About 30 students per year visit the University of Richmond's Counseling and Psychological Services staff to seek treatment for anorexia or bulimia, according to Peter LeViness, director of CAPS.
A 2006 National Eating Disorder Association poll revealed that 20 percent of students on college campuses suffered from disordered eating of some type. Only 25 percent of those students had received treatment for disordered eating.
Applying this to Richmond would mean that 610 students out of the 3,048 undergraduate students enrolled, as of fall 2011, had disordered eating problems. Of those 610 students, only 152 would have come forward for treatment.
Disordered eating applies to a whole range of inconsistent eating behaviors, most commonly anorexia or bulimia. LeViness said disordered eating habits fell on a spectrum and were not always diagnosable forms of anorexia or bulimia.
"Binge eating happens every once in a while," LeViness said. "Binging and purging and then feeling ashamed of it."
Nationwide, 38.8 percent of students said they knew someone who purged by vomiting. Another 26 percent of students said they knew at least one other student who used laxatives to lose weight.
Getting students to come in for anorexia, bulimia, binge eating or anything else on the disordered eating spectrum can often be difficult.
"Patients with anorexia don't usually come in voluntarily," LeViness said. "Someone is usually twisting their arm to come in." These patients are often the hardest to convince that they have a problem. "Someone with anorexia will typically hear 'you're too skinny' and think 'you're just jealous,'" he said. "Better approaches to talking with someone about their disordered eating habits would be to say 'you don't look well' or 'you don't look happy.'
Across college campuses nationwide, about 319 of 1,002 students who were polled knew someone who had an eating disorder and also had taken the initiative to speak to them about it.
In the past, the University of Richmond has asked students to complete surveys on body image. LeViness said the surveys revealed a big gender split. Women tended to obsess over their images more than men, but both sexes ranked their appearance as one of the most important and central aspects of how they viewed themselves. Women largely wanted to slim down while men said they wanted to bulk up.
LeViness said that college was a big part of this concern about image. "Being around so many peers and comparing yourself to others everyday creates a tendency to find something we don't like," he said.
Too much exercising can often be an indicator of poor body image. Some students with disordered eating habits eat too little and spend too long at the gym, trying to burn more calories than they are eating. The poll revealed that 44.4 percent of college students nationwide know someone who compulsively exercises more than two hours at a time.
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"Unless you're training for the Olympics, it's not good to spend two hours on the bicycle," LeViness said. He encourages all students to incorporate a healthy amount of exercise into their routines and not use excuses like "I'm too stressed," or "I'm just too busy." Exercise can be a useful tool to be more alert, focused, have more energy, and to fight stress, he said.
In order to help students with disordered eating habits, CAPS helps students develop goals they want to work on or aspects of their lives they would like to change. "We're more like a coach, giving tips," LeViness said. "We can't do it for them. We support them. It's very collaborative." He explained that many students with disordered eating habits on all campuses had to come up with their own realization and understanding that they had a lifestyle and mindset that needed to change.
Yet the road to recovery can often be a winding one. "Eating disorders are tricky because they are long standing [habits] and it's what's comfortable," LeViness said, "It's challenging to change, because the path is so well worn. There's progress and slips.
"If a person doesn't want to be there, and only is there because they promised their parents, if it wasn't their own idea, it's challenging right from the start. The dean can mandate that students get assessed, but it's tricky because they may deny everything. Getting students to change their mindsets depends on the person and the situation. There's no way to compel someone to get better if they don't want it."
The media also plays a large part in the appearance of eating disorders on college campuses. Among students nationwide, the poll revealed that 57.3 percent of students believed cultural pressures to be thin caused the onset of eating disorders.
"The ideal mindset would be seeing that people come in different shapes and sizes and that my size is okay," LeViness said, "How many of us can be 5'11" and 105 pounds? It's unrealistic. Challenging the media is where we want people to get to."
One anonymous Richmond student admitted she battles daily against disordered eating. She, 21, was diagnosed with anorexia with "binge-purge tendencies" when she was 13-years-old. She said the college atmosphere enabled her to engage in disordered eating habits.
"Ever since coming here, I haven't really engaged in restricting, but more binge-purging because it's so easy. There are numerous girls on my hall that do it. I can do it in my room. There are no questions asked," she said, "It makes it easier for me -- nobody is really turning me in or telling the resident assistant that this is what's going on."
Yet the college atmosphere also makes her disorder harder to deal with. "I cannot escape," she said. "I go anywhere in D-hall or anything like that, [and] someone is talking about how fat they are or complaining about how they eat so much. Even if you're not someone who has an eating disorder, it just raises your awareness of what you're eating, but for me, especially, I always automatically think, 'are they judging me, are they judging what I'm eating?'"
The "food-talk" obsession isn't just at the dining hall; it's all over campus, she said. "You go to the gym and its pretty much just women at the gym," she said. "You go to D-hall and you get judged if you go and get a dessert. It's kind of disgusting. I absolutely can't stand it, but at the same time, I mean, I do the same thing in judging."
She said she was interested in the efforts of organizations like Images. "I think personally it's important for other girls to have healthy body images because I know for myself, I never have, and I really ruined my body because of my eating disorder," she said.
Because of the influence of the media and college peers, she said she believed eating disorders were turning into a trend. "[Students] see other people doing it so they want to do it, and once you make that choice, there's no coming back," she said. "Eating disorders are probably the worst addictions in my opinion, because [with] alcoholism you don't have to drink alcohol to live, but you have to eat to live."
And she knows better than most how dangerous eating disorders can be to one's life. When she was 15 years old, she almost died because of her anorexia.
"I was completely strung out on cocaine and so emaciated I got down to 74 pounds," she said, "and I was told that I only had two weeks to live because I couldn't keep food down, I couldn't walk, I was suffering organ failure and my hair was falling out. It was a complete disaster."
Because of her traumatic experiences, she said that she would tell another student with an eating disorder that no matter how many times they went to treatment, it was up to them to get their lives together, no matter how draining the process.
"It sucks because you'll always have issues with food, but I think it's worth it in the end," she said. "I pretty much haven't lived my life for eleven years now and that's time I'm not going to get back."
The college experience is dominated by obsession over body image, eating and peer pressure. Of the 20 percent of students across college campuses who suffered from disordered eating, 75 percent had never received treatment.
To these students, she had some advice: "[My eating disorder] is the most intimate relationship I will probably ever have because I created it. It's the voice in my head, it's always there, and that really sucks. It rules my life, and so if you really want help you should get it"
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