‘Restricted’: How disordered eating is disguised and normalized on college campuses
For students attempting to define themselves as individuals, sometimes for the first time, college can present an environment that makes comparison, competition and disordered eating seem like normal parts of the process.
By Tess Wells
Published April 21, 2022
Rani Bawa was in recovery for an eating disorder and doing well when she came to Ohio State as a freshman.
Her struggle with anorexia nervosa began in high school, and she planned to continue recovery as she moved away from home-cooked meals and parents who kept a watchful eye over her. She and her family made plans about how best to keep up her health while on campus, including starting her on the unlimited meal plan due to her history with restricted eating.
Rani Bawa, a Ph.D. candidate in social psychology. Credit: Mackenzie Shanklin | Photo Editor
Then came new classes, new surroundings and a desire to regain control, all in a college environment that Bawa, now a first-year Ph.D. candidate in social psychology, said normalizes restricted eating and demonizes weight gain.
Bawa went on in her time as an undergraduate to become the president of Project HEAL at Ohio State — a branch of the national organization, which works to spread awareness about eating disorders and raise funding for treatment grants. She said noticing disordered eating in herself and other students was what drove her to try to make a difference.
“Eating disorders thrive in times of transition and control because they give you something to control,” Bawa said. “So when everything is changing — you’re moving, you’re making new friends, you’re doing new classes — I think that’s such a time when people are very vulnerable to disordered eating and eating disorders.”
Kristen Swope, a senior staff psychologist with a focus on men’s issues for Counseling and Consultation Service at Ohio State, said 6 percent of students receiving treatment through CCS from July 1, 2020, to June 30, 2021, met the criteria for a diagnosable eating disorder.
Swope declined to comment on the percentage of students at Ohio State seeking help with CCS for body image or eating disorders as their primary concerns, citing patient privacy. However, she said 13 percent of students seeking help nationally indicate these as primary concerns.
“While 13 percent might not sound like a lot, I do think that’s increasing over time, not only because the prevalence is increasing, but also because people — as stigma decreases — people are becoming more comfortable to indicate that as their primary concern,” Swope said.
The differences between diagnosable eating disorders — such as anorexia and bulimia nervosa — and more isolated disordered eating tendencies can be nuanced, but disordered eating tendencies often manifest as a handful of unhealthy behaviors that still may not qualify as a clinical eating disorder, Bawa said.
“Any behavior that is used to control one’s diet or one’s body shape, but it applies to just any behavior. So it can be restricting, it can be overexercising, it can be purging,” Bawa said. “An eating disorder is a combination of a lot of those behaviors that qualifies for a clinical diagnosis.”
On college campuses, disordered eating tendencies can manifest as a desire to “save calories” by not eating before going to bars, overexercising, purposely substituting caffeine for meals or habitually skipping meals altogether, according to students and experts interviewed by The Lantern.
So when everything is changing — you’re moving, you’re making new friends, you’re doing new classes — I think that’s such a time when people are very vulnerable to disordered eating and eating disorders.
Disordered eating behaviors often go hand-in-hand with “a rigid food and exercise regime; feelings of guilt or shame when unable to maintain said regime; a preoccupation with food, body, and exercise that has an impact on quality of life; [and] compulsive eating,” according to the National Eating Disorders Association.
Competitive mentalities about eating less than others can further fuel disordered behaviors on college campuses, which could stem from students wanting to define themselves as individuals for the first time, Morgan Blumenfeld, embedded care manager at Student Health Services and a Greek life liaison for CCS, said.
“A lot of that competitive behavior comes from the developmental stage that college students are in, right, where they’re trying to define their own identities, and they’re becoming an independent adult from their families,” Blumenfeld said.
Samantha Tortora, a psychotherapist for the Wexner Medical Center at Ohio State, said unlike anxiety and depression, which students seek help for much more commonly, disordered eating is not always seen as a problem — it’s more so deemed a personality trait.
