Inspiration for healthy eating is everywhere these days—we’re finding more veggie options in the dining halls, mouthwatering (yet healthy) recipes on Instagram, and better snacks in vending machines.
For the most part, this is great—healthy eating goals are a good thing. But they can also go too far. This is especially true in college, where eating can become a coping mechanism for dealing with the added stress of new classes, thesis papers, and exams. Using food to cope is more common than you might think—two-thirds of respondents in a recent Student Health 101 survey said they’ve used food to exert more control over their lives or feel better emotionally.
When good eating goes bad
The line between healthy eating habits and concerning behaviors can be a fine one. “Eating behaviors exist on a continuum,” says Elizabeth Curran, a licensed clinical therapist and clinical manager of the adolescent program at the Eating Recovery Center in Colorado. This can range from culturally normalized (and perfectly fine) behaviors, such as binging on Thanksgiving, to eating behaviors that negatively interfere with life, such as extreme dieting. “‘Disordered eating’ is a descriptive way to label eating behaviors that may fall toward the unhealthier side of the continuum,” she says.
Eating disorders and disordered eating are not the same thing
Eating disorders are extreme eating behaviors that fall into categories such as anorexia nervosa and binge eating disorder. Disordered eating can be any unhealthy eating habit or attitude about eating—such as compulsive eating, intense focus on weight or body image, or exercising like crazy to compensate for a big meal—and can be a precursor to having an eating disorder. However, not everyone with disordered eating habits will develop an eating disorder. These patterns can be exhibited by both men and women and by people of all ages, backgrounds, and identities.
What to know about disordered eating
People with eating disorders and disordered eating habits come in all shapes and sizes.
You don’t have to be underweight—many individuals with eating disorders or disordered eating patterns are of average weight or are overweight.
Disordered eating habits and eating disorders are often coping mechanisms.
It’s not vanity that drives people with eating disorders to follow extreme diets and obsess over their bodies; rather, it’s an attempt to deal with feelings of shame, anxiety, and powerlessness.
Eating disorders and disordered eating should be taken seriously.
All eating disorders can lead to irreversible and even life-threatening health problems, such as heart disease, bone loss, stunted growth, infertility, and kidney damage.
When I moved away from my family support system to begin college, I had a strong desire to control one or two aspects of my life. With a schedule full of difficult classes, wanting to connect with new friends, and a lack of self-confidence, I was striving to feel “together” and successful in whatever way I could. So I began cutting calories and devoting myself to a one-hour workout each day. Although I really didn’t need to shed any pounds, I felt a sense of accomplishment—particularly because I believed I was dieting in a healthy, admirable way.
By the time my sophomore year began, there was a noticeable shift in my priorities. Whereas academics used to dominate my schedule, my new routine revolved around working out, looking for health tips, and planning my meals. My social life began to drop off as I turned down offers to eat with friends.
Though my relationship with food felt like an experience that other people wouldn’t understand, I later learned that my behaviors fell under a large umbrella of disordered eating patterns.
In my case, I felt anxious about my role in a large university. The ability to control the food I was, or wasn’t, eating gave me false confidence and masked the real issues in my life.
Identifying unhealthy eating habits
According to the National College Health Assessment, Fall 2017 survey, 34 percent of men and 58 percent of women in college are trying to lose weight—even though only 31 and 39 percent of men and women respectively indicated they were overweight.
So how do you know when a weight loss goal or increased focus on health becomes unhealthy?
Common signs of disordered eating include:
- Rigidity around timing or number of meals and snacks
- Excluding certain food groups or ingredients because you perceive they’ll make you gain weight
- Regularly consuming excessive amounts of a food or beverage
- Categorizing food as either “good” or “bad,” “healthy” or “unhealthy”
- Avoiding situations that involve eating around others
- Increased weight monitoring
- Overindulging or feeling a lack of control when eating (on a regular basis)
- Using diet pills, diuretics, laxatives, or excessive caffeine
- Exercising excessively to “make up for” eating
You might identify yourself doing any of these, or notice a friend or peer behaving in a way that concerns you. “It’s best to recognize and address disordered eating patterns early on. Even if behaviors seem harmless or trivial, they have the potential to spiral out of control and [develop] into a clinical eating disorder if left untreated,” says Jenna Volpe, a registered dietitian in Massachusetts who works with eating disorder patients.
