Navigating Eating Disorder Recovery in College

Types Of Eating Disorders

According to the DSM V, there are 5 main ED diagnoses. The diagnoses include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder (ARFID), and other specified feeding or eating disorders (OSFED). These eating disorders are defined by various behavior use and body image disturbances. It can be validating for someone to “get diagnosed” with an eating disorder because it puts a name to their struggle. And it shows the need for support is valid. However, like with any diagnostic tool, there are many shortcomings with the DSM V. What happens if someone doesn’t meet the criteria? What happens if someone struggles with many different behaviors?

DSM Shortcomings

While the DSM V can be used as a guide, ultimately, an eating disorder occurs when an individual experiences disruption in their daily life related to food. Think acting on certain food, body or exercise related behaviors. Or being consumed with negative and obsessive thoughts about food, body or exercise. Whether we define this as an eating disorder or disordered eating, a person deserves to have a peaceful and positive relationship with food and body. A reminder that you deserve support and help regardless of receiving a diagnosis. Your struggle is valid and you deserve healing.

What Causes Eating Disorders in College Students

Why Are Eating Disorders So Common At The College Level

The National Eating Disorder Association (NEDA) estimates at least 10-20% of college-age women and 4-10% of college-age men struggle with an eating disorder. Eating disorders in college students are also rapidly on the rise, especially in men. Why? Firstly, eating disorders are a complicated mental illness, and it’s impossible to pinpoint just one cause. However, college students are a very unique group.

The college environment and experiences puts these students in a vulnerable place. Here are some possible contributing factors:

Leaving home (the first time for many students)
Increased independence and increased responsibility
Being away from a support system (family and friends)
Pressure for academic success
Pressure from society to maintain a certain body shape and size (think: fears of gaining weight freshman year*)
Increased presence of social media
Desires to “fit in” in an unfamiliar place
Increased exposure to drugs and alcohol
Less structure
Struggles with navigating dining halls and food options

I want to add that weight gain throughout college is absolutely normal and 100% okay. We can anticipate that our bodies are always going to change. It’s normal to gain weight steadily throughout our lifetimes. This is unfortunately villainized by society.

Who Is Affected?

Eating disorders can affect anyone. We have a lot of preconceived notions of what an eating disorder “looks like,” however, this is not an accurate representation of who can struggle. EDs affect people of all body sizes, ages, gender identities, ethnicities and races. It’s important to take note of loved ones who seem distressed around food. Let’s talk about some warning signs.

What Are The Warning Signs?

Warning signs include. But are not limited to:

Spending majority of time thinking about food
Anxiety about eating out
Feeling dizzy, tired, or fatigued
Experiencing GI issues (like constipation or bloating)
Spending time planning out meals (and feeling anxious or guilty about diverting from that plan)
Isolating from loved ones
Acting on behaviors like restricting, bingeing, purging or obsessive exercise
Cutting out foods or food groups
Labeling foods as healthy or unhealthy
If you’re looking for more information about warning signs of eating disorders. Check out our blog on this topic.

How To Deal With An Eating Disorder In College

Getting support for an eating disorder at any stage of life is brave. In college, it may feel like support is limited because you are away from home and in a new environment. Here are some ideas of how to navigate eating disorder recovery in college:

Talk to a trusted friend or family member. Perhaps they can help you research support options
Ask your counseling center for support options in the area
Look for a support group in ANAD
Work with a dietitian that can see you in person or virtually
Remind yourself: you deserve recovery

The Impact Of Eating Disorders On College Students

Eating disorders have significant psychological and physical effects on college students. Let’s talk about some of them.

Psychological effects include:

Isolation from friends and family
Increased overall stress and anxiety
Trouble sleeping
Mental fatigue
Rigidity in thinking (with food and other things)
Decreased self esteem
Increased feelings of guilt and shame

Physical effects include:

General fatigue/malaise
Weakened heart muscle
Lack of focus
Dry skin and hair and/or brittle nails
Weakened immune system
Dysregulated menstrual cycle (for those who get a period)
Decreased bone density
Lab abnormalities

Like I said before, college students are experiencing a unique time in their lives. This confusing, yet often exciting, time should be met with self-discovery and enjoyment. An eating disorder certainly prevents both of those things and can contribute to a negative college experience.

I understand how the effects of an eating disorder can sound scary. While the impact of eating disorders are serious, the side effects (other than bone density) can be improved through nutritional support and therapy. This is why it’s crucial to begin recovery early and NOT delay treatment.

Navigating College With An Eating Disorder

Navigating college while in recovery from an eating disorder can be complicated. You do not have to do it alone. Think about it this way. If you’re paddling a boat all on your own, it’s going to take way longer to get to the final destination. But, if you have a support team on that boat, even though the journey might still be tough, you’ll have others to rely on. Consider working with a dietitian, a therapist and a physician. If you’re looking for options in your area, Courage to Nourish is happy to help. We’re happy to meet with you individually (in person or virtually), or direct you to other support options.

What Can Students Do to Recover from Eating Disorders

If you’re a college student looking for support, ideally you would work with a team of trusted professionals. As I mentioned before, Courage to Nourish is more than happy to work with you. Other than working with a team, I’d recommend doing some reflecting on your own. Below are 3 ideas to get you started:

Updating your social media:

Is social media helpful or harmful? Well, it’s both. Reflect on what you find helpful about social media and what you find harmful. Notice if there are accounts you frequent that make you feel badly about yourself. If so, consider unfollowing them. On the flip side, consider following recovery positive accounts. Head to our resources page to download our social media handout.

Journaling:

Take some time to journal a few times a week. It certainly doesn’t have to be daily! If you find it helpful to use specific prompts as a guide, we have a journaling prompt handout on our resources page. Feel free to check it out!

Challenging food rules:

Jot down eating disorder food rules. Work to challenge them one by one. It’s possible you may need to spend a few days (or weeks) on 1-2 rules. This is where a dietitian can support you. It may be difficult to challenge these rules on your own, and that’s totally normal. You are brave for reaching out for support.

How to Find the Right Certified Dietitian

Finding the right team is crucial. It’s important to feel comfortable with your team and trust them. When searching for a dietitian, you want to look for an RD that aligns with Health at Every Size © or is weight inclusive. It’s a red flag if the dietitian (or the group practice) works with both eating disorders and “weight management.”

Consider searching for a dietitian who is a “CEDRD” or in the process of becoming one. The CEDRD is a specific eating disorder credential. It means the dietitian has over 2500 hours working with eating disorders. They also received supervision to increase their knowledge on working with EDs.

Most practices offer a “discovery call” with the dietitian, so I’d recommend talking to them for 15 minutes before your initial appointment. This can help make sure they are a good fit. Write down your list of questions ahead of time, so you don’t forget anything you wanted to ask!

Next Steps

Courage to Nourish is a group of eating disorder specialized dietitians. We have in person locations in Alexandria, Virginia, Columbia, Maryland. and College Park, Maryland. We offer virtual services across the state of Virginia, Washington DC, Pennsylvania, and Colorado. We offer individual nutrition therapy. As well as support groups. We would love to guide you in building a better relationship with food.

Contact us for more information. And to schedule a discovery call. Also, sign up for our client or clinician newsletter!

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Navigating Eating Disorder Recovery in College