College can be a pressure cooker. Between exams, trying to look good, social life FOMO (fueled by social media) and the pressure to “find yourself” in four short years, it’s a wonder more students don’t crumble. But when it comes to eating disorders, a whole lot of students actually do.
Eating disorders (I’ll refer to them below by using “ED”) are like that sneaky toxic roommate who seems harmless at first—until they take over everything. These disorders often slip in during college, where the chaos of new responsibilities and stress turns many students’ relationship with food and body image into a battleground. Sometimes, they’re there even before freshman year when junior and senior high school year pressures really dial up.
How EDs Manifest in College
First off, let’s talk about the “how.” EDs—whether it’s anorexia, bulimia, binge eating, or the less flashy but just as destructive disordered eating—feed off the overwhelming pressures that college students face. It’s like the perfect storm of insecurity, peer comparison, and the feeling that life is spiraling out of control.
Here’s a quick review of the differences between the diagnoses:
Anorexia Nervosa: Extreme food restriction, an intense fear of gaining weight, and a distorted body image.
Bulimia Nervosa: Involves cycles of binge eating followed by purging behaviors (vomiting, laxative use) to avoid weight gain.
Binge Eating Disorder: Frequent episodes of consuming large quantities of food without purging, often followed by feelings of shame.
Disordered Eating: This is a super broad range of irregular eating behaviors that may not warrant a diagnosis of a specific eating disorder but are unhealthy and impact one or more life domains (eg. academics, social life).
In college, students are thrown into an unstructured environment where food becomes something they can control—or at least, they think they can. They may start by skipping meals to focus on schoolwork or bingeing because of stress, and boom—it snowballs. Pretty soon, food isn’t fuel anymore, it’s the enemy, the solution, the distraction, or all of the above.
Eating disorders are a significant and growing concern on college campuses. Over the past decade, research has shown that college students are particularly vulnerable to developing eating disorders. The pressure to fit in, fear of the “Freshman 15,” academic stress, and the transition to independent living all contribute to this risk.
Recent data suggests that approximately 13-18% of female college students and 10-12% of male students have some form of an ED. Furthermore, student-athletes and transgender students are at an even higher risk, with transgender students being up to four times more likely to suffer from these disorders. These patterns are concerning, as EDs carry serious physical and mental health consequences, including malnutrition, heart complications, and increased anxiety and depression. For example, that same study cited earlier also found that up to 78% of women and 68% of men with eating disorders also showed signs of major depressive disorder.
One study from the American College Health Association in 2019 highlighted that the normalization of disordered eating behaviors on campus is widespread. Students may skip meals due to busy schedules or use stimulants as appetite suppressants, which can spiral into more serious eating disorders. Early intervention is crucial, but many students do not seek help due to stigma or lack of awareness. They also go weeks or months keeping their struggle from friends and family.
Why This Matters (and What Parents Need to Know)
If you think your kid is “just trying to eat healthy” or is “on a diet,” don’t be fooled. It’s easy to brush off early signs of an eating disorder as college experimentation or a phase. But when you start seeing patterns of restriction, secretive behavior around food, or obsessive exercise, it’s time to step in before things go full-blown bad. I’ve had tons of college students tell me that restricting food helps them get wasted faster at parties. Makes sense in a distorted kind of way if they’re only looking at the short term benefits of restriction. What can parents do if they’re not micromanaging and on campus all the time? A good time to check for this is when you visit for parents weekend. Instead of relying on what they say, focus on behavior.
Communicate without judgment. Your kid doesn’t need a lecture about nutrition—they’re probably drowning in more information than they can handle. What they need is to feel seen and supported. Ask questions about how they’re feeling, not just what they’re eating.
I also want to address the more acute question I get which is “When should I pull our (son/daughter) from school? When is an eating disorder too bad to address on campus?” This is a simple but hard answer – Unlike other mental health struggles at school, the canary in the coal mine here is not GPA or their social life, it’s simply their biometrics. Now, what do I mean by “biometrics” and how could I believe this is simple?? When a student participates in an ED assessment, medical exam, and blood work – we can pretty accurately determine whether someone has an ED. While not all of these are biometric assessments, the lab work can conclusively show clinically indicated thresholds (either too low or too high) likely caused by an ED.
This is when parents need to intervene. A medical professional and mental health professional should immediately be sought to develop a treatment plan. If the assessment comes back with critical concerns, residential treatment may be necessary at which time working with a professional who provides therapeutic placement consulting is essential.
What College Students Can Do to Help Themselves
[Parents – feel free to cut-and-paste this section to your kiddos.]
Here’s the deal: eating disorders are not just about food. They’re about control, stress, and managing feelings. If you’re skipping meals, counting every calorie, or punishing yourself after eating, it’s time to pause and ask, “WTF am I doing to myself?” Also, eating disorder mess with our perception. You likely have no idea how obvious your issues are to others and how your friends are being affected by it.
Here’s a wild idea—talk to someone! Maybe not your parents if they won’t get it. You don’t have to handle this on your own. Most campuses have mental health services (aka CAPS) that include therapy and nutritional counseling. And if that sounds too “official,” just find a friend, a mentor, or a group where you can be honest about your struggles. Trust me, there’s no trophy for “most resilient student with lowest body fat%.”
Mental Health Providers: Step Up
Mental health providers need to update their skills and not just throw generic advice at students. These disorders are sneaky, and often, the signs are subtle. It’s our job to dig deeper and create safe spaces where students feel comfortable talking about their body image and relationship with food.
We need to not assume all college students are too busy partying to need help. They’re out there, quietly struggling. We need to be proactive, make ourselves visible on campus, push for outreach, and offer specialized therapy for eating disorders.
Final Thoughts
EDs are quietly brutal. They are widely acceptable on campus but come at a high cost to students struggling with them as well as friends and family. They don’t care if your kiddo is the perfect student or the life of the party—they’ll chew them up all the same. But the good news is they’re treatable. If you’re a parent or a mental health provider, you have the power to make a difference, whether that’s through communication or proactive intervention. Similar to suicidal ideation, drug use and sex, talking about eating disorders doesn’t make someone want to engage more in the dysregulated behavior.
Let’s just agree on one thing: no one should have to fight this battle alone.