I do, if he or she becomes defensive?" These are good questions, but don’t let your fear stand in the way of expressing your concern to the other person. It is critical that the person receive professional help sooner rather than later, so be willing to intervene.