Eating disorders boom as kids enter college

NASHVILLE, Tenn. -- As college students are home for winter break, it is an opportunity for parents to notice changes in their college-age children. Those changes could include eating disorders. The real tip-off to an eating disorder isn't their appearance, but rather mood and habits.

The National Institute of Mental Health estimates that 25% of college students have eating disorders. The same percent of college women report managing weight by binging and purging, says the National Association of Anorexia Nervosa and Associated Disorders.

The problem's more widespread among women, but men aren't immune. The association says 10% to 15% of anorexics and bulimics are male.

"You can pick them out," says Katie McInnis, 32, of college students with eating problems. At 15, she began an 8-year battle with anorexia when she resisted eating in a desperate effort to be thin and perfect. "I gravitated toward them. It's almost this silent club."

McInnis was a cheerleader who ran track, and once during training, somebody commented about her "huge thighs." She hid her condition, running the shower to mask the sound of her vomiting and lying to her mother abut meals.

Though McInnis' anorexia began in high school, the average age for the onset of anorexia and bulimia is between 18 and 20, depending on the study - just as teens begin college.

Broach subject carefully

Counselors describe many signs of an eating disorder:

• Is the student depressed, anxious?
• Is he isolating himself?
• Does she seem obsessed with her appearance, size or food?
• Does he avoid eating with people, perhaps saying, "I ate earlier?"
• Is he scrutinizing food labels, counting calories?
• Is she so dissatisfied by her appearance or clothes that she avoids social activities?
• Is food disappearing?
• Does she suddenly favor loose, baggy clothes?
• Does she disappear after meals, particularly to the bathroom? (That's a sign of purging, either through induced vomiting or laxative abuse.)
• Are there sudden problems with the home's plumbing?

Parents should discuss observations with their child, but this conversation is extraordinarily delicate.

"There is a lot of secrecy and a lot of shame," says Holly Fitzhenry, a Mercy Ministries counselor.

Some students may be eager to unburden themselves, but most are defensive. Even the most well-meaning questions can prompt denial or anger.

McInnis actually advises avoiding confronting this until the student's about to return to school. Then, suggest meeting with a counselor or nutritionist together, and leave the student with a list of resources, she says.

"It's a seed that might grow later," McInnis says.

Counselors urge getting the subject out in the open - however, very carefully. Avoid words such as "heavy," "fat" or "thin."

"Ask open-ended, tentative questions," advises Nashville, Tenn., psychotherapist Kim Simpson. Say: "I notice your eating habits changed. Want to talk about that?"

Fitzhenry suggests even more subtlety. "Don't come at it from an eating angle," she says.

Try a casual review of the semester, touching on college in general. Parents can ask, "What went well for you this semester? What are you disappointed with?" That could include friends to grades to food, a natural segue to the campus meal plan. Ask, "Did your plan include too much food? Not enough?" That's the time to say, "You seem anxious/sad/preoccupied with food. I'm concerned. Anything you want to talk about?"

When to seek help

Regardless of how these chats go, parents can follow up by scheduling an appointment for their student with the family doctor. This can rule out any medical issues, such as thyroid problems. The parent can say the appointment's for a flu shot or physical, then warn the doctor in advance about eating-disorder worries.

If the student resists further treatment, parents should seek professional help, Simpson says. McInnis says the student needs some control, so give options: "Who do you trust to talk to about this?"

Finally, don't expect communication from your child's university about her eating habits or mental health. While most colleges have on-campus counseling available, it's generally up to students to seek it out, and privacy laws prevent campus-based counselors from discussing students' health with parents.

On the Web:

www.nationaleatingdisorders.org, National Eating Disorders Association, helpline: 1-800-931-2237

www.anad.org, the National Association of Anorexia Nervosa and Associated Disorders, helpline: 630-577-1330, email anadhelp@anad.org

USA Today