It's More Than Moving Out: Why College Students Develop Eating Disorders

Written by CCTC Staff Writer

Anyone who's ever been to college can tell you about it's highs and lows: from the euphoric feeling of passing a test you were sure you would fail, to the near-constant state of sleep deprivation, to the sense that there's always something you should be doing, college is nothing short of transformative. Is it the highs, the lows, or simply change that causes eating disorders in college students?

In this article, you'll find out:

Several possible reasons why college students develop eating disorders
Barriers to eating disorder diagnosis and treatment in college
What to do if you or someone you know is a college student with an eating disorder

Moving out is hard. But there are so many reasons why college students develop eating disorders that people just don't talk about. So let's get into all of them.

Separation from Familiarity: Friends, Family, and Environment

As soon as you graduate high school, you start a separation process.

Your friends from high school set off on their own paths. Your familiar routines no longer exist. And you set off on a new course, whatever that may be.

Those who go to college may leave home, family, and familiar territory.

You may feel isolated, restless, and anxious when you go to school, and this can really take a toll on your mental health. And more than that, you have no solid foundation to lean on. You don't have the defining features you used to — you can be anyone you want in college, and that leaves many feeling lost.

In your search to find out who you are, you may end up on a diet, in the gym, or trying to improve your appearance in general. You might take your new habits to an extreme. Maybe it's to solidify your new "healthy" or "attractive" persona, or maybe it's just to cope with the negative feelings that arise when you have no idea who you are on your own.

A Jarring New Level of Responsibility

Throughout your life thus far, you had a routine imposed on you. Breakfast and lunch were set at a specific time. You were supposed to wake up at a certain time. Someone was there to monitor you.

In college, however, you are responsible for taking care of yourself. Most students don’t have the background knowledge in nutrition and intuitive eating to have strong food regulation. They’re not sure what they need nutritionally, how much is a normal amount of food to eat at meals, or how to listen to their internal needs.

Also, most students don’t have good sleep hygiene, or they lose it when they go to school. They have not developed time-management skills before stepping foot on campus. Many get overwhelmed with class times and assignments, staying up later and later to finish their work. The lack of food and sleep regulation causes emotional disturbances and often causes issues with food.

Larger Pool of Comparison and Competition

You may have been one of the best students, athletes, or performers at your local high school. Maybe you have “been the best” at things for so long that you identify with being a high achiever.

But when you show up to an institution with a larger pool of capable people, you may not be the “the best” anymore. You may not get the highest grades, run the fastest times, or get the leading roles you once did.

It’s almost like losing a part of your identity, when you’re not the extremely high achiever you were back home. There are two common reactions to this experience:

You work tirelessly to get back to the high achiever status you held in high school.
You focus on becoming “the best” at something else — something like losing weight, keeping a strict diet, or maintaining an exercise regime.

Eating, Exercise, and Size Comparisons

Once you get onto a college campus and see so many people while in class, in dining halls and gyms, and just walking around, you might find yourself glancing at those around you. You're comparing your eating, exercise, weight, shape, or size with others. Sometimes it's strangers, and at times, it's your friends.

Body, Food, and Exercise Comparison in College: The research is in.

In this large study, 232 women from large university were asked to record:

How often they compared their shape, weight, and eating and exercise habits with others
Whether they saw themselves as "better off" or "worse off" than those they compared themselves to
Their relationship to those they compared themselves to (stranger, acquaintance, or friend)
Where they were when they made the comparison
How many people were around when they made the comparison
Whether the comparison made them want to control their weight, shape, or exercise/eating habits

They answered these questions three times a day over the span of two weeks. Researchers found that almost all the women made comparisons, and most of them were negative ones.

When it came to eating habits, most women felt they didn't eat as "healthy" as others. They also felt they ate too much in comparison to those around them. They made most of their comparisons in places where they ate with friends.

In terms of exercise, most women felt they didn't exercise "enough" and that they did not exercise as intensely as those around them. Most comparisons were made while walking around and at campus gyms.

Most women also felt they weighed "too much" than others. They also had negative thoughts about their shape and size when comparing themselves to others. Body comparisons happened everywhere.

Comparisons made these women want to control their food, weight, and exercise. Many did end up using eating disorder behaviors — often without realizing that they were disordered.

Related: Body comparison is part of a larger set of eating disorder behaviors: body checking.

Pervasive Diet Culture

Being in close proximity to others opens up opportunities for diet culture to spread. When you eat with others all the time, and comparison and competition is high, diet culture will find its way to the table. Toxic fitness culture is also evident in the gym, especially for athletes.

Related: If you suspect you or someone you know is an athlete with an eating disorder, read this.

Experiencing Failure

There is a difference between not being "the best" and outright failing. Many people were not valedictorian in high school. Maybe you weren't, either. At the same time, you certainly did well enough to get into college.

So you've probably never outright failed an exam, or an entire class. You've probably never imagined that you might not be able to graduate with the degree you initially went to school for. And you, like most people, never, ever expect to have to take more than four years to get their degree, or to take time off of school.

But — and this is really important — failure happens. It's normal. It happens to everyone.

