Eating disorders run rampant on university campuses. How to protect your college-bound kid

Analysis by Oona Hanson, CNN

(CNN) — If you’re sending a kid off to college, it makes sense to experience a mixture of excitement and worry — about their leaving home, sleeping enough and making friends but also the mental health crisis on many college campuses.

But I find most parents and guardians  aren’t aware that this crisis includes eating disorders — which are serious, life-threatening mental illnesses characterized by a disturbance in one’s relationship with food, exercise and/or body size.

The transition to college is a time when students are especially vulnerable  to developing an eating disorder, and today’s students are at greater risk than ever, according to a November 2022 study.

“Eating disorders are common, and can have significant effects on students’ physical health, mental health, social engagement, and academic performance,” said Dr. Leslie Gee, a primary care physician at the University of California, Berkeley, via email.

Many parents and guardians I meet assume their child could never develop an eating disorder. “No young adult is immune. Eating disorders can affect people of all genders and ethnicities,” said Lauren Muhlheim, a clinical psychologist in Los Angeles and the director of Eating Disorder Therapy LA.

As your family prepares for move-in day, learning about these illnesses and having candid conversations can help protect your child as they leave the nest. Here’s what to know.

Fear of the ‘freshman 15’

The first year of college inevitably brings up references to the so-called freshman 15, where students assume they will gain 15 pounds while away at school.

If your child is afraid of weight gain or even makes an offhand joke about the freshman 15, it’s an opportunity to listen and connect.

It’s never a good idea to encourage dieting, a major risk factor for eating disorders. Instead, “try acknowledging the distress and opening the door to a deeper conversation about unrealistic body ideals and diet culture,” said Toby Morris, lead clinical dietitian for students  at the University of California, Berkeley.

The key is to engage your child without judgment so they will feel comfortable sharing their concerns with you.

“The most important thing is to have open and honest conversations about how they feel about their body, the dangers of intentional restriction and why bodies are unique,” advised eating disorder specialist Whitney Trotter, a registered nurse and dietitian in Memphis, Tennessee. For families of color, Trotter also recommended talking about “the cost of assimilation and how BIPOC (Black, Indigenous, People of Color) bodies experience the world differently.”

If you’re wondering how to respond to your child’s concerns about weight, Morris offered this conversation starter: “I’m sorry to hear you’re worrying about that. I want you to experience all college has to offer no matter what size your body is. Why do you think our culture is so fixated on thinness?”

Students are supposed to gain weight

In contrast to what our culture promotes, college students are supposed to gain weight because they are “in a phase of important and ongoing growth and development. This includes acquisition of bone density, brain growth, and physical development,” Gee said via email.

Parents and guardians can help combat body-shaming messages. Support your child by normalizing “the need to gain weight as bodies mature rather than reinforcing fear about it,” Muhlheim added.

One of the most powerful things parents and caregivers can do — which may also be the hardest — is to model body neutrality and embrace body diversity themselves.

Food insecurity in college

Body image concerns and dieting aren’t the only potential disruptors to a college student’s eating behavior. Many students don’t have access to all-you-can-eat dining halls offering three meals daily.

“Food insecurity is a major issue for many college students, and is related to eating disorder risk,” said Sarah Minkow, a registered dietitian at the University of California, Berkeley.

“Sometimes dining hall meal plans only provide two meals per day and no meals on the weekends. Even if students have the financial means to purchase food, campuses may be in food deserts.”

Families can encourage their young adults to understand the meal plan and dining hall hours — and to estimate a budget for additional food needs. Planning to have go-to snacks and other familiar food in their dorm room can be an important safeguard, Trotter advised.

Keep lines of communication open

As classes get underway, parents and guardians can make a point of routinely staying in touch with their child by text or video chat. Trotter suggested “approaching with empathy and curiosity” while asking about their social life and experience with the dining hall food.

Warning signs of an eating disorder include weight loss, mood changes, social isolation, or a preoccupation with food, weight or exercise. Parents and guardians should listen to their gut if they sense something isn’t right.

“Colleges typically tell parents to stop helicoptering,” but in this case, Muhlheim said she disagrees. “I don’t advise parents to completely abdicate their roles. The school will not get involved until the problem is obvious and profound. Parents should trust their instincts if they sense their student is struggling with an eating disorder or any other mental health issue.”

Going to college with an eating disorder

If your college-bound child has previously been diagnosed with an eating disorder, they will need extra support during this transition. The first step is for families to be honest about whether a young person is truly ready to live away from home.

“As hard as this decision is, I would urge families to hold off on sending their child to college until they are solidly in recovery,” Morris said. Working with a treatment team to develop a robust relapse prevention plan is key before starting, or returning, to college. It often makes sense for students to sign information release forms so parents and guardians can communicate directly with health care providers, Morris noted.

While there is no way to prevent every eating disorder, awareness of risk factors and open communication can make a difference. If your college student does end up struggling with an eating disorder or other mental health issue, it’s crucial that they know you are there for them to catch them if they fall and help them get the support they need.

If you are worried your child may have an eating disorder, it is important to get an evaluation and treatment as soon as possible. Families can find resources and referrals at The National Alliance for Eating Disorders.

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