Eating Disorders: A Silent yet Deadly Epidemic
A look into the rise of eating disorders on college campuses nationwide
—By Spencyr Aronson
TW: Eating Disorders are discussed in this article. If you or a loved one is struggling with an eating disorder, contact the National Eating Disorders Association helpline for support options at (800) 931-2237. You can find additional resources at NationalEatingDisorders.org.
As I sat on the floor of my childhood bedroom and attempted to pack for my rapidly-approaching start of freshman year, I tried to tune out the insensitive words of one of my closest friends: “Let’s make a pact that neither of us will gain the Freshman 15 this year,” she said. It had been months since the pandemic began, and I had struggled with disordered eating habits for so long by that time that I felt hopeless. This triggering dialogue only worsened the growing pit of anxiety in my stomach. Unfortunately, seemingly innocuous statements like my friend’s have harmful impacts that live long past their utterances.
In the United States, 28.8 million Americans will suffer from an eating disorder at some point in their lives. Eating disorders are mental and physical illnesses that, when left untreated, can have grave consequences. The fact that their severity is often overlooked is troubling, given that eating disorders have the second highest mortality rate of all mental health disorders, surpassed only by opioid usage.
While eating disorders are undoubtedly a serious issue among people of all ages, genders and races, they have increased dramatically on college campuses in recent years. Countless factors contributed to this increase, including the rise of social media and the influence of the Coronavirus pandemic. Speaking with several college students, experts, and University of Michigan alumni, this article investigates what has led to this spike in eating disorders, and what can be done going forward to help resolve this growing epidemic.
Why is college the “perfect storm” for eating disorders?
Along with the self-doubt that accompanies the start of college, the transition from home life to a more independent lifestyle at college is a topic that deserves greater attention. Attempting to create a healthy food balance while moving directly into a dorm, where meal options are often limited, can be a hurdle for many well-intended freshmen, including myself. Diet culture is everywhere on campus, specifically within dining halls, which include messages that support unhealthy dialogues surrounding food. For instance, caloric information is often over-emphasized along with materials that promote stereotypical pillars of health. Research supports the fact that nutrition labels can trigger disordered eating behaviors. In women, increased nutrition facts use was associated with a 10% greater likelihood of engaging in unhealthy weight control behaviors, and a 17% greater likelihood in men, along with a lower level of intuitive eating. Moreover, dorms generally don’t accommodate a lifestyle fit for nutritional meals, and shared mini-fridges don’t provide sufficient room to stock healthy ingredients to cook. These conditions can contribute to an unhealthy relationship with food, and allow for eating disorders to develop.
The everyday stressors associated with being a college student can easily take their toll on students’ mental health as well. To gain further insight into these issues, I spoke with Dr. Kendrin Sonneville, Assistant Professor in the Department of Nutritional Sciences at the University of Michigan School of Public Health. Dr. Sonneville is a registered dietitian, behavioral scientist, and public health researcher whose work is largely focused on the prevention of eating disorders. “The college years, she noted, “coincide with the peak age of onset of disordered eating. Students are vulnerable, not only because of their age developmentally. There’s a lot of traumatic things that happen in college that can increase risk of eating disorders, from sexual assault to the overall heightened pressure. It’s just really a perfect storm.” This perfect storm often occurs when the realities of college life—increased workload, less structure, and more focus on social obligations—collide with anxieties, learning issues, or low self-esteem. Teenagers who were able to successfully manage stress during high school through hard work and parental support can easily find themselves drowning in the complex sea of the college lifestyle. Eating disorders can in turn develop when students feel the need to take control over their lives within these demanding environments. This is often accomplished through food restriction, excessive exercise, and an unhealthy focus on body weight.
Moreover, the party-heavy culture that exists at many large universities exacerbates these issues. For many struggling students, binge drinking dominates the college experience, and restricting calories to compensate for drinking alcohol is often normalized. This concept, known as “drunkorexia” and more recently, Food and Alcohol Disturbance (FAD), continues to receive attention from healthcare professionals as it has dangerous and long-term implications for students. According to U of M junior Jennie Tannenbaum, this toxic culture surrounding alcohol is more harmful than many realize: “Unfortunately, I have seen several of my peers have to go to the hospital after a night out because they didn’t eat all day before drinking. This is done intentionally in an attempt to look skinny and ‘save up’ calories. It’s an awful and far too common circumstance at so many schools across the country.”