“It’s thought of more as like, ‘This is just part of who I am as a person. So then there’s nothing wrong, there’s no issue here,’ ” Tortora said. “It’s the combination of that, how normalized these things are just societally, so it is very rare that someone will self-identify as having an eating disorder. And even then, it’s also still rare that they are really wanting or willing to get help.”
Although determining the number of students who engage in disordered eating behaviors is notoriously difficult due to the vast range of possible disordered behaviors, a 2020 study cited a 2011 study published in the Journal of American College Health and a 2017 study to estimate the range falls between 20-67 percent of college students.
Tortora said there are likely many students who engage in more isolated disordered behaviors, compared to those who obtain clinical diagnoses.
“I want to believe that people who have, like, a really clinical, diagnosable eating disorder, I hope, is small,” Tortora said. “But there probably is a lot more people in that subclinical piece where they have some behaviors that, in isolation, are not an eating disorder, like counting calories or obsessively weighing yourself, or restricting certain foods or food groups.”
Gillian DeRoche, a fourth-year in human nutrition, was often thought of as the “fit friend” in high school. She was a rugby player who could frequently be found in the gym and received outside praise about her body.
However, when DeRoche came home from two-hour-long practices, she would sometimes consume a snack-sized amount of food in place of dinner. Although she said she now has a much healthier relationship with food, her own experiences have made her keenly aware of disordered eating tendencies around her.
Eating tendencies and party culture
Some of the most prevalent disordered eating tendencies DeRoche said she has seen in college students — particularly women — are related to nightlife and going out.
“They will, like, work out and eat what they deem perfectly healthy all week. And then, when the weekend comes, they don’t really have control over what they eat once they go out, once they’re in a drunk state or a more relaxed state,” DeRoche said. “It’s kind of like a cycle on college campuses, that girls will restrict, and then once they go out, they’ll eat more.”
This type of yo-yo dieting — which DeRoche described as a cycle of losing then regaining weight — is not uncommon, and DeRoche said this can lead to even more weight gain in the long run because undereating can slow one’s metabolism.
“You see more girls doing these things than you see them not doing these things, which is a little ridiculous when you put it out on paper that girls are going to undereat so they can get drunk faster so they can look good in their crop top for some frat man that’s not even going to notice,” DeRoche said.
Jessica Altshuler, a fourth-year in psychology and women’s, gender and sexuality studies, said disordered eating tendencies surrounding going out are so prevalent that there have been specific terms coined to describe different habits.
“Pulling trig” — inducing vomiting after drinking excessively — and “drunkorexia” — deliberately not eating before going out to increase the effects of alcohol — were several phrases she said are common enough to be recognized by many students.
Credit: Christian Harsa | Special Projects Director
Altshuler is the president of Body Sense, a student organization that aims to promote inclusivity within the body positive movement, according to its student organization page. She said she has struggled with anorexia since her senior year of high school and is still receiving treatment for her eating disorder. When she first came to Ohio State, she said she was more able to see disordered eating tendencies in those around her because of her own struggle with an eating disorder.
“Going out and drinking and people not eating is something I noticed right away,” Altshuler said. “So I was like, ‘Oh, if I’m doing this and I have this diagnosed problem and they think it’s normal, it’s probably not normal.’ They just don’t want to talk about that, they’re not ready to talk about that.”
Campus meal plans and competitive eating
Disordered eating on campus is not limited to nightlife, however, and Altshuler said other behaviors she has noticed include constantly skipping meals or substituting caffeine for food.
Of the two meal plans that allow students to dine at any location on campus, the largest is the Scarlet 14 plan, which allots 14 swipes a week worth $8 each to students. Bawa said only allowing students to eat twice a day without spending additional money does not provide them with enough food.
Despite the already limited swipes provided by the Gray 10 and Scarlet 14 meal plans — with the Unlimited plan only accepted at three Traditions locations on campus — DeRoche said she has noticed a competitive nature regarding how many swipes the people around her have left at the end of the week, as though having more swipes left over is better than eating regularly.
