An eating disorder is diagnosed by observing certain eating patterns and behaviors that disrupt someone's life. The eating disorders most commonly talked about are anorexia, bulimia, and binge eating disorder. However, eating patterns and behaviors don't need a diagnosis to be considered problematic. Due to America's fascination with being thin and the coinciding growing incidence of overweight and obesity, food restrictions and dieting have become "normal", especially on college campuses. However, obsessing about food and weight is not healthy and there are solutions.

Types of Eating Disorders and Other Eating Problems:

Anorexia Nervosa
Characterized by self-starvation and excessive weight loss. People with Anorexia:

• Resist maintaining a normal body weight for their age and height.
• Have an intense fear of weight gain even though they are underweight.
• See their body weight or shape in a distorted manner.
• Deny the seriousness of low body weight.
• Lose their menstrual periods (post-puberty girls and women).

Bulimia Nervosa
Characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting that is intended to undo the effects of binge eating. People with Bulimia:

• Regularly eat large amounts of food while feeling out of control over their eating behavior.
• Regularly use inappropriate compensatory behaviors, such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
• Are extremely concerned with body weight and shape.

Binge Eating Disorder
Characterized by recurrent binge eating without the regular use of compensatory behaviors. People with Binge Eating Disorder:

• Frequently eat large quantities of food in short periods of time.
• Feel out of control over their eating behavior.
• Feel ashamed of or disgusted by their behavior.

Disordered Eating
Characterized by eating behaviors or attitudes that have a negative impact on physical, mental, or emotional well being. People with disordered eating:

• Spend excessive amounts of time planning and evaluating their diet.
• Frequently allow food and diet behaviors determine their emotions.
• Frequently set unrealistic food and diet expectations, and feel ashamed and depressed when they do not meet their goals.

Signs and Symptoms of Eating Disorders and Disordered Eating

• Constantly thinking or talking about food, diet, and body image
• Feeling guilty after eating
• Maintaining an excessive, rigid, and/or inflexible exercise schedule
• Weighing yourself compulsively or frequently (one or more times per day)
• Shame or anxiety when eating in front of others
• Constant excuses to avoid mealtimes or other situations that involve food
• Fear of eating certain foods or food groups
• Compulsive food behaviors, such as consistently weighing/measuring food, only eating foods with food labels, etc.
• Intense fear of gaining weight or overeating
• Using laxatives, diuretics, or diet pills to lose weight or prevent weight gain
• Vomiting after meals or snacks
• Idealistic or unrealistic weight expectations
• Constantly comparing yourself to others
• Extreme guilt and/or anxiety regarding eating habits
• Lying about food and dieting behaviors

What Causes Eating Disorders?

Psychological and Interpersonal Factors Certain psychological and interpersonal factors can lead people to focus more attention on weight loss and food intake. These characteristics include:

• Low self-esteem
• Feelings of inadequacy
• Lack of control over events, situations, or other people
• Depression, anxiety, anger, or loneliness
• Troubled relationships
• Difficulty expressing feelings and emotions
• History of physical, sexual, or emotional abuse

Biological Factors
Certain biological factors may predispose certain people to eating disorders. Currently, scientists are studying brain chemistry and genetic links as possible contributors to eating disorders.

How Do Eating Disorders Develop?

Consequences of Eating Disorders

General consequences include:

• Poor concentration
• Fatigue and low energy
• Physical weakness
• Social isolation
• Lowered self-esteem
• Mood determined by diet and exercise success and failure
• Irregular menstrual cycle
• Depression

Physical consequences of starvation:

• Abnormally slow heart rate and blood pressure, risk for heart failure
• Osteoporosis
• Muscle loss and weakness
• Severe dehydration with possible kidney problems
• Fainting, fatigue, and overall weakness
• Dry hair and skin
• Hair loss
• Increased sensitivity to cold temperatures
• Excessive growth of very fine body hair

Physical consequences of purging (vomiting):

• Electrolyte imbalances with risk for irregular heart beat, possible heart failure
• Inflammation and possible rupture of the esophagus
• Tooth decay and staining from stomach acids released
• Peptic ulcers
• Risk for pancreatitis

Physical consequences of laxative abuse:

• Electrolyte and mineral imbalances
• Severe dehydration
• Laxative dependency (the inability to have bowl movements without laxative use)
• Damage to the colon, increased risks for infection

Physical consequences of excessive exercise:

• Stress fractures
• Lack of menstrual cycle
• Osteoporosis
• Dehydration

What is Healthy Eating?

