One of the tricky things about mental health problems is that the outside world only sees the tip of the iceberg. The observable behaviors and symptoms are apparent for all to see, but underneath the visible exterior is a complex set of thoughts, emotions, beliefs, and experiences. These are the mechanisms which truly power things like eating disorders and OCD, but for better or worse, they tend to go unnoticed. It makes sense, then, that someone might believe that treating these problems is as simple as telling someone to “just eat” or to “just stop eating.” After all, we have the ability to make choices about our behavior, so shouldn’t we be able to wrangle these symptoms into our control? When a therapist says to resist a compulsion or to follow a meal plan, aren’t they saying that it’s just a matter of pushing through the discomfort?

As you probably know, it’s not quite that simple. Sure, determination and willingness will come in handy, but we have to be careful not to reduce this process to something so simple. The oversimplified American mentality of “picking yourself up by your bootstraps” doesn’t always fit with the complexities of mental health. Tempting as it might be to double down on willpower, it’s actually not a particularly effective way to get things done. Willpower is a finite resource. We inevitably lose steam and end up depleted. 

Episode description:

In this episode of Peace Meal, Rachael Steil shares her past struggles with anorexia and binge eating and her current passion for helping athletes with eating disorders. Rachael loved running from a young age, but the drive she felt to improve in her sport contributed to restrictive eating behaviors. She says she became obsessed with food and started pulling away from her friends and hobbies. Once Rachael started her recovery journey, she received incredible support from her college running coach. Reflecting on this experience, Rachael explains the essential role that coaches can have on their athletes’ lives and the importance of educating coaches on eating disorder warning signs. Rachael ends the podcast with the inspiration for creating her memoir Running in Silence and her nonprofit of the same name and previews the topic of her next book. 

Rachael Steil is an eating disorder recovery advocate and the author of Running in Silence, which details her story as an All-American athlete struggling with anorexia and binge eating. She is also the founder of the Running in Silence nonprofit to break misconceptions and raise awareness for eating disorders in sports, serves on the board of the Michigan Eating Disorder Alliance, and is currently a mentor for the USTFCCCA Female Coaches Mentorship Program. 

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For many people, college is a time of tremendous transition and change. It provides new freedom and responsibility and offers lessons in life far beyond the classroom.

It is a milestone time—and one far too often hijacked by eating disorders.

All types of eating disorders can develop, return, or worsen in young people during their college years. Though these illnesses occur across the lifespan, they are particularly prevalent between the ages of 18 and 21. Research has found that the median age of onset is 18 for anorexia and bulimia and 21 for binge eating disorder, both findings within the age range of the traditional college student.

This article examines eating disorders in college students, including potential risk factors, warning signs, and tools for screening and intervention. Learn what makes college students particularly vulnerable to these complex mental illnesses as well as ways to identify and support those affected by them during college and beyond.

Tell us about yourself!

Hi! My name is Tamara Peters (she/her), BSN, RN, and I am the Lead RN at The Emily Program’s Seattle Residential site. I have worked with the Seattle Residential team as a nurse for over four years, and I hope to remain here for many years to come.

Describe the career path that led you to The Emily Program.

I have been a nurse for ten years. I started my nursing career as an LPN in 2012 and then earned my ADN in 2014. During the pandemic, I returned to university and earned my BSN in 2021. I love being a nurse. It has allowed me to help others and meet many wonderful patients and clients over the years. I have worked in various specialty settings, including adolescent behavioral health, medical-surgical, oncology, and at present, eating disorder treatment. 

“Eating disorders.” Reading those two words, most of us just visualized a teenage or college-aged girl. And let’s be honest—she’s probably white as well.

Not so long ago, age seemed to immunize adult women from the body image concerns, weight issues, and eating disorders that plague the younger years. Although most cases still appear in adolescent girls and young women, an alarming shift has occurred. Eating disorders have been on the rise among middle-aged and older women. Between 1999 and 2009, inpatient admissions showed the greatest increase in this group, with women over age 45 accounting for a full 25% of those admissions in the United States. Despite this, these women are invisible in our healthcare system. This must change.

The cultural pressures to be perfect—including having a flawless, slim body—have no expiration dates and no boundaries. This pressure is now occurring across age, gender, sexual orientation, race, ethnicity, ability, class, culture, and place. Our fast-moving consumer culture has created unprecedented opportunities and stress for women. Despite growing economic strength, political influence, and educational and career opportunities, a Gallup Well-Being Index indicates that women aged 45 to 64 have the lowest well-being and highest stress of any age group or gender in the United States.

What is ARFID?

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by food avoidance or restriction that results in nutritional deficiencies and interferes with daily functioning. As in anorexia, ARFID can lead to significant weight loss or a failure to gain weight. It does not include concerns about body weight and shape, however. Instead, ARFID primarily manifests as avoidance related to the sensory properties of food and fear about eating.

Previously known as selective eating disorder (SED), ARFID was introduced in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The following criteria must be met for an individual to be diagnosed with this eating disorder: