Eating disorders at university: how to spot the signs and get the help you need

Going to university can be an incredibly exciting time for any student: it’s the chance to learn new skills, make new friends and explore new surroundings, all while having more control over your life than ever before.

However, it can also be a pretty daunting and overwhelming experience too. There’s a lot of pressure, both academic and social, on students and, as such, some find their mental wellbeing put under strain.

These pressures can make existing mental health difficulties worse or make it harder to cope if new problems develop. For some students, this can include eating disorders.

Here’s our guide to what eating disorders are and what you can do if you – or someone you know – is affected…

What is an eating disorder?

Eating disorders are serious mental health conditions that can affect the way a person thinks about food, eating, weight or body shape. They can involve eating too much or too little, feeling out of control around food, or using food as a way to cope with difficult feelings.

People living with eating disorders may restrict what they eat, binge eat, purge, over-exercise, or experience a mix of behaviours. These behaviours can be harmful and may be difficult to stop without support.

Eating disorders can also be linked with worries about body image, low self-esteem, anxiety, depression, obsessive thoughts or compulsive behaviours..

Here are the most common forms:

Anorexia Nervosa: This can involve trying to keep weight as low as possible by restricting food, over-exercising, misusing medicines or other methods. People affected may have an intense fear of gaining weight, and their self-esteem may become closely tied to weight or body shape.

Bulimia: This can involve binge eating and then trying to compensate by making yourself sick, misusing laxatives, fasting or over-exercising. Often those affected by bulimia are of an average weight – as the purging maintains their weight – so it can be harder to spot if someone is living with this.

Binge Eating Disorder (BED): This can involve regularly eating large amounts of food over a short period while feeling unable to stop. It can be followed by distress, guilt or feeling overwhelmed. This behaviour is usually triggered by some kind of negative emotion – like stress or depression – and those affected use food as a coping strategy to help them feel better. That sense of happiness soon fades and sufferers often feel worse about themselves than they did before.

There are also Other Specified Feeding or Eating Disorders (OSFED) which don’t necessarily match the above illnesses but are just as serious and require specialist help.

Eating disorders are classified as mental illnesses, but they can have a huge impact on your physical health too... They can increase the risk of serious physical health problems, including tooth decay, fatigue, anaemia, hormone changes, fertility problems, and kidney or liver problems.

And if the problem goes on untreated long enough, you could even lose your life to the illness. Research conducted by eating disorder charity, Beat, reports that 20% of anorexia sufferers die prematurely.

The seriousness of an eating disorder should never be underestimated and if you think you might need help or know someone who does then you need to act now.

Who gets eating disorders?

There is still a stereotype that eating disorders mainly affect young, white, middle-class women, but that isn’t the full picture. Eating disorders can affect anyone, regardless of age, gender, ethnicity, background or body type. The NHS says eating disorders are mental health conditions linked to the control of food as a way of coping with feelings or situations, and that anyone can develop one, although teenagers and young adults are most commonly affected.

Beat estimates that at least 1.25 million people in the UK have an eating disorder, and around 25% of those affected are male. The real number may be higher, as eating disorders can be hidden and not everyone seeks help.

Eating disorders can also affect people from all ethnic backgrounds. Beat’s annual Eating Disorders Awareness Week highlights that misconceptions still stop people from talking about eating disorders, with many survey respondents saying they had experienced misconceptions from others. This matters because stereotypes can make it harder for people to recognise that they need support, or to feel confident asking for it

University can be a time when eating disorders – and other mental health issues – can take hold. If you are suffering, then it’s important you speak to someone and seek help as soon as you can.

What causes eating disorders?

There is no one single reason why someone develops an eating disorder. They can develop for many different reasons, and there is rarely one single cause. Factors can include trauma, stress, anxiety, depression, low self-esteem, difficult life events, or feeling out of control in other areas of life..

Whatuni spoke with clinical psychotherapist and hypnotherapist, Nick Davies, who says: "Eating disorders can be created by childhood trauma, the child often learns unconsciously that they can gain some form of control over their life with their level of food intake."

The idea of control is an important one in eating disorders. Many sufferers use food as a way of taking control and giving emotional support. At university, changes in routine, more independence and more control over what, when and how you eat can sometimes make difficulties with food easier to hide or harder to manage.

Beat has many survivor stories that highlight the fact that everyone’s journey is different:

Liora shares her story here and says:

“Only now am I aware I had been living my life believing my own taunts and accusations of failing to be a good enough daughter, granddaughter, sibling or friend. I created a self-induced, unreachable high standard I figured I ought to reach for myself and because I assumed others held me to this same expectation.

