By Rae Jacobson
Eating disorders can and do occur in teenagers, and even in young children. But it's during the college years that young people, especially young women, are most at risk for developing them. The challenges of college life, adding pressure to underlying mental health issues, create what Dr. Alison Baker, a child and adolescent psychiatrist, calls a "perfect storm" for these disorders.
The storm occurs when the realities of college life—increased workload, less structure and more focus on peers—collide with anxieties, learning issues or poor self-esteem.
Hating her body
"I couldn't stop comparing myself to every girl I saw," says Jessica, who struggled with anorexia during her late teens and early twenties. " 'Am I thinner than her? Am I fatter?' It was endless, and I was almost always the fat one. It was all I thought about so it was all I wanted to talk about."
This kind of constant self-criticism is pretty common, and can be a clue to parents that an eating disorder may be developing.
"Eating disorders are not about vanity or just the desire to be thin," explains Dr. Baker, "but it's important not to dismiss that piece of it because it can be the language of distress. In a lot of cases this is the first clue."
College is a place where you can find people to participate in almost anything you're interested in, and criticizing your body is no exception. Now 25 and in recovery, Jessica says it was easy to get other girls talking about how much they hated their bodies—even if they didn't have an eating disorder. "We were all worried about our weight. Someone was always willing to go down the rabbit hole with me," she says.
While some weight concerns are normal, the mix of anxiety and the constant pressure to be thin can be a very dangerous mix for some. A history of serious anxiety is a strong indicator for eating disorders during college.
Dr. Baker notes that if a student seems very stressed out, or down, and has been obsessing over losing weight, it's important to intervene.
"If she's reporting that she's unhappy or very anxious, and she looks very different than the last time you saw her, then it's time to ask," says Dr. Baker. Eating disorders include anorexia, bulimia and binge eating disorder, and each disorder has a different set of signs.
Anorexia is characterized by an intense fear of gaining weight. People with anorexia go to extremes, restricting food and over-exercising to prevent weight gain.
Signs that someone might be anorexic include:
- Losing weight unexpectedly and/or being dangerously thin
- Obsessing over calorie counts and foods perceived as being “fattening”
- Spending many hours on the treadmill or jogging to burn off calories
- Skipping meals or parties where eating or drinking are expected
- Irregular periods, thinning hair and constant exhaustion
Bulimia is a cycle of binging—eating large amounts of food in a short period of time—and purging, which could include self-inducing vomiting, abusing laxatives or diuretics, over-exercising or a combination of all three. People with bulimia aren't necessarily noticeably thin, which can make it harder to spot.
Signs someone might be bulimic include:
- Inventing reasons to go to the bathroom immediately after meals to purge
- Bad breath, swelling under the jaw or cheeks, tooth discoloration, acid reflux or even knuckle calluses from self-induced vomiting
- Exercising excessively or using diet pills or laxatives
- Talking about weight and size more than is usually considered normal
- Passing on activities that interfere with the routine of binging and purging
- Buying and hiding large amounts of food
- Hiding uneaten food or wrappers from binges
Binge eating disorder
People who struggle with binge eating disorder will frequently eat large amounts of food, but unlike a person with bulimia, they don't engage in any of the "purging" behaviors. The disorder is different from anorexia and bulimia because people with BED are not preoccupied with thinness, although they may struggle with poor self-esteem and often feel guilty and ashamed over any weight they've gained from their binges.
Signs that someone may have BED include:
- Eating unusually large quantities of food
- Buying large amounts of food and hiding it
- Eating in private or secretly
- Rapid weight gain
- Wearing baggy clothes to hide weight gain
- Feeling depressed, anxious or ashamed about eating habits
Eating disorders don't discriminate
Recognizing an eating disorder sometimes means looking beyond the typical stereotype.
Eating disorders are more prevalent in females, but approximately 10% of people with anorexia and 40% of those with binge eating disorder are male. Boys and men with an eating disorder often go overlooked.
Originally published on February 29, 2016
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