What factors fuel disordered eating?
Troubled eating habits are rarely stand-alone issues—often, they’re not even about food. “Disordered eating can serve a multitude of different functions that are as unique as the individual struggling with the behaviors,” says Curran. There are two main driving factors, according to the experts:
1. Coping and control
“One way to view disordered eating is to see the eating behaviors as a coping strategy for an individual who has difficulties with emotional expression,” says Curran. “Disordered eating behaviors may serve as a distraction from daily stressors or a way to numb out difficult emotions.”
“Finding healthy coping strategies for dealing with stress is important,” says Lauren Smolar, director of programs at the National Eating Disorder Association (NEDA). “If someone is finding that they use disordered eating as a coping mechanism, we recommend seeking help from a specialist.” This could be a recovery specialist or a therapist or counselor who specializes in disordered eating.
2. Unhealthy body image
The media, including social media, doesn’t exactly help our body image. “I think that the media is the biggest contributor to self-consciousness and perfectionism,” says Betsy M., a fourth-year undergraduate student at Marian University in Indiana. “Magazines, television—it’s everywhere,” adds Amanda N., a second-year graduate student at Pennsylvania State University. “We’re surrounded by images of the perfect [man or] woman, and it’s hard not to compare yourself to an impossible standard.”
Messages about body image start working their way into your brain before you even realize—media influence shapes ideas about our bodies as early as elementary school. Sixty-nine percent of elementary school girls who read magazines said the pictures influenced what they thought was an ideal body shape, and 47 percent said the pictures made them want to lose weight, according to a 2010 study published in Pediatrics.
Social media also plays a part. In one small 2014 study, 84 women were asked to either use Facebook or another site for 20 minutes—researchers found that more frequent Facebook use was associated with anxiety over weight concerns and greater disordered eating behaviors. “I purposely limit myself to one social media account and take breaks from social media during midterms and finals,” says Liam K., a third-year student at Oregon Institute of Technology.
- Bullying: “I was bullied in middle school, which I’ve realized largely contributed and was most likely the main cause of my developing an eating disorder,” says Ashlin P.*, a fourth-year undergraduate student at the University of Massachusetts.
- Anxiety and depression: “If I’m in a bout of depression, I definitely feel more self-conscious and don’t feel like I’m good enough compared to others,” says Lynne P., a recent graduate of Rappahannock Community College in Virginia.
- Sports: According to data from NEDA, a third of male athletes and two-thirds of female athletes engage in disordered eating behaviors.
- Major life transitions and stressors: Think parents getting divorced, breakups, or traumatic experiences.
- Lifestyle changes: “Pulling all-nighters and dining hall buffets don’t exactly promote a healthy relationship with food,” says Volpe.
Building healthier eating habits
While it’s not always easy, it’s possible to turn unhealthy disordered eating behaviors around. The first step is recognizing them, says Curran.
How to help yourself
Identifying disordered eating behaviors in yourself can be particularly tricky—you have to be informed about the warning signs and then totally honest in evaluating yourself. “If you’re feeling like you’re having a hard time eating when you’re hungry, stopping when you’re full, or feeling guilty about the amount or types of food you’re consuming—those may be signs of disordered eating,” says Smolar.
- Explore the intentions behind your eating patterns to illuminate emotional concerns.
- Consider societal, academic, and personal pressures that impact how you feel about your body.
- If you’re concerned, talk with a professional. You can call the confidential, toll-free National Eating Disorder Helpline, or complete a screening tool online.
