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Eating Disorders

Eating disorders, like anorexia and bulimia, are complex medical and psychiatric illnesses that patients don’t choose; they are bio-psycho-social diseases that result in abnormal patterns of eating and/or exercise. There is no single cause for these disorders, but society’s emphasis on physical appearance and leanness as a means of achieving success and beauty often play a role in their development. Many eating disorders begin as diets to lose a few pounds, and then become extreme. The majority of people with eating disorders are female, perhaps because women are more socialized to link their self-esteem to body image. Although eating disorders are more common in females, researchers and clinicians are becoming aware of a growing number of males and non-binary individuals who are seeking help for eating disorders. A 2007 study by the Centers for Disease Control and Prevention found that up to one-third of all eating disorder sufferers are male. Disordered eating typically begins in adolescence or early adult life. The academic and social stress of college life may trigger the onset of an eating disorder in a vulnerable person or may worsen an already existing disorder. Many college students do not meet all the criteria for an eating disorder but still have serious eating problems.

The following psychological characteristics describe people who are at a higher risk of developing an eating disorder:

  • Perfectionistic
  • Intelligent, but driven to succeed by the fear of failure
  • Low sense of self-worth
  • Difficulty in expressing both positive and negative emotions
  • “People pleasers” (feel responsible for making others feel good, especially parents)
  • Things are seen as absolutes (things are either black or white, good or bad)
  • Depressed and anxious
What is Anorexia Nervosa?
Anorexia nervosa is an eating disorder which involves significant weight loss due to self-imposed dieting, starvation, and/or excessive exercise.  Anorectics often feel they lack control over their lives, and weight loss is something over which they can have complete control. They are preoccupied with food; but instead of eating, they spend time shopping for food, planning and preparing meals, and watching others eat. They may continue to view themselves as overweight in spite of being noticeably underweight or even emaciated (“body image distortion”). 

What is Bulimia?
Bulimia is an eating disorder which involves occasional to frequent binge eating, usually followed by purging.  Common purging methods are vomiting, use of laxatives, diuretics, or excessive exercise.  When on a binge, bulimics will uncontrollably eat large quantities of food in a relatively short period of time.  Because of an intense fear of becoming fat, bulimics will attempt to rid their body of the food by purging.  This binge-purge cycle can and does become habit forming.

Bulimia can also lead to serious health problems:  dental and gum disease, digestive problems, irregular or cessation of menses, difficult weight control, injury to the esophagus, lung, stomach and or intestines, electrolyte abnormalities, kidney and heart complications, dehydration, mood changes, seizures, and dangerous heart rhythms.

What is Binge Eating Disorder?
Binge eating disorder (BED) is an eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating. Binge eating disorder is a severe, life-threatening and treatable eating disorder. Common aspects of BED include functional impairment, suicide risk and a high frequency of co-occurring psychiatric disorders.  

For You
Individuals may develop eating disorders as a way of dealing with the conflicts, pressures, and stresses of their lives. Eating disorders are often a vehicle to express control when the rest of your life seems out of control. If you have concerns about your eating or exercise habits or body image, consult with a mental health or medical provider as soon as possible.

For a Friend
Being a friend or relative of a person with an eating disorder can be a frustrating experience.  It is difficult to understand why bright and talented people punish themselves in such a severe manner.  An eating disorder is not a disorder of choice, but rather a genetic predisposition that can be triggered by any number of life changing events, such as the transition to college.

Eating disorders extend far beyond a simple issue with food, and at their worst, can be life-threatening.  Therefore, early intervention is critical. The support of family and friends can be instrumental in helping someone seek treatment and achieve a sustained recovery from an eating disorder.

If you do elect to confront your friend, a straightforward approach is best.  Emphasize the fact that you care about what happens to them.  Objectively state their behaviors that have given you cause for concern.  Try to avoid labeling or “diagnosing” the disorder. Suggest where they can go to get the help they need.  You may offer to go with them for their first visit.  When initially confronted, most people have a defensive reaction.  If this occurs, you should “leave the door open,” suggesting that they can discuss this with you at any time.

Resources Available:


The Alliance for Eating Disorders Awareness:


COPE (Coalition for Overcoming Problem Eating/Exercise) is an interdisciplinary group of medical and mental health providers, dieticians, residential and recreational professionals who work as a team to help students at IU with eating disorders. You can access COPE services through an appointment at the Medical Clinic, CaPS, or with a dietician through Health and Wellness Education.

Counseling and Psychological Services
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