• Includes a variety of foods and food groups
• Doesn't eliminate any particular food or food group
• Provides more vegetable fats than animal fats
• Contains fresh foods instead of processed foods (when available)
• Ensures plenty of vegetables
• Contains whole grains (when possible)
• Includes nuts, seeds, and beans
• Prevents you from eating too many sweets because you don't want them, not because you can't have them
• Allows you to eat out
• Includes your favorite foods
• Provides an even distribution of food throughout the day
• Provides regular meals
• Allows for snacks as necessary
• Uses your hunger and fullness cues to determine portion sizes
• Satisfies physical hunger
• Contributes to emotional nourishment, but cannot satisfy emotional need
• Requires planning and preparation
• Is flexible according to your schedule
• Can be affordable
• Allows for overeating sometimes without feeling guilty
• Allows you to try new foods
• Makes eating fun and enjoyable
• Is a priority but not your only priority
• Enables a healthy and stable body weight
• Provides physical and mental energy for activities and responsibilities

Developing a Positive Relationship with Food

Appreciate what food can do for you.

Physical Noruishment

Whole grains are a good source of B vitamins, which are necessary for energy production. They also contain lots of both soluble and insoluble fibers, which aid digestion and balance blood sugar. Whole grains include products made from wheat, corn, rice, oats, barley, quinoa, sorghum, spelt, and rye.

Cruciferous vegetables, such as cabbage, broccoli, cauliflower, kale and brussels sprouts are a good source of carotenes, vitamins C and E, and selenium, all of which work to protect against free radical damage (consequences of normal chemical reactions within the body) and reduce carcinogenic (cancer causing) activity. Cruciferous vegetables are also a good source of indoles, a type of phytochemical (plant-derived disease fighting chemicals) that may reduce the incidence of cancer, particularly breast cancer.

Citrus fruits are a good source of vitamin C, folate, and potassium, as well as phytochemicals. Eating citrus fruits regularly may reduce the risk for cancer, stroke, and heart disease.

Vegetable and fish fats are an excellent source of vitamin E and essential fatty acids. Omega-3 fats may help to support blood sugar regulation, alleviate depression, increase metabolism, promote healthy skin, reduce joint inflammation, and improve cardiovascular health. Sources of omega-3 fats include flax seed, walnuts, canola oil, and salmon.

Dairy, including milk, yogurt, and cheese, is a good source of protein, calcium, and vitamin D. Dairy products provide for strong bones, satiety (feelings of satisfaction after a meal), and possibly even healthy weight management. Yogurt is a probiotic, which means it supplies a healthy dose of good bacteria to support immune function and aid digestion.

Emotional Nourishment
There are lots of ways to appreciate food beyond just how it tastes. Food, and the act of eating, can be very nurturing. Food provides enjoyment through the fulfillment of hunger and also through the act of self-care. Taking care of yourself means giving yourself time and attention, despite a busy schedule and many competing priorities. It is not just important, it is vital to relax, recharge, regain focus, and recognize accomplishment. Self-care, whether through food, sleep, exercise, spirituality, or other forms, keeps us going.

Eating for self-care doesn't mean overeating. In fact, it means giving your body and mind what it needs and what you value. While occasionally eating beyond the point of physical fullness is normal, attempting to use food beyond that point is a sign that you have unfulfilled needs that food cannot solve. Many college students eat when not hungry to procrastinate on assignments, take a study break, or alleviate anxiety. Talking with a counselor or trusted friend can help to better understand reasons for eating.