How to help a friend
“Isolation is a common early sign,” Curran says. “If you notice a friend’s behaviors or attitudes around food, exercise, or their body are beginning to change, or their typical responses to requests to grab dinner are switching from a ‘yes’ to a ‘no,’ be curious and supportive in asking about their change in behavior.”
This can be tricky to talk about—people who are struggling with disordered eating are often reluctant to open up about it. Curran suggests taking a little time to prep before you bring it up. “Prior to the conversation, it may be helpful to gather recent observations or changes that led to your concerns, such as noticing they have been skipping or working through lunch, mood shifts around meals, emotional eating, increased exercise, etc.” If you’re not comfortable bringing it up with them directly, you can also share your concerns with an appropriate authority figure—like a coach or counselor.
Also, if you’re going to bring this up to a friend, make sure you empathize; don’t pity. “The worst thing you can do is have a tone that comes across as feeling sorry for them and taking the stance that you’re almost better than them. They don’t always realize they even have an unhealthy relationship with food or what the big deal is,” says Delaina E., a first-year student at Boise State University in Idaho.
Getting help from a professional is often part of the treatment for disordered eating. “The most important task in the treatment for disordered eating is nutritional restoration [restoring nutrients in the body],” says Curran. “Subsequently, the work can focus on addressing temperament, identifying stressors, and learning alternative coping styles. Most treatment centers offer free and confidential assessments, both online or over the phone, to determine the appropriate level of care for treatment.”
It never crossed my mind that my eating or exercise habits were unhealthy or problematic. I was living in a dreamland where calories were bad and running just one more mile was a great accomplishment.
Then I received an email from a trusted friend who said, “I know that you’re simply doing everything that’s associated with ‘being healthy,’ but done to an extreme, it’s dangerous.” My initial reaction was defensive: “I’m being healthy!” I told myself. But doubt started to creep in.
Wanting to settle the matter, I set up an appointment with a nutritionist. I believed that this professional would support my diet and prove that I was healthy. But during that first meeting, the nutritionist looked at me with sadness in her eyes as I described my miserly routine of small meals and big workouts. I asked her not to tell me my weight, but she informed me that it had fallen below the body mass index (BMI) range that’s considered safe.
If you notice signs of disordered eating in a friend or family member, let that person know you’re concerned and available to listen. If he or she is receptive, encourage your peer to meet with a doctor, nutritionist, or counselor. Many school health centers offer free or low-cost consultations.
As I began to address my behaviors, I never once harbored resentment against my friend. On the contrary, my friend’s willingness to reach out and help reminded me that people care about my well-being, and this motivated me to get healthy again.
National Eating Disorders Association Helpline (M–F, 9 a.m.–5 p.m., EST): 1-800-931-2237
Emily Curran, licensed clinical therapist, clinical manager of the adolescent program, Eating Recovery Center, Colorado.
Lauren Smolar, director of programs, National Eating Disorder Association.
Jenna Volpe, registered dietitian and eating disorders specialist, Walden Behavioral Care, Massachusetts.
Eisenberg, D., Nicklett, E. J., Roeder, K., et al. (2011). Eating disorder symptoms among college students: Prevalence, persistence, correlates, and treatment-seeking. Journal of American College Health, 59(8), 700–707.
Field, A. E., Cheung, L., Wolf, A. M., et al. (1999). Exposure to the mass media and weight concerns among girls. Pediatrics, 103(3).
Mabe A. G., Forney, K. J., & Keel, P. K. (2014). Do you “like” my photo? International Journal of Eating Disorders, 47(5), 516–523.
NEDA. (n.d.) Media and eating disorders. Retrieved from https://www.nationaleatingdisorders.org/media-eating-disorders
NEDA. (n.d.) Statistics and research on eating disorders. Retrieved from https://www.nationaleatingdisorders.org/statistics-research-eating-disorders
Tylka, T. Pressure to be muscular may lead men to unhealthy behaviors, presented at the American Psychological Association’s 2006 annual meeting. Retrieved from http://researchnews.osu.edu/archive/maleobj.htm