This meant, regardless of any achievement, it was never enough. I frequently bit off more than I could chew to assist and impress observers with my multi-tasking skills and prove my success at everything I did. I often found myself spiralling out of control and living with constant anxiety of not being in control. It was a vicious cycle: the more I tried to take control, the less I could”.

Chrissie shares her story here and says:

“My first year of sixth form felt like a complete blur. I went to parties, I got a weekend job, I studied hard for tests, I aimed to wear a new outfit every single day, but I wasn’t happy, despite what my thinning face would tell others. I can’t really pinpoint when anorexia first began to creep up on me.

It wasn’t like one day I woke up and made some kind of conscious decision that I would now begin to starve myself to the point of total self-destruct. The whole process was gradual; it started with small things like skipping snacks and preparing family meals to cater to my new ‘healthy lifestyle’, and I did not think I was doing anything wrong, or at least that’s what anorexia had managed to convince me.

This continued for months and probably reached its worst as I began to sit my AS levels. By this point, food was the only thing I could think about. I swapped playing my guitar for a half-hour walk each day, and everything I had once loved perished into thin air.

What I’m trying to say is that, ultimately, all I wanted was to be the best. Perfectionism is a trait often associated with anorexia sufferers and is something that I continue to find hard to believe could be linked to myself. In my eyes, nothing I do will ever be good enough, so how could I possibly be called a perfectionist when I never actually reach both my own and society’s standards of perfection?

Throughout my entire time at school, I never got full marks on a test, I never had the most friends, I wasn’t the teacher’s first choice when giving examples of an A* student, but actually, before sixth form I don’t think I cared. It seems to me the moment I walked into sixth form something in my brain decided that I had to be nothing but ‘the best’."

You can read other stories from eating disorder sufferers here.

Symptoms of an eating disorder

Those affected by eating disorders often become very good at covering up their illness until it’s too late. But here are a few signs you can look out for:

• Fear of gaining weight or concerns about body shape

• Following eating plans or diets – obsessively weighing out food

• Exercising excessively

• Missing mealtimes

• Avoiding eating with others

• General avoidance of social events or spending time with friends/family

• Rapid weight loss or weight gain

• Looking tired or complaining of dizzy spells

• Becoming angry or defensive when asked about food or their eating

What to do if you think you, or someone you know, has an eating disorder?

If you think your relationship with food has become unhealthy or out of control, or you have someone close to you that you think might be suffering from an eating disorder then the good news is that there is plenty of help out there for you…

A good place to start is speaking to a GP or a trusted person who can help you get support. But if you don’t feel confident in doing that then there are plenty of online resources available to give you advice on how to spot the symptoms – the NHS website is the best for this.

There are also many charities set up to help eating disorder sufferers. Beat, for example, has a number of support services, including a helpline, online support groups and one-to-one web chat. This is great for those who don’t have the confidence to speak to someone in person and want to seek help but stay anonymous – at least for now.

If you do want to talk face-to-face but don’t want to see a doctor, then many universities and colleges have wellbeing, counselling or student support teams who will talk to you in confidence and help you work out what to do next. Take a look here at which universities have excelled in their efforts to support students.

What treatment is available?

Treatment for eating disorders depends on the type of eating disorder, the person’s symptoms and the level of support they need. The NHS website explains that, with treatment, most people can recover, but the right approach can vary from person to person.

Support may include guided self-help, talking therapies such as cognitive behavioural therapy, specialist eating disorder services and medical care. For example, NHS guidance on binge eating disorder says guided self-help is often offered as a first step, while CBT may also be offered in group or one-to-one sessions.

CBT for eating disorders usually focuses on the links between thoughts, feelings and behaviours. It can help someone understand patterns that may be contributing to their eating disorder and develop practical strategies to manage them.

Recovery can take time, and support may look different for different people. If you think you may have an eating disorder, it’s important to speak to a GP, your university wellbeing service or a specialist organisation such as Beat, which offers helplines, webchat and online support.

Final thoughts

The most important thing to remember is that no one chooses to have an eating disorder. It is not your fault, and asking for help does not make you weak or a failure.

Eating disorders can affect anyone, and they can seriously impact both your mental and physical health. If you’re worried about your relationship with food, eating, weight or body image, try to reach out for support as soon as you can.

You could start by speaking to someone you trust, contacting your GP, reaching out to your university wellbeing team or using a specialist service such as Beat. You don’t have to have everything figured out before you ask for help. Taking that first step can feel difficult, but it can also be the start of getting the support you deserve.