A lot of people can't process the experience of failure. That's because, for a lot of people, self-worth is tied into academic and professional performance. Good grades are a sort of "high," a source of joy that naturally comes with accomplishment.

Once you fail, you need something else to replace your sense of self-worth, and something to replace the "high" of good grades. Many college students turn towards eating disorder behaviors to deal with failure.

Research shows that those who get their self-worth from academic achievement are more likely to engage in restrictive and bulimic behaviors. Those who feel low after failure are more likely to engage in these behaviors, as well as binge eating.

Related: Use simple dialectical behavioral therapy skills to cope with crisis moments like finding out you failed an exam.

Low Sense of Self-Efficacy and Self-Esteem

Self-efficacy is a person's belief that they can perform well in a given set of circumstances. It involves determination, perseverance, resilience, and overcoming obstacles. When you do well in a class, receive positive feedback on a project or creative work, or receive awards or leadership roles, your sense of self-efficacy improves. If you do experience failure or feel like a failure in comparison to peers, then your sense of self-efficacy lowers.

Low self-efficacy also influences your self-esteem. College students with a low sense of self-efficacy and self-esteem are more likely to develop an eating disorder than their peers.

Exposure to Substances

College is, for many people, the first time they have easy access to drugs and alcohol.

Many students go overboard, though, for a lot of reasons:

Your peers engage in heavy substance use and you don't want to be left out
Social anxiety at small or large events (large events happening after COVID restrictions lift, of course)
Substances are a way to numb any pain due to failure, isolation, etc.
Study drugs (that often cause weight loss) are used during testing seasons
Substance use as a response to trauma, especially sexual assault in college

Related: This is the link between trauma and eating disorders.

Drunkorexia: A Common Eating Disorder in College Aged Students

Drunkorexia is a term describing the behaviors one uses to compensate for the calories they consume while drinking.

Over half of college students use behaviors like restricting calories, exercise, and purging to "save calories" before, during, and/or after drinking, according to research. These behaviors put college students at a high risk for developing an eating disorder.

Comorbid Disorders

Comorbid disorders like depression and anxiety commonly emerge after a life transition or painful experience. It makes sense, then, that a lot of college students develop depression, anxiety, and substance disorders. Comorbid disorders can also act as catalysts to developing an eating disorder.

Related: This is how comorbid diagnosis and treatment works within the framework of eating disorders.

Barriers to Treatment for College Aged Individuals

Even though eating disorders are common in college students, there are so many barriers to getting an eating disorder diagnosis and treatment. These barriers include, but are not limited to:

A Full Course Load

Keeping up with lectures, labs, and assignments is enough without having to dedicate (much needed) time to managing mental illness.

Eating disorder treatment can be substantially more intense and longer lasting than treatment for other mental health problems. Many students have to take time off of school to receive eating disorder treatment at a higher level of care and to take care of any physical side effects of eating disorders that may arise.

Many college students refuse to seek help out of the fear of leaving school. They deny having a problem to try and stay on track for graduation. But waiting to start recovery only makes the problem worse. And historically, the students who wait to address their problem usually end up missing out on more school than the ones who seek help when they first notice a problem.

Related: Setting goals (like graduating college) is one way to maintain motivation in eating disorder recovery.

Lack of Resources

Your school may not have an eating disorder specialist at their campus health center. There may not be any available providers in the area, either. And you may not have the necessary insurance or financial resources to get help for an eating disorder.

Related: This is how to pay for eating disorder treatment.

Mental Health Stigma

Colleges are making great strides in terms of reducing mental health stigma on campus. But many students still experience mental health stigma, or fear mental health stigma, whether it comes from their peers, professors, employers, or family. For this reason, many students avoid seeking help for, or even admitting, that they are suffering from mental illness.

Weight Stigma

Weight and shape stigma keeps so many people (not just college students) from admitting they have a problem. They worry they won't be taken seriously if they don't "look like" they have an eating disorder.

Related: This is why eating disorders don't actually have a "look".

And unfortunately, many people aren't taken seriously when they open up about an eating disorder. Medical professionals and med school students at campus health centers just don't know enough about eating disorders to spot them. They rely on physical factors like weight — which has nothing to do with having this mental illness — to diagnose someone with an eating disorder.

Unwillingness to Start Eating Disorder Recovery

Even though an eating disorder can take over your whole life, many people are unwilling to start eating disorder recovery.

Despite failing grades, isolation, and general misery, people don't want to change. They identify with being small, eating "healthy," or exercising a lot. Or they simply need something to hold onto while everything else feels out of control.

Related: Do you think your eating disorder is your entire personality? Here's how to figure out who you are outside of your eating disorder.

What do you do if you are a College Student with an Eating Disorder?

Tell someone: a friend you feel safe telling, a school counselor, someone from an eating disorder helpline. They can give you the strength to take the next step: getting help. You may have to drop some classes, or step away from school altogether, to focus on recovery.

But if you take time away now, you are less likely to fail in your courses. This will save a lot of time and money down the line, as you won't have to retake classes. Taking the time to heal now will not only save your academic career — ultimately, it will save your life.

If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or simply learn more about the holistic eating disorder recovery programs we offer.

Ai PonoMay 19, 2021