College Students: Types of Eating Disorders

Eating disorders are a group of related conditions involving extreme food and weight issues, but each disorder has unique symptoms and diagnosis criteria. Some eating disorders are more common than others and a few are most prevalent and known within colleges and schools.

1. Anorexia nervosa

Anorexia nervosa is likely the most well-known eating disorder and is the most common on college campuses as well as in high schools.

Anorexia usually develops during teen years or early adult years and tends to affect more women than men, however it can and does affect men as well. People with anorexia generally view themselves as overweight, even if they’re dangerously or significantly underweight. They tend to constantly monitor their weight, while they avoid eating certain types of foods, watch their calorie intake, and severely restrict their diet to a point where it's not healthy.

Common symptoms of anorexia nervosa include the following:

restricted eating patterns
intense fear of gaining weight or persistent behaviors to avoid gaining weight, despite possibly being underweight
unwillingness to maintain a healthy weight
a heavy influence of body weight or perceived body shape on self-esteem/low self esteem/body images issues
a distorted body image, including denial of being seriously underweight/feelings that they need to lose additional weight to be seen as healthy and/or attractive

Anorexia is not just about weight loss and when being diagnosed, weight loss should not be the primary focus. Instead, the focus should be on their mental health, reasoning for losing weight, and their behaviors surrounding weight, body image, self esteem, and nutrition. Significant weight loss does not mean someone has anorexia, however, as some illnesses and drugs can induce quick weight loss. With that said, someone with anorexia may also not be severely underweight. In atypical anorexia, a person may meet the criteria for anorexia but not be underweight, even if they have lost a significant amount of weight. Many people with anorexia are preoccupied with constant thoughts about food, and some may display signs of OCD or anxiety. They may also have difficulty eating in public and exhibit a strong desire to control their environment, limiting their ability to be adventurous as they want to maintain control over who they are with and where they are going, especially when it comes to eating meals or going out.

Anorexia is officially categorized into two subtypes — the restricting type and the binge eating and purging type. Individuals with the restricting type lose weight solely through dieting, fasting, or excessive, unhealthy exercise. Individuals with the binge eating and purging type may binge on large amounts of food or eat very little throughout the day. In both cases, after they eat, they purge through vomiting, taking laxatives, or exercising excessively. This is more common on college campuses than the other eating disorders. Over a longer period of time, anorexia can be very damaging to the body. Over time, individuals living with it may experience thinning of their bones, infertility, skin issues, trouble concentrating, higher levels of anxiety, and brittle hair and nails. In severe cases, anorexia can result in heart, brain, or multi-organ failure and even death in more extreme cases of anorexia.

2. Bulimia nervosa

Bulimia nervosa is another well-known eating disorder, and is more common during teen years and young adulthood. Based on studies, bulimia is more common with women, than with men. People with bulimia frequently eat large amounts of food in a specific period of time, often later in the evening or at night. Each binge eating episode usually continues until the person becomes overly full. During a binge, the person usually feels that they cannot control how much they are eating. Binges can happen with any type of food but most commonly happens with foods the individual would usually avoid, typically more unhealthy foods such as candy, snacks, and high calorie meals. Individuals with bulimia then attempt to purge to compensate for the calories consumed. Most common purging behaviors include forced vomiting, fasting, and excessive exercise. Vomiting and fasting or most common within colleges.

Individuals with bulimia usually maintain a relatively typical weight rather than losing a large amount of weight like with anorexia.

Common symptoms of bulimia nervosa include:

recurrent episodes of binge eating with a feeling of lack of control
recurrent episodes of inappropriate purging behaviors to prevent weight gain after eating
feelings of guilt for eating large amounts of food which typically lead to purging
self-esteem overly influenced by body shape and weight
issues being on social media, always comparing themselves to others/not happy with their body type
a fear of gaining weight, despite having a typical weight

Side effects of bulimia may include an inflamed and sore throat, swollen salivary glands, worn tooth enamel, tooth decay, acid reflux, irritation of the gut, severe dehydration, and hormonal disturbances (11Trusted Source). In more severe and rare cases, this can cause a stroke or heart attack.

3. Binge eating disorder

Binge eating disorder is the most prevalent form of eating disorder in colleges and one of the most common chronic illnesses among adolescents and young adults. It typically begins during adolescence and early adulthood, although it can develop later on. People with binge eating disorder typically eat unusually large amounts of food in relatively short periods of time and feel a lack of control during binges, same as with bulimia and anorexia. However, people with binge eating disorder do NOT purge, vomit, or use other means to reverse their purging.

Common symptoms of binge eating disorder include:

eating large amounts of food rapidly, in secret, and until uncomfortably full, despite not feeling hungry
eating even when body is full and uncomfortable
feeling a lack of control during episodes of binge eating/can't stop eating
feelings of distress, such as shame, disgust, or guilt, when thinking about the binge eating behavior
no use of purging behaviors/only binges food

People with binge eating disorder often consume an excessive amount of food and usually do not make nutritious food choices. This may increase their risk of medical complications such as heart disease, stroke, and type 2 diabetes. People with binge eating disorder often feel that they are being healthy as they are only eating one meal a day.

4. Pica

Pica is a lesser well known eating disorder that involves eating things that are not considered food and that do not provide nutritional value. Individuals with pica crave non-food substances such as ice, dirt, soap, paper, hair, or even things like cloth, rocks, sand, and laundry detergent. Pica can occur in adults, children, and adolescents. It's most common in those with autism, intellectual disabilities, or mental health conditions like schizophrenia. A serious concern for those with pica is damage to their internal organs, poisoning, internal injuries, and risk of illness or infections by what they consume, as the body is not typically used to these items being digested. Depending on the material and item being used, it can be serious, life threatening, or fatal. For the condition to be considered pica, the eating of non-food substances must not be considered a socially acceptable practice by a person’s peers and must be more consistent. For example, eating sand once on the beach as a child wouldn't be considered pica.

5. Rumination disorder

Rumination disorder is a newer eating disorder and is not commonly talked about, you may not have even heard of it yet! With this eating disorder, a person re-chews or spits up food they have already chewed and then re-swallows it or spits it out. This typically occurs within the first 30 minutes after a meal.

Other less-common eating disorders in colleges

Purging disorder: Individuals with purging disorder often use purging behaviors, such as vomiting or using excessive exercise, however, they do not binge.
Night eating syndrome. Individuals with this syndrome frequently eat excessively at night, often after awakening from sleep or rifght before they go to sleep. These individuals do not purge and may not eat throughout the day