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Healthy eating and eating disorder education for college students

Attending college is an exciting milestone, offering new levels of freedom and independence. But it’s also a time of significant change and comes with new responsibilities and stress. Combined, these factors can lead to the development of destructive new habits, including unhealthy or disordered eating behaviors.

Learning more about why college students are vulnerable to eating disorders, how to identify the symptoms, how to support those affected, and how to build healthier eating habits can help someone avoid this common pitfall and truly get the best out of their college experience.

25
 minutes read
Last updated on 
March 26, 2024
Eating disorder education for college students
In this article

How common are eating disorders in college students?

It’s impossible to tell exactly how many college students struggle with eating disorders. The conditions are notoriously private, and people who struggle are often in denial of the seriousness of their condition or loathe to disclose what they’re going through.

Still, what data is available suggests that eating disorders and disordered eating behaviors in college students are on the rise, with 4.2% of college students following a restricted diet for weight loss in 1995 but 22% doing the same by 2008.1

Prevalence of eating disorders in college students

Although it’s commonly assumed that women are more likely to experience an eating disorder, the reality is that all college students are at risk for developing these behaviors. A survey by the American College Health Association found:12

  • 3% of college-aged women and 0.4% of men received a diagnosis of anorexia
  • 2% of college-aged women and 0.2% of men reported a previous bulimia diagnosis
  • 4% of college-aged women and 1% of men admitted using laxatives or engaging in self-induced vomiting in an attempt to lose weight
Eating disorders can affect people of all ages, genders, races, ethnicities, sizes, and weights.
College student

At-risk populations for eating disorders

Certain student populations may be more at risk for eating disorders than others. For example, transgender students have reported disordered eating behaviors, including vomiting, use of diet pills, and laxative use, at four times the rate of their cisgender classmates.6 

Sexual minority students also show elevated rates of compensatory behaviors compared to their heterosexual classmates, particularly cisgender men.6

Athletes and transgender students are at higher risk for developing eating disorders.

Student-athletes may also be at an increased risk of eating disorders. Research suggests anywhere up to 19% of male college athletes and as many as 45% of female college athletes struggle with these conditions.7

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The risk is typically higher for sports focusing on appearance, weight requirements, or muscularity, such as gymnastics, bodybuilding, diving, or wrestling. Individual sports, including dance, figure skating, some track and field events, and endurance sports, like running and cycling, also see a higher risk for the development of disordered eating behaviors.8

The risk of developing an eating disorder is even higher among aesthetic sports that emphasize appearance and weight.

Eating disorder risk factors for college students

Several factors coalesce around college that could increase the likelihood of developing an eating disorder.

The college environment

The college environment itself presents many conditions that could open up the possibility of developing an eating disorder. Some potentially contributing factors include: 

  • Increased workload and learning issues
  • Less structure and reduced parental presence and support
  • Unscheduled eating
  • All-you-can-eat dining halls
  • Loss of personal space and privacy, especially when living with roommates
College students sitting in a circle

Without their usual routine and family support, especially when far from home, students may develop disordered eating behaviors to deal with the stressors of college in an attempt to feel in better control of their lives.1

Access to an unlimited and large variety of food in college dining halls can also present problems for students. Those restricted in their diets at home may find this overabundance of food to trigger binge eating.

Furthermore, students may feel anxious about their lack of control over food choices in the college food hall, which could trigger disordered eating behaviors.

New social pressures

New college students face many new social pressures, including finding ways to fit in with new classmates, roommates, and social groups. 

The pressure to conform to make friends can be immense. Many students turn to fraternities and sororities as a way to assimilate. But members of these organizations have been found to struggle with poor self-esteem and disordered eating behaviors.9

The confluence of greater autonomy, greater options for feeding oneself, and social events that involve alcohol or unhealthy food can also lead many college students to gain weight. Colloquially called the “freshman 15,” fear of this scenario could lead a student to push in the other direction instead, exerting more control over their diet or workout routine to avoid putting on those first-year pounds.10

Stress and anxiety

The pressure to maintain good academic standing in college can cause increased stress, anxiety, and depression, which may contribute to the development of an eating disorder.11

Risk factors for eating disorders

Additionally, research has shown that students with depression, generalized anxiety disorder, panic disorder, self-harm, and suicidal ideation are more likely to screen positive for an eating disorder.12

Health-related behaviors

Certain health-related behaviors associated with the college experience have been shown to increase the likelihood of developing an eating disorder. They include:12

  • Binge drinking
  • Marijuana use
  • Cigarette smoking
  • Frequent exercise
  • Gambling

Personality traits

Certain personality traits, including perfectionism, have been tied to a higher risk of developing disordered eating behaviors.13 Perfectionism, in particular, may be triggered by the pressure of college to maintain grades, make certain clubs or teams, or fulfill other social or academic obligations. 