“I eat my three meals a day, you know, I’m not the type of person that I’m going to skip meals just because I only have so many swipes,” DeRoche said. “I felt like I saw all these women around me that would have, like, 10 swipes at the end of the week, and I’m like, ‘How is this even possible?’ ”
Similar competitive eating behaviors are not limited to Ohio State. Naseem Dillman-Hasso, a first-year Ph.D. candidate in environmental social sciences, said behaviors around swipes and meal plans at Ohio State are strikingly similar to what he noticed during his undergraduate career at Carleton College in Northfield, Minnesota.
Dillman-Hasso said the idea of competing with other students was prevalent in many facets of college life around him, as well. He said he noticed students at Carleton College refraining from using swipes in order to compare with others at the end of the week.
“I feel like the best analogy is very similar to how people stress brag and ‘lack of sleep’ brag, where it’s like, ‘Oh my gosh, I’ve been doing so much work, I only got four hours of sleep last night,’ or, ‘I’m so stressed, no, no, like, I’m more stressed than you,’ ” Dillman-Hasso said. “I feel like that parallels a lot into the areas of food or overexercise.”
DeRoche said she has noticed a competitive nature regarding how many swipes the people around her have left at the end of the week, as though having more swipes left over is better than eating regularly.
Anna Carli, a second-year in international studies and Spanish. Credit: Mackenzie Shanklin | Photo Editor
Anna Carli, a second-year in international studies and Spanish, said she attributes the competitiveness that is inherent on a college campus to the age-old adage that college is supposed to be the best time of one’s life. Students want to be the smartest, the most successful and the best-looking, she said.
“People kind of emphasize how college is your golden years. And it’s the time to find, like, people you’re going to end up marrying or participating in sororities and social events. It’s your first time putting yourself out there with people you didn’t grow up with,” Carli said. “Everyone kind of emphasizes the value of how you look because it ‘matters’ in so many different aspects.”
DeRoche said it’s common for students to compare themselves to others in situations ranging from the classroom to social functions.
“I feel like everyone on a college campus is always comparing themselves to other people, whether it be academically, socially or physically,” DeRoche said. “And then the physically kind of just manifests itself in really ugly ways, in disordered eating, overexercising, undereating, and then binging; like, it all kind of culminates into a huge issue.”
The desire to feel a sense of superiority extends beyond comparing meal swipes at the end of the week, and Carli said that same feeling often comes with disordered eating tendencies or eating less than someone else in a college setting.
“I remember I was getting sushi and I picked up the roll I wanted, and I saw a girl, she was watching me,” Carli said. “She picked up the roll I wanted, looked at the calories, looked at me and put it back down and got the lower calories.”
Carli said despite the moment of satisfaction that someone may feel when they eat less than another person, there is no real “winning” when it comes to disordered eating tendencies.
“I mean, if you really think about it, how is it winning? If you’re eating less calories, the only thing that does for you is make you have less energy,” Carli said. “There are so many cons. The only pro is, like, ‘winning diet culture,’ but that’s the only pro, and that’s temporary happiness — it’s very temporary, very fixed happiness that will not last. And so just, at the end of the day, who’s really winning?”
I feel like everyone on a college campus is always comparing themselves to other people, whether it be academically, socially or physically.
The idea of what constitutes a healthy diet and exercise regimen can be distorted on a college campus and is often viewed as a “one-size-fits-all” blanket. DeRoche said she used to habitually replace foods with their lowest-calorie-possible counterparts, instead of taking nutritional value into account — such as exchanging whole eggs for egg whites — and knows people who do the same.
Despite students sometimes taking a blanket approach to health, Tess Coscarella, a fourth-year in pharmaceutical studies and current president of Project HEAL, said health is subjective depending on one’s caloric needs and stage of development.
However, Coscarella said this can be hard to remember as a member of a 60,000-person student body. Many people, herself included, compare themselves to one another on a regular basis, sometimes subconsciously, she said. It’s important to remember that it is unrealistic to expect one’s body to look like any other, she said.
“If everyone on this planet ate the exact same meal every day and worked out the exact same, we’d all still look different,” Coscarella said. “But I think that’s hard to remember when you’re on campus.”
