Eating Concerns and Disorders
Many people have eating concerns yet do not have a full-blown eating disorder. They may be preoccupied with calories, fat grams, or exercise. They may place great personal importance upon weight and feel their self-worth hinges upon maintaining a particular weight. They may exercise excessively, keep detailed food diaries, or experience intense guilt or shame after eating foods with high sugar or fat content. They may engage in episodes of bingeing followed by periods of restricting food intake. While students with eating concerns may not qualify for a diagnosis of an eating disorder, nonetheless their thoughts, emotions, and behavior may cause them to feel a great deal of distress, anxiety, or sadness, and may significantly impair their quality of life.
At times, eating concerns develop into full-blown eating disorders, which in addition to causing great emotional distress also bring with them the potential for serious and permanent physical damage or even death. Below are descriptions of the most common eating disorders treated at college counseling centers. You can learn more from the National Eating Disorders Association.
- Anorexia Nervosa
Anorexia Nervosa (AN) is characterized by a weight loss of 10-15% below the lowest weight considered acceptable for a person's age and height. Individuals with AN experience an intense fear of gaining weight, and they demonstrate grossly distorted body image (i.e. they see themselves as "fat" despite their severely underweight status). In adolescent and adult women, there is an absence of at least three consecutive menstrual cycles. People with this disorder may abuse laxatives or exercise excessively. They are generally extremely sensitive to cold and may grow soft hair called lanugo on their arms and face. AN is an extremely serious condition that some research has found results in death in 10% of cases.
- Bulimia Nervosa
This illness is characterized by a pattern of bingeing and purging. A binge is defined as eating, within a 2-hour time period, an amount of food that is significantly larger than most people would eat under similar circumstances. During a binge, people feel out of control and often experience anxiety-like symptoms such as racing heart and shakiness. Purging consists of recurrent compensatory behaviors that are performed in an attempt to prevent weight gain, and include self-induced vomiting, excessive exercise, and laxative abuse. In order to be diagnosed with BN, a person must engage in this pattern at least twice weekly for three months. Like AN, BN is a very serious condition that causes dangerous and potentially lethal medical problems. These include chronic gastric reflux, dehydration, hypokalemia (low potassium), electrolyte imbalance leading to cardiac arrhythmia or arrest, esophagitis, esophageal rupture, mouth lacerations, gastroparesis (slowed digestion), constipation, peptic ulcers, dental erosion, and swollen salivary glands.
- Eating Disorder Not Otherwise Specified
A person who carries this diagnosis exhibits symptoms of one or more eating disorders but does not fulfill the minimal criteria to qualify for those diagnoses. For example, a woman may show several symptoms of AN yet she still continues to menstruate. Someone else may engage in bingeing and purging behavior, yet not at the frequency required to be diagnosed with BN. This diagnosis carries with it all the seriousness and risk of both AN and BN, and should not be considered a less dangerous condition.
- When to Worry
Eating disorders are common among college-aged people, and friends and roommates of an affected person are often the first to notice the problem. You may notice visible changes in weight, or increased time spent in strenuous exercise. You may notice that your friend disappears after every meal or never eats with other people. If you are concerned, express your worries to your friend in a quiet, private space (NOT during mealtime). Strive to be caring and empathic in your approach, and let your friend know you are there to talk things over. Offer to accompany your friend to CAPS for an intake appointment. Your friend may deny there is a problem, or minimize the seriousness of the issue. If this occurs, try not to press further. Let your friend know you are always there and willing to listen. In the meantime, we encourage you to make an appointment with CAPS to talk through the issue and determine whether there may be a better way to approach your friend with your concerns.