Unpredictable peers, new roommates, and uncertainty in where one stands in the social pecking order can also contribute to the sense of a loss of control, which people with certain personality traits may attempt to cope with through exerting extra control over their food and exercise routine.

Warning signs of an eating disorder in college students

Warning signs of an eating disorder in college students
Common eating disorders and their symptoms
Learn about effective remote treatment for eating disroders.
Learn >

Effect of eating disorders on college students

Eating disorders and disordered eating behaviors are often associated with significant health concerns, as well as a negative impact on a student’s academic performance, social life, and overall college experience.4

Undergoing intensive and time-consuming treatment can interfere with students participating in the full college experience they hope for. This may mean some students delay treatment or ignore their disordered eating behaviors. In fact, denial of any problem is very common.

However, If a student doesn’t seek treatment for their eating disorder, there can be serious long-term medical consequences. The longer an eating disorder goes untreated, the more serious the physical and mental complications can be, and the harder it can be to treat the eating disorder and associated conditions.

The longer an eating disorder goes untreated, the more serious the physical and mental complications can be and the harder it can be to treat.
Medical consequences of common eating disorders

For parents of college students with eating disorders

If your child is planning to attend college soon but has an eating disorder or is showing signs of disordered eating behaviors, it’s essential you consider whether sending them now is the right time.

Consider a gap year
Establish criteria for staying at college
Invest in tuition insurance
Stay involved

Tips for maintaining eating disorder recovery in college

You can’t guarantee a relapse won’t occur in college, but there are things you can do to help maintain your recovery.

Have a plan
Work with your treatment team
Make time for self-care
Make a meal plan
Prioritize recovery

How to manage eating habits in college

Those who go away to college encounter many changes to navigate, such as: 

  • Being away from a familiar environment and usual routines
  • Getting adjusted to a new place
  • Meeting new people, making new friends
  • Building a new lifestyle

There are also the pressures of learning how to manage your time, schedule, and academic workload. 

These changes can be overwhelming, and in the face of those feelings, people may turn to food as a comfort or a way to help them feel more in control. In either case, the concept can be dangerous.

College student looking at computer screen

So, what steps can you take to ensure you’re eating well at college and getting all the nutrients you need to maintain a healthy and properly functioning body and mind? 

Of course, many factors can affect your physical and mental well-being, not just food. But research has found there are two things you can do every day that can have a positive impact on your well-being and grade point average (GPA):21

  1. Get enough sleep
  2. Eat breakfast

As for when, what, and how much to eat, it’s time to ditch all the food rules you’ve learned so far in life and follow just one rule: tune into your body’s cues.

What is intuitive eating?

Your body knows what to do when it comes to food. It will tell you when it’s hungry, what it’s hungry for, and how much to eat.

This concept is called intuitive eating. Intuitive eating is simply:22
  • Eating when you’re hungry
  • Stopping when you’re full
  • Not restricting specific foods or quantities of food unless you have a medical reason, such as an allergy

Sounds simple, doesn’t it? But it’s not so easy when you’ve been conditioned to ignore your body’s cues by a lifetime of well-meaning but misleading messaging from the media, “health” and fitness companies, and even healthcare providers around food, eating, fitness, and health telling you what you “should” or “shouldn’t” eat or do.

Here are just a few of those harmful messages:

  • There are “good” foods and “bad” foods. “Healthy” choices and “unhealthy” choices. 
  • “Cheat” foods, “free” foods, and “green” foods. 
  • There are “supposed” to be three meals a day: breakfast, lunch, and dinner, eaten at specific times and involving certain types of foods. 

Not to mention all the messages your parents may have told you:

  • “Don’t snack between meals.” 
  • “Don’t spoil your dinner.” 
  • “Don’t eat after 8 pm.” 
  • “You can’t have dessert until you’ve eaten all your dinner.” 
  • “You’ve had enough.” 
  • “You can only have cake on special occasions.”

And then there are the messages you may be hearing or telling yourself now:

  • Don’t drink your calories. 
  • Save your calories for later if you know you’re going to “overindulge.” 
  • You can eat “junk” food if you exercise it off. 
  • Since you were “bad” and overindulged in something yesterday, you need to be “good” today.

All this goes against your body’s built-in ability to tell you what, how much, and when it needs to nourish itself. Following rules like these can be dangerous and feed disordered eating patterns, which can lead to serious harm, including full-blown eating disorders, mental health challenges, medical complications, and even worse.

Intuitive eating 101
Three quick tips for busy days (intuitive eating)

Alcohol and eating disorders

There may be pressure to drink alcohol or try other substances at college. And this may be very hard to avoid. Being away from home and having freedom can lead to risky behavior. 