Not only is a college campus rife with comparison, but college is a time complete with change in every regard, Carli said. College students often find themselves fully developing from their teenage bodies to adult bodies — especially during the first few years of college, she said.
Despite the understanding many students already have of the prevalence of normal weight gain in college, Bawa said there is still a pervasive tendency to reflect on high school bodies instead of working to embrace their new ones.
“People are scrolling through their Instagram and being like, ‘Oh, my God, I was so skinny back then, look at my prom pictures,’ ” Bawa said. “You’re not in the same body as you were back then, so it doesn’t make sense to make those comparisons.”
Khaila Washington, a third-year in social work, said disordered eating comments and tendencies are picked up on by those around one another, which is part of the reason they have become so normalized on campus when students are so frequently around others.
“It’s so easy to get so caught up in those disordered eating habits, especially if you’re friends with someone,” Washington said.
Washington said her own relationship with food changed from several disordered eating tendencies to an eating disorder in 2020. She said comments from others about her weight — whether the comments were about her gaining or losing it — were what truly caused her disorder to spiral out of control.
Despite the harm from comments about weight, Washington said she still catches herself making similar comments in front of her own friends. In one of those instances, she said she noticed her own behaviors manifesting in a friend of hers.
“I would sit and weigh myself in front of her, and then if I see a number I didn’t like, I’m freaking out, and so then she would do the same thing,” Washington said. “I would force her to come to the gym. I’m like, ‘We’re on our healthy stuff, like, let’s get skinny,’ and I just vividly remember her also stepping on the scale, and if she gained weight, it was like this big freak-out moment, and she has never done that before.”
Those who are particularly vulnerable to weight-related comments and who also tend to receive them the most are freshmen, who are infamously warned to avoid the notorious “freshman 15” — the idea that students will gain 15 pounds within their first year of college. Washington said she found herself adhering to disordered eating behaviors to avoid weight gain during her first year at Ohio State and subsisted largely on cereal and fruit.
Elliot Marrocco, a fourth-year in environment, economy, development, and sustainability, said they have struggled with anorexia since they were 10 years old. However, they said it became the worst it had ever been during their freshman year of college. The combination of navigating isolation and attempting to exert control over something in their life, along with fear of the “freshman 15,” caused them to fall into extreme patterns of restriction.
Union Market, located in the Ohio Union, allows students to explore multiple food options. Credit: Mackenzie Shanklin | Photo Editor
“The only, really, control that I had in my life was through my eating — it was very restrictive,” Marrocco said. “It kind of snuck up on me. It started out as only eating the same thing in the dining halls, like every single day. And then it went into calorie counting, and then it went into really extreme levels of restriction.”
The idealized male body and eating disorders in men
Marrocco said although it is wonderful to see how many resources there are out there for women who may struggle with body image and disordered eating, the lack of similar resources for men is jarring.
“It all starts with, like, ‘Here is the image of what men should look like.’ And it’s a very built person, someone who’s strong,” Marrocco said. “That becomes the standard that men kind of feel like they have to reach in order to be worth anything, in order to be noticed by other people, in order to find happiness.”
Dillman-Hasso said this idealized male physique could stem from the fact that men often are shown a distorted version of what the average male figure is supposed to look like when growing up and are never shown anything to the contrary as they get older.
“Teenagers idealized these really buff, bulky, strong, built people when they’re younger and they see people in pop culture and movies and TV shows and stuff like that,” he said. “I feel like that also creates unrealistic expectations. And it’s just like, people perceive that, like, this is what someone who’s attractive, this is what someone who’s healthy, this is what someone who’s made it, quote-unquote, is supposed to look like.”
In Swope’s dissertation, “Muscle Dysmorphia Characteristics and Body Dissatisfaction Among Exercise Science Majors,” she cited a 2015 study that stated 80 percent of college men admitted to some level of body dissatisfaction. Although this does not mean the same number of men engage in disordered eating tendencies, it is a number Swope said warrants a closer look.