Consequences of Coronavirus
Since the pandemic began in March of 2020, the number of diagnosed eating disorders has skyrocketed. A new report from the Centers for Disease Control and Prevention (CDC) found that the number of adolescent females going to the ER for eating disorders nearly doubled during the pandemic. Additionally, the National Eating Disorders Association recorded a 58 percent increase in calls, texts, and chats from March 2020 to October 2021. This surge reflects the lack of structure that was available within teenagers’ daily routines, emotional distress, and fluctuations in food availability throughout the pandemic. In addition, extended periods of social isolation drove a spike in depression, anxiety, and trauma-related mental health conditions among children and teenagers.
Dr. Sonneville further noted that given so many adolescents were stuck at home with limited options for connecting with others, social media grew more influential than ever before. Similar to the term the “Freshman 15,” millions of social media users grew obsessed with avoiding the internet-coined “Quarantine 15” weight gain. Platforms such as TikTok and Instagram were overflowing with harmful content surrounding eating habits and over-exercising. Additionally, seeing constant examples of “perfect” bodies on social media promoted the message that these bodies are normal and most desirable. These images made the viewers feel as though their bodies were less acceptable by comparison and created a negative impact on body image. According to Dr. Sonneville, “The messages related to post-pandemic ‘glow-ups’ really set this idea that people should emerge from the pandemic looking a particular way. This is probably the most profound collective trauma we have ever experienced, yet so much of what we’re talking about is whether or not I gained some weight, which was really sad to think about.”
Consistent with Dr. Sonneville’s findings, research has shown that high social media use is linked with greater odds of developing an eating disorder, further supporting the hypothesis that these platforms can be detrimental for users’ mental and physical wellbeing. Max Appel, a 21-year-old college student who was a freshman at the University of North Georgia at the onset of the pandemic, recalls his time on social media during lockdown: “It definitely was extremely toxic for me to spend hours a day mindlessly scrolling on these apps. A lot of the posts I saw encouraged over-exercising and other harmful behaviors. This was difficult for me to talk about with my friends and family, and especially hard to ignore during such a hard time. Now, I make sure I’m much more mindful of who I follow and the content I see on a daily basis.” Recognizing that social media can be damaging, being cognizant of whom you follow, and reducing screen time substantially (if not altogether) can help to protect your mental health. This is a helpful strategy for anyone recovering from an eating disorder or other mental illness.
While the pandemic certainly compounded the struggles of countless adolescents now grappling with these issues, eating disorders were on the rise even before Covid struck. It is important to note that these challenges are not reserved for those college age and older. In less than a decade, the rate of eating disorders rose by 119 percent in kids under 12, and Anorexia is now the third most common chronic illness among adolescents after asthma and obesity. If prevention efforts are not improved for children in school, these statistics will only continue to worsen.
Struggling students
Given the rise of eating and mental health disorders across college campuses, universities have struggled to keep pace with an overwhelming demand for counseling services. Amid a nationwide shortage of mental health professionals, colleges are competing with hospital systems, private practices, and the growing telehealth industry to recruit and retain counselors. Professionals at these college counseling centers themselves have seen their workloads and the gravity of individual cases rise exponentially, causing some to seek employment elsewhere. As a result, wait times for students seeking help routinely stretch into weeks and months. This leaves it up to struggling students to find resources themselves from outside providers, many of whom do not accept student’s health insurance plans.