But it’s important to be aware of the very real dangers of alcohol, the risks of substance abuse, and the consequences of overdoing it. Alcohol is dehydrating and can act as an amnesiac, loosen inhibitions, and impair judgment.  It is also a toxin to the body and can be deadly. 

Alcohol consumption is also strongly correlated with eating disorders.

Drunkorexia
Binge drinking
Substance use

When to get help

If you suspect you or a friend may have a problem with alcohol or any other substance, it’s crucial to get help as soon as possible. This may not be easy. Denial is a powerful force that drives many people to continue self-destructive habits until serious damage has been done. It’s helpful to talk to a counselor about how to approach this topic. And it’s important to remember it’s not a sign of weakness or failure. It takes great courage and strength to face your challenges.

Group of college friends

How to help a college friend with an eating disorder

Eating disorders are dangerous conditions and can even be deadly if left untreated. If you have a college friend you suspect or know is struggling, it’s important to help them find appropriate treatment and care.

Still, the process will likely not be easy. Eating disorders tend to be particularly sensitive issues, with many people struggling to admit the severity of their condition or even that they have a problem at all.

Expect denial and resistance
Share how you feel
Show full support

Where to find help for college students

Despite the high prevalence of eating disorders among college students, it appears many aren’t receiving the help they need. Recent research found that only 20% of college students diagnosed with an eating disorder reported receiving mental health treatment within 12 months.12

Only 20% of college students with eating disorders reported receiving mental health therapy for the condition in the past year.12

The barriers to care on campus for eating disorders can contribute to this issue. Understaffing at college counseling centers and the increased number of students with mental health issues may be part of the problem, as well as stigma, shame, and financial costs.4

Despite these challenges, there is effective help and support for those who need it. Many colleges offer counseling services for students who are struggling for any reason. These counselors can help directly or point students toward more specific eating disorder-related programs. Some colleges also have eating disorder specialists on campus.

Tips for seeking eating disorder treatment in college

What eating disorder treatment looks like

Eating disorders are typically treated by a multidisciplinary team, which includes a collaborative approach from a therapist, dietician, nutritionist, and medical doctor. The severity of a person’s eating disorder, the state of their mental well-being, and any co-occurring disorders—like depression—will determine the course of treatment.

Generally speaking, the goals of eating disorder treatment are to:

  • Prevent disordered eating behaviors, such as fasting, purging, binging, excessive exercise, and restriction
  • Establish the underlying causes of the maladaptive eating behaviors and introduce alternative coping mechanisms to college stressors
  • Create a plan to prevent relapse
  • Address other mental problems and medical complications

Residential and inpatient eating disorder treatment may be required in cases where a person requires round-the-clock monitoring and structure to engage in their care plan. But many common treatments for eating disorders can work around college commitments and include:

