The Freshman 10? Freshman 15? As 1.5 million students pack up their lives and enter college this fall, weight will be an issue. But is the concern more about pounds on or pounds off?
We all know the message of weight gain, as mythologized by "The Freshman 10" (or 15, these days), referring to the alleged propensity of students to pack on 10-15 pounds as they first enter the world of dorms and frat parties. The myth has been debunked. But that doesn’t stop public health officials from aggressively counseling students about how not to get fat at school.
In their zeal, anti-obesity campaigners have overlooked a startling proportion of students losing 15 pounds, and more, and getting eating disorders. A startling poll commissioned by the National Eating Disorders Association (NEDA) showed that 20 percent of students admitted to having an eating disorder at some point in their lives. More frightening, 75 percent of surveyed students claimed that they never got any treatment.
How many are sick at the time they are in college? No one really knows. Some studies estimate that 4-5 percent of college students suffer from an eating disorder.
But that is likely an underestimate because, in part, students with bulimia often weigh in the normal range and become highly skilled at hiding symptoms (bingeing, vomiting and/or overexercise). And those with binge eating disorder (BED) aren't even counted. (A person with BED consumes 2,000 to 10,000 calories in a sitting and feels out-of-control to stop. No purging involved.)
If a student gains weight at school, parents typically chalk it up to late-night pizza and bagels. But excessive weight gain can equally signal an eating disorder. Ditto for excessive weight loss. Both should trigger flashing red lights and a treatment plan.
I was lucky. When I was in college, I had anorexia and, therefore, my problem was obvious. When, as a freshman, I came home on Columbus Day weekend for my first break, I weighed 85 pounds. Seeing my gaunt frame, my parents immediately knew to call a local psychiatrist, who set me up with regular psychotherapy for the next four years. If I had had bulimia or even binge eating disorder, I don’t know how soon I would have asked for help, if at all. And my parents would not have the telltale clue of my weight to guide them.
As much as we are warned and warn about drinking, sexual promiscuity and, most recently, violence on our nation’s campuses, we also have to think and counsel about dorm rooms as Petri dishes for eating disorders of all dimensions.
One of the difficulties is the public's general lack of understanding about causes eating disorders. The conventional wisdom says that eating disorders are stem from a desire for thinness. Simple causal relationship. And, in fact, that desire may be the gateway into dieting, bingeing, and purging.
But eating disorders are also misguided attempts to deal with overwhelming stress, a given for any life transition. And one of the most powerful transitions is puberty, which is usually the first time we see the onset of anorexia and bulimia in many girls and boys. But later transitions can spawn eating disorders, too. College is the second blip, where bulimia, and now binge eating disorder, are surging.
Why? Eating disorders experts cite pressure to keep grades up; fit in socially; live with other people with different values, habits and personality styles; and navigate the nutty world of dorm rooms, and who is sleeping where and with whom.
For many students, this is the first time that they will have to get their own meals. When and what to eat? Those with the drive to binge, go for comfort foods, often laden with fat and calories. It solves two problems: getting fed and also coping with stress. Those with the drive for thinness cut back to nothing and develop a series of rigid rules about food and exercise that seem to provide safety, but actually set the groundwork for a life-long battle with anorexia.
Thus, amid courses of Economics 101, General Biology, and Introduction to Shakespeare, a lesson in balance is warranted – balance between nutrition, sleep and exercise.
The overall idea is for a student to learn how to take care of him or herself and so feel good about who he or she is -- even in a stressful, shifting academic world. Food is part of the landscape. Good foods are fuel and therefore healthy. Food is not a drug. Nor is it something to view as poison.
And body size is not identity. There is so much more to a person who is standing on the brink of his or her life, ready to take the first step. Thus, public health officials and campus counselors need to broaden their message about maintaining a healthy weight to encouraging overall well-being. Parents, roommates, and teachers need to know the warning signs of all kinds of eating disorders.
And then look out for The Freshman ± 15.
If you see the following behaviors, they are red flags for an eating disorder:
1. Skipping meals or gorging on food
2. Obsessing about body and clothing size
3. Exercising excessively and compulsively
4. Acting moody, irritable and having difficult talking about feelings
5. Having problems with forming and maintaining friendships
Web Resources:
More Signs of an Eating Disorder
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Ten Things Parents Can Do to Prevent Eating Disorders in their Children
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General information about Eating Disorders, Prevention and Treatment
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