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:

Episode description:

In this episode of Peace Meal, Eric Pothen discusses how well-meaning comments about his body played a part in the development of his eating disorder. Following the body commentary he received after college, he says he started restricting, bingeing, and purging via excessive exercise. Eventually exhausted by the darkness he was living in and the feeling of losing himself, he set out on a path to recovery. He explains how preparing for a marathon helped his recovery because he had to focus on nourishing his body to prepare for the race. He also tells us how affirmations played an integral role in his recovery. Eric ends the podcast by explaining that recovery not only gives you freedom from your eating disorder, but also helps you rediscover and love yourself.

A middle school choir teacher in Albertville, MN, Eric struggled with an eating disorder for several years. Today, he uses his previous struggles of having an eating disorder as his strength to raise awareness and serve as an advocate for those who struggle with these illnesses, disordered eating, or body image. Eric is the owner and founder of the apparel company Embrace Wear, whose mission is to help others learn how to embrace themselves and discover beauty and self-worth within. He recently launched a podcast of his own, Embracing You, which is now available on Apple Podcasts.  

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Tell us about yourself!

My name is Jill Fondriest (she/her), and I am the Office Manager at The Emily Program’s Columbus, Ohio outpatient site. I have a Bachelor of Science in Accounting from the Urbana University College of Business. I started at The Center for Balanced Living in July 2016, and we became The Emily Program in March 2020., So, I have been with the company for a little over two years and working for clients with eating disorders for almost six years. Initially, I worked with The Emily Program admissions team (an AMAZING team—I adore and miss you all!) before starting in my current role as Office Manager in May 2021.