Recognize the Nourishment Food can provide

Dietary satisfaction is not defined by portion size or taste alone, but rather is achieved when we feel comfortably full and have appreciated the eating experience. Each individual must explore and define dietary satisfaction for themselves.

8 Tips for Attaining Dietary Satisfaction

1. Eat food that you appreciate. Consider taste, texture, aroma, temperature, cooking methods, nutrition, ingredients, and other characteristics that might be important to you.
2. Before eating, turn off the TV, computer, stereo, and anything else that could distract you from listening to your body.
3. Before eating, take a moment to really listen to your body. Are you hungry?
4. Eat sitting down at a table using dishes. Avoid eating out of a package, while standing-up, or on-the-run.
5. Slow down. Eat slowly. Reprioritize your schedule as necessary to give yourself the time to nourish your body.
6. Focus on chewing, tasting, and swallowing each bite before taking another.
7. Put down your utensils frequently to check-in on your hunger. Use your body's cues, instead of time or portion size, to determine when you are finished.
8. After eating, give yourself a few minutes to reflect upon, learn from, and appreciate your eating experience.

Getting Help for Yourself

We understand that seeking help with a problem can cause fear and anxiety. Unfortunately, too many people are overcome by shame to seek help. Please know that having an eating disorder is not a sign of weakness. Many college students struggle with food and the motivations for weight loss. You are not alone in your struggle, and help is available.

Treatment is typically provided by a team, which should include a therapist, a registered dietitian, a physician, and sometimes a psychiatrist, all of whom specialize in eating disorders. Treatment options depend on the individual, but can include outpatient appointments (e.g. weekly or monthly appointments), intensive outpatient programs (daily appointments), or inpatient care (hospitalization).

UT offers outpatient treatment through University Health Services and the Counseling and Mental Health Center. A link is provided at the bottom of this page. A link for treatment options within the Austin community is also provided. (Please note that we do not necessarily endorse any of the resources listed. You are encouraged to investigate your options, the qualifications of those offering care, and costs before pursuing treatment.)

No matter what type of eating problem you may be experiencing, you can begin the recovery process. Here are some steps you can take on your own.

1. Explore and understand your motivations for dieting, overeating, binging, and/or purging.
2. Learn about good nutrition. Get accurate information that is appropriate for you and your specific needs.
3. Accept that "mistakes" and setbacks are necessary to learn and grow.
4. Find self worth in who you are, not what you look like.
5. Judge your behavior, not yourself as a person. Try to suspend self-blame and self-criticism.

How to Help a Friend

If you think a friend may have an eating disorder, consider the advice that therapists at the UT Counseling and Mental Health Center suggest:

1. Talk to your friend about his/her specific behaviors. Do not comment on the eating habits themselves. Instead, focus on the observed behaviors consequent of the habits, such as social isolation or preoccupation with food and exercise. Question how the behaviors are affecting their life. Do not comment on weight and appearance. Express concern for the behaviors and allow your friend to tell you how they feel about them.
2. Send "I" messages instead of "you" messages. For example, say "I am concerned with how frequently you weigh yourself," rather than "You need to stop weighing yourself ten times a day."
3. After communicating your concerns, listen with empathy and an open mind. Avoid making judgments.
4. Reach out to that person as a true friend without a personal agenda. Communicate that you care.
5. Avoid agreeing to keep your friend's problem a secret or otherwise doing anything that might "cover up" your friend's behavior.
6. Be supportive and encourage your friend to seek help.
7. If you are not close to the person, find someone else who is a good friend. Messages are usually better received from close friends.
8. Avoid making comments about appearance. Such comments, whether negative or positive, encourage someone with an eating disorder to judge and define themselves by what they look like rather than who they are.
9. When someone says, "I feel fat," ask them "but how do you feel?" Fat is not a feeling, but is often used to describe one. What's more important than how we look is how we feel. Although feelings can be negative, fat doesn't have to be.

Online Resources