Not only do the majority of college men feel dissatisfied with their bodies to some extent, but Swope cited a 2013 study indicating those with muscle dysmorphia — a form of body dysmorphic disorder that causes those affected to have a skewed perception of the size and shape of their own muscles, Tortora said — have higher levels of dissatisfaction with their bodies.
“The ideal body for males (similar to females) is unrealistic and nearly impossible to achieve and/or maintain without prioritizing diet and exercise over the demands of everyday life,” Swope said in her dissertation.
When men do engage in disordered eating tendencies, Swope said overexercise is common because it “kills two birds with one stone” and burns calories while growing muscle. She said other behaviors she has seen include the use of diet pills, laxatives and, less commonly, steroids, as well as undereating and overconsuming protein.
Despite the hold these behaviors sometimes have on college-aged men, Swope said it is less common for men to reach out for help. Part of this stems from a lack of awareness amongst men that behaviors they exhibit are disordered in the first place.
“In my experience, the vast majority of men who I’ve worked with who, like, eating concerns, body image concerns, ends up being a significant portion of our work together, did not originally come in with that,” Swope said.
For many college-aged men, habits that qualify or may be seen by those around them as disordered are sometimes viewed as healthy, Carli said.
“Any time I’ve seen this and brought it up, people were like, ‘Stop being a snowflake, like, it’s literally fine, I’m just, like, trying to feel better in my body,’ ” Carli said. “There’s a really fine line between taking care of yourself and just totally being disordered.”
Although only 3.6 percent of undergraduate men on college campuses screen positive for eating disorders, according to the 2011 study, Swope said the number is likely higher than is reported in studies for reasons beyond men not seeking help on their own or realizing they are exhibiting disordered symptoms. She said diagnostic criteria for eating disorders are gynocentric, meaning they reflect how women tend to present, not men.
“So if you think about anorexia, for example, one of the criteria is fear of gaining weight or becoming fat. Well, if men are restricting their diet in some way to achieve, you know, the ideal like masculine, super, hyper muscular, you know, ideal, they might not be fearing gaining weight. They want to gain weight. They want to gain muscle,” Swope said. “That doesn’t mean that they don’t have some type of disordered eating, but we’re missing it.”
Seeking treatment and speaking up
Despite the relative lack of conversations on college campuses around disordered eating, eating disorders and what constitutes a healthy body, Altshuler said it is worth initiating conversations that are conducive to healthy eating habits and recovery, even if they may feel uncomfortable.
Altshuler said her own eating disorder was caught by someone in her high school marching band who messaged her to offer support and say she could sympathize with the former. Although she didn’t immediately act on the message, Altshuler said it helped her put her behaviors into perspective and was the catalyst for her road to recovery.
“I’ve seen the good that can come out of recovering and being healthy, and so that’s why I have my reasons now to stick with it,” Altshuler said. “But at first it was very much outside of myself. Like, I have a little sister; I wanted to be around to see her do things in life. I wanted to be able to do things with my friends and not be stressed about what I was eating or what we were doing.”
Marrocco said it can be easy to assume it’s not one’s place to speak up when suspecting someone of having an untreated eating disorder. However, they said eating disorders are some of the most lethal mental disorders and warrant people speaking out about them.
I’ve seen the good that can come out of recovering and being healthy, and so that’s why I have my reasons now to stick with it. But at first it was very much outside of myself. Like, I have a little sister; I wanted to be around to see her do things in life. I wanted to be able to do things with my friends and not be stressed about what I was eating or what we were doing.
Additionally, they said eating disorders and disordered eating tendencies are not something anyone should assume they have to struggle with alone. For those questioning whether or not their behaviors are healthy, Marrocco said to think about how much time they spend thinking about food and exercise and whether they use food and exercise to be healthy or to reach an “amorphous goal in your head about how you think you should look.”
“You’re not alone in what you’re going through, obviously, since it is almost an epidemic in college,” Marrocco said. “You don’t have to live like that. You don’t have to live with the thought process that food is not your friend, because it is. It’s what keeps us alive. It’s what keeps us going.”
Resources for those looking for help with disordered eating, eating disorders or other related concerns:
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