I next spoke with University of Michigan alumni Liadan Solomon, a current MSW/MPH candidate at Boston University. Liadan is interested in expanding access to peer support programs for college students, so I wanted to hear her thoughts on this issue. She stated, “I think it’s an issue that is a reflection of a greater society that doesn’t value the mental wellbeing of students. A lot of what I saw at Michigan was the lack of prevention, but it’s a budgetary thing at the end of the day. Until people in administrations largely value mental health, it’s really difficult to make change happen. I know from my work with Counseling and Psychological Services (“CAPS”) that it’s a short-term treatment model, and a lot of people who have these issues need longer-term care. Michigan has a lot of room for improvement in terms of connecting students to community resources as well.” Liadan also expressed her appreciation for all of the CAPS counselors who already work incredibly long hours and have high caseloads. As an aspiring mental health professional herself, Liadan urges readers to consider the toll that the profession can take on the mental health of the providers, too.
With counseling centers unable to provide access for everyone, the next best thing for some sufferers is to utilize mental health services that can be accessed online or over the phone. While the majority of schools did not offer online services before the pandemic, this option may become a lifeline for many colleges and universities looking for a practical solution. Emma Shelton, a sophomore at Vanderbilt University, has taken advantage of online mental health counseling herself: “I definitely would recommend looking into the telehealth space for anyone who feels their campus doesn’t provide adequate in-person counseling services. I received help virtually after struggling for some time, and the assistance I was provided with definitely helped me begin to heal.”
The importance of prevention
While eating disorders as a mental health issue will likely never disappear completely, this epidemic can be helped if greater prevention efforts are taken by educators for the younger generations. To further explore the importance of education I interviewed Dr. Marcy Forta, MBA. Dr. Forta is a certified holistic nutritionist and the Founder and Director of Atzmi, a Michigan-based non-profit that aims for greater eating disorder education, awareness, and prevention.
Atzmi’s mission is centered around youth appreciating their unique selves through programs that are designed to increase self-compassion. Dr. Forta remarked, “We are all built differently. If we only value ourselves for our bodies, then as soon as they change, we feel we’re not valuable anymore. Sometimes we even think being skinny is the most valuable thing, which is false. It’s time for us to emphasize the importance of being healthy versus being skinny.” Dr. Forta went on to explain that with her programming (set to begin testing in schools and summer camps this spring), she hopes to educate youth before they get to college. This way, adolescents are better equipped to deal with the transition and less likely to develop disordered eating habits as a whole. “I really do believe that knowledge is power. When you have education and awareness on topics like this, you’re much better prepared to handle what may come down the road. Ultimately, my vision is that the girls that we teach today are the mothers of tomorrow. Then, that generation will be spoken to differently, and they won’t have to grapple with dialogue surrounding body dissatisfaction and negative body image.”
Get involved and discover resources
For those readers who wish to get more involved in the fight against the rise of eating disorders, there are several on-campus organizations that would welcome their participation. First, Project HEAL is an inclusive club which delivers prevention, treatment financing, and recovery support to individuals with eating disorders through training and education. Though the University of Michigan chapter of Project HEAL just formed last fall, the organization has already hosted several events throughout the year, from body-positive workout fundraisers to group craft nights. The Wolverine Support Network, otherwise known as WSN, is another great organization with which students can become involved. WSN gives undergraduate and graduate students alike the opportunity to disclose their struggles, triumphs, and everything in between in weekly group sessions. Liadan Solomon was involved in WSN throughout her Michigan college experience and looks back on her time with the club fondly: “WSN is where I felt the most myself on campus because it’s a space where you can come as you are, whatever that may mean to you.”
For those who may be struggling with any mental health issues and wish to utilize on campus resources, there are many options available. As previously discussed, CAPS is available and is now open with extended hours, and also has urgent/crisis support available 24/7. Some of their other services include tele-counseling and virtual outreach. The Michigan Medicine Comprehensive Eating Disorders Program is another great resource which offers partial hospitalization (PHP), intensive outpatient (IOP) and outpatient treatment. Lastly, Wolverine Wellness and University Health Services (UHS) are both outstanding options to receive services.
While eating disorders will likely never go away completely, as a society we can keep the hope alive that these prevention and treatment options will positively impact those struggling today, and hopefully lessen the number of youth who develop eating disorders in the future.
Photo Credit: By Thought Catalog @thoughtcatalog on Unsplash