Is Your Student at Risk for an Eating Disorder?

Oona Hanson

With increased awareness of mental health challenges among adolescents, parents are more attuned than ever to their children’s well-being. However, before the departure for college, many families haven’t talked about one of the most insidious threats to student health: eating disorders.

Why should we be aware of eating disorders? They are far more common than you think, and they are deadly serious; after opioid addiction, eating disorders are the most fatal mental illness. They wreak havoc on both mind and body, but the good news is that they are treatable. Early detection and family support can make a world of difference.

Here’s what you need to know, red flags to look for, and conversation tips.

Starting College Increases Your Student’s Risk

The first year of college is one of the peak times for the onset of an eating disorder. The stressors (living away from home, losing access to familiar foods, less structure in the daily schedule) all make it more likely that a young person will skip meals, binge eat, or engage in other disordered behaviors around food.

In addition, many new students worry about the so-called “freshman 15.” This fear of weight gain can increase the risk for an eating disorder by leading to dietary restriction, body image concerns, and/or over-exercise. Eating disorders are incredibly complex but we know that dieting is the single biggest risk factor. What’s tricky is that today’s teens are unlikely to use the term “dieting” — instead, they may call it “clean eating,” a “detox,” or a “lifestyle change,” or they may use a weight-loss or fitness app that claims it’s “not a diet.”

You might assume your child could never develop an eating disorder because they don’t fit the image associated with these illnesses. Contrary to popular myths, eating disorders don’t have a “look” — they affect people of every gender, race, socioeconomic background, and body size. Stereotypes about who gets eating disorders (thin, white, affluent teen girls) can make it hard for families to recognize that their loved one is struggling.

Although anyone can develop an eating disorder, certain groups of college students are at higher risk than others.

Athletes, LGBTQ+ students, and those who are neurodivergent (such as having ADHD or being on the autism spectrum) all have a heightened risk of developing an eating disorder.

Do you have a son starting college? Body image concerns don’t affect only girls and women. Males make up roughly 40% of those with eating disorders, and diagnosis rates have been increasing. In addition to anorexia, bulimia, binge-eating disorder, and ARFID (avoidant/restrictive food intake disorder), young men in particular are vulnerable to a condition called “bigorexia,” a type of body dysmorphia that leads to an obsessive attempt to build muscle mass. In addition to overtraining and making drastic changes to macronutrient intake, young men with this condition are likely to use potentially dangerous supplements.

Keep the Lines of Communication Open!

Before you say goodbye: If you can, talk to your teen about eating disorders before move-in day. Ask what they know about these illnesses, or why they think they’re so common among college students. If your first-year student is actively trying to lose weight, discuss the serious risks of dieting and support them in exploring ways to improve their relationship with their body. In the lead-up to departure, make family meals a priority and focus on connecting around some of their favorite dishes.

During fall semester: As your teen navigates their first months on campus, check in regularly about their eating habits. What do they think about the dining hall food? You might also ask whether their friends are dieting or if there’s a lot of pressure to “eat healthy” or to look a certain way. If they express worries about the “freshman 15,” listen and empathize with how hard it is to live in a culture with so much fat phobia and an unrealistic thin ideal.

Over Family Weekend and holiday breaks: When you see your teen in person, try to avoid commenting on their appearance. If they seem concerned about having gained weight, listen and focus on how they’re feeling without rushing in to praise their looks or encouraging a weight-loss plan. You can also normalize gaining weight during adulthood, especially during big life transitions. If your teen needs new clothes, supporting them in that process is one of the most powerful things you can do to help their body image.

If you observe any concerning changes in their eating habits or attitude toward food and exercise, pay attention and get support. If you notice weight loss, this is a red flag and not something to be celebrated. If the weight loss is significant and/or you observe changes in mood (such as anxiety, depression, irritability, social withdrawal), get them to a primary care physician as soon as possible. Contrary to a lot of parents’ fears, expressing your concern and getting a medical evaluation won’t make things worse. The National Eating Disorders Association is a great resource for more information.

The transition to college can be challenging for the whole family, and it’s not always easy to know how involved we should be as parents. By staying informed and keeping the lines of communication open, we can support our young adults’ healthy development and give them the best chance to thrive in this next stage of their lives.

Oona Hanson

Read more by Oona Hanson

In education for twenty-five years, Oona Hanson helps parents and guardians raise kids who have a healthy relationship with food and their body. In addition to her private practice as a parent coach, Oona also works as a Family Mentor at Equip, an eating disorder treatment program. Oona holds a Master's Degree in Educational Psychology and a Master's Degree in English. She lives in Los Angeles with her husband and two teenagers.