  • Cognitive behavioral therapy (CBT): This form of talking therapy focuses on negative thoughts and beliefs about food, as well as the underlying triggers that cause them. CBT teaches an individual to identify these problems and learn healthy ways to cope with difficult emotions.26
  • Nutritional counseling: Carried out with a registered dietitian, nutritional counseling is a key part of eating disorder treatment.19 It teaches a person how their eating disorder may be preventing them from getting the nutrients their body needs to function. Furthermore, nutritional counseling helps to develop a meal plan, develop normal eating patterns, improve their relationship with food, and work towards a stable, healthy body weight.
  • Family-based therapy: As opposed to addressing the root cause of an eating disorder, family-based therapy teaches families as a unit about eating disorders so they can support their child, sibling, or friend through recovery.16
  • Acceptance and commitment therapy (ACT): ACT is used to help those with eating disorders to recognize and accept their thoughts and emotions. Acknowledging the thoughts and urges tied to their disorder can help individuals develop a better understanding of their triggers.2
  • Group therapy: Many people with eating disorders find it incredibly healing to discuss their fears and concerns with others in a similar situation to them. Group therapy helps people form genuine connections, which is so valuable during recovery, especially when at a college far from home.
  • Intensive outpatient treatment (IOP): If it fits in around campus life, IOP is an excellent treatment option for those who respond better to treatment in a more structured environment. Patients typically attend an outpatient clinic for a few hours a couple of days a week to receive additional support.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Eating Disorders in College Students: Effects on Mental Health. (2021, October 28)  Regis College. Accessed January 2024.
  2. Dindo, L., Van Liew, J. R., & Arch, J. J. (2017). Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. Neurotherapeutics: The Journal of the American Society for Experimental NeuroTherapeutics, 14(3), 546–553.
  3. Noordenbos, G., Oldenhave, A., Muschter, J., & Terpstra, N. (2002). Characteristics and treatment of patients with chronic eating disorders. Eating Disorders, 10(1), 15–29.
  4. Grammer, A. C., Fitzsimmons-Craft, E. E., Laing, O., Pietro, B., & Wilfley, D. E. (2020). Eating Disorders on College Campuses in the United States: Current Insight on Screening, Prevention, and Treatment. Current Psychopharmacology, 9(2), 91–102.
  5. Blair, L., Aloia, C. R., Valliant, M. W., Knight, K. B., Garner, J. C., & Nahar, V. K. (2017). Association between athletic participation and the risk of eating disorder and body dissatisfaction in college students. International journal of health sciences, 11(4), 8–12.
  6. Diemer, E. W., Grant, J. D., Munn-Chernoff, M. A., Patterson, D. A., and Duncan, A. E. (2015). Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 57(2), 144–49.
  7. Bratland-Sanda, S., & Sundgot-Borgen, J. (2013). Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. European Journal of Sport Science, 13(5), 499–508.
  8. Nickols, R. (2018, April 27). Eating Disorders & Athletes. National Eating Disorders Association. Accessed January 2024.
  9. Mitchell, C. (2013, October 4). The Sorority Body-Image Problem. The Atlantic. Accessed January 2024.
  10. Jacobson, R. (n.d.). College Students and Eating Disorders. ChildMind. Accessed January 2024.
  11. Understanding Eating Disorders in College.  (2022, January 19). BestColleges.com. Accessed January 2024.
  12. Eisenberg, D., Nicklett, E. J., Roeder, K., & Kirz, N. E. (2011). Eating disorder symptoms among college students: prevalence, persistence, correlates, and treatment-seeking. Journal of American College Health, 59(8), 700–707. 
  13. Bardone-Cone, A.M., Katrina Sturm, M.A. Lawson, D. Robinson, P., Smith, R. (2010). Perfectionism Across Stages of Recovery from Eating Disorders. The International Journal of Eating Disorders 43(2): 139–48. 
  14. Jacobson, R. (2022, February 14). Signs a college student may have an eating disorder.  Child Mind Institute. Accessed January 2024.
  15. Eating Disorders. (n.d.). National Institute of Mental Health. Accessed January 2024. 
  16. Eating Disorder Treatment: Know Your Options. (2017, July 14). Mayo Clinic. Accessed November 2024.
  17. Orthorexia. (n.d.). WebMD. Accessed January 2024. 
  18. Binge-eating disorder. (2018, May 5). Mayo Clinic. Accessed January 2024.
  19. Ozier, A. D., Henry, B. W. (2011). Position of the American Dietetic Association: Nutrition intervention in the treatment of eating disorders. Journal of the American Dietetic Association, 111(8), 1236-1241.
  20. Nitsch, A., Dlugosz, H., Gibson, D., Mehler, P. (2021). Medical complications of bulimia nervosa. Cleveland Clinic Journal of Medicine, 88(6), 333-343.
  21. Reuter, P. R., Forster, B. L., & Brister, S. R. (2021). The influence of eating habits on the academic performance of university students. Journal of American College Health, 69(8), 921–927. 
  22. Van Dyke, N., & Drinkwater, E. J. (2014). Relationships between intuitive eating and health indicators: literature review. Public Health Nutrition, 17(8), 1757–1766.
  23. Schaefer, J. T., Magnuson, A. B. (2014). A Review of Interventions that Promote Eating by Internal Cues. Journal of the Academy of Nutrition and Dietetics, 114(5), 734-760. 
  24. Eisenberg, M. H., & Fitz, C. C. (2014). "Drunkorexia": exploring the who and why of a disturbing trend in college students' eating and drinking behaviors. Journal of American, 62(8), 570–577.
  25. Khaylis, A., Trockel, M., & Taylor, C. B. (2009). Binge drinking in women at risk for developing eating disorders. The International Journal of Eating Disorders, 42(5), 409–414.
  26. What is Cognitive Behavioral Therapy? (n.d.). American Psychological Association. Accessed January 2024.

FAQs

How common are eating disorders in college?

It’s impossible to know the exact number of college students who struggle with eating disorders, but more college students than ever are likely experiencing these conditions. One recent study found that 22% of college students were practicing restrictive dieting in 2008.1

Which college students are the most at risk for eating disorders?

It’s possible for anyone—of any gender, ethnic background, or sexual orientation—to develop an eating disorder, whether or not they’re in college.

Still, certain students have a higher risk of developing the conditions, including athletes, transgender students, and sexual minority students.6,7,12

How can I avoid eating disorders in college?

There are no foolproof ways to avoid developing an eating disorder. But these tips might help.

Focusing on building a healthy routine can be a great start. Eating breakfast, drinking enough water, sleeping enough, and making time for healthy workouts can all help. Avoiding drinking too much is also a good idea.

Many students also develop disordered eating behaviors as maladaptive stress mechanisms. However, finding healthier channels for stress can be a good way to counteract this tendency. Yoga, journaling, going for walks, socializing with friends, and practicing self-care can all help ease the stress many students experience at college.

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Further reading

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