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Eating disorders rise among college students during COVID-19 pandemic

The combination of the uncertainty from COVID-19 and the transitional period of college has led to a spike in eating disorders among young adults

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Diet culture and the onset of COVID-19 made balanced and non-restrictive eating habits more difficult for college students. Diagnoses of eating disorders increased by approximately 15 percent overall in 2020 among people under age 30 compared to previous years, per a study from the British Journal of Psychiatry. 

Eating disorders are a common mental illness experienced by college students all around the world. There are a multitude of side effects that arise out of eating disorders and the causes of eating disorders vary due to one’s family history, lifestyle, self-image and more.

Studies show that eating disorders often arise out of harmless intentions and most commonly take root in young adults. Through social media, teens — especially girls — are likely to compare themselves to photoshopped and unrealistic photos that surface on the internet. This acts as a catalyst for negative body images and eating disorders.

There are many different types of eating disorders — including anorexia, bulimia and orthorexia. Anorexia is categorized as the drastic limitation of food intake, while bulimia involves the consumption of excessive amounts of food followed by purging. Orthorexia is a fixation on righteous eating, which involves excessive dieting and restriction in order to eat “healthy.” 

Eating disorders revolve around “food rules” and the assignment of moral values to food — labeling food as good or bad. Some examples of food rules include restricting the hours of the day in which you can eat, the elimination of certain food groups from one's diet — such as oil or processed sugar — or participating in fasting outside of a religious context. 

Dr. Sarah Groff Stephens, a specialist in eating disorders among adolescents at the University’s Children’s Hospital, has studied many aspects of eating disorder prevention.

“We know that there's a lot that can be done for prevention, and one is just having a healthy relationship with food, '' Stephens said. “Saying no foods are good, no foods are bad … and just really creating a family environment where all foods fit.”

Especially with young impressionable audiences, it is important to emphasize balanced and non-restrictive eating from a young age. Diet culture and fad diets can often be the center of a family’s eating habits. This restrictive way of eating can deeply influence children and teens that are encouraged to partake in this unhealthy lifestyle by other family members.

Fad diets have been around for centuries, but in the digital age, youth have been exposed to diets and the concept of weight loss at a much higher rate than previous generations. Studies show that on TikTok, a large social media platform with the majority of its users being in high school or college, over 70 million users have interacted with hashtags relating to eating disorders. Some of the fad diets promoted on these apps are keto, intermittent fasting, liquid diets, laxative teas and even the infamous grapefruit diet, which was known to be used by Hollywood actresses. These diets presented out of context and without the help of a licensed nutritionist can be turned into restrictive eating habits. 

During COVID-19 and quarantine, many teens and young adults became exposed to quarantine trends that revolved around strict diets and workout regimens. With people staying inside their homes, diets and changing one's appearance became methods to pass the time and have a goal for post- COVID-19 summer. 

"There's been some pretty good research showing that eating disorders have risen among teens and young adults, and one of the ideas why is because everything that was normal for us was taken away,” Stephens said. “And so a lot of people channel that into ‘healthy eating’ or improving their bodies, which spirals into an eating disorder.”

Eating disorders can be described using a biopsychosocial approach — an approach that combines biological, psychological and social aspects in its diagnosis of mental disorders. Social media exposure, one’s home environment and the current state of society can all be included in the social aspect of eating disorders, but there is also strong evidence that eating disorders are affected by one's genes and biology. 

Dr. Julia Taylor, certified pediatrician at U.Va. Children’s Hospital with experience in eating disorder clinical practice, explains how eating disorders are largely a product of one's family history.

Eating disorders are determined by genes and studies have shown one, if not more, genes of interest in anorexia, according to Taylor. Genes of interest are genes that contribute to the biological onset of eating disorders and can be passed down through relatives. More biological evidence of eating disorders includes the altering of brain function as a result of this illness. Nonetheless, more research is needed in this area.

More research is being poured into eating disorder prevention due to the increasing prevalence of disordered eating among all ages, races, genders and sizes.

“We know that males and people with a BMI in the ‘normal,’ ‘overweight’ or ‘obese’ range are often overlooked when it comes to diagnosing eating disorders,” Taylor said. “There has been this unhelpful stereotype that eating disorders are a wealthy, white, female disease and this makes it challenging to seek care if you don’t fit that mold.”

Among college students specifically, campuses can act as a breeding ground for negative body image and eating disorders due to the frequent discussion of physical appearance amongst students. One study shows that over the past 13 years eating disorders increased 9 percent for female college students and 17 percent for male college students. 

While complimenting someone on weight loss or even “looking good” can seem like a harmless comment, for some this can motivate individuals to continue restricting  caloric intake or  prompt a search for new ways to expedite weight loss. The social commentary surrounding one's body can create a psychological response in which an individual’s brain treats these comments as “rewards.” This programs a person’s mind to perform behaviors, such as starving oneself or over-exercising to be thin, that prompt these rewards. Oftentimes, these behaviors are unhealthy and lead to the onset of an eating disorder. 

Melanie Brede, a Certified Eating Disorder Registered Dietitian at the Office of Health Promotion, explains the importance of body positivity as a way to prevent disordered thoughts concerning food. Body positivity is the belief that everyone — no matter their body size or type — deserves to have a positive body image.

“By being cognizant of language that promotes idealized bodies and changing it, we can all help to create a culture of respect and support for people of all body types,” Brede said.

Body neutrality is another movement that stemmed from the body positivity movement, but took a different approach to how we discuss and view our own bodies. Body neutrality emphasizes neutrality towards one's bodies — focusing less on loving the body’s appearance and more on what the body can do for us. Body positivity and body neutrality are both tools that people can use to better appreciate their bodies in whatever fashion they feel comfortable. 

Body positivity also means that we recognize that our bodies are the least interesting thing about us. U.Va. Body Positive, a student-run organization on Grounds, encourages students to reframe their language towards their bodies and remember that our bodies do not determine our health or worthiness. 

Julia Paraiso, fourth-year College student and intern at U.Va. Body Positive, explains how body positivity can be practiced even on college campuses by avoiding the toxic aspects of college life. 

“By trying to do things that make your body feel good and bring you joy and practicing moderation, you can get out of the unhealthy loop of toxic drinking and dieting culture,” Paraiso said. “Whatever that looks like for you personally, so that you can support yourself best, instead of just being like, ‘Every Tuesday I have to work out since I am drinking.’”

U.Va. Body Positive also emphasizes the importance of having a support group when practicing body positivity. Support is something that is also vital for those with eating disorders and a major part of recovery. 

Unintentionally, many people distance themselves from those facing eating disorders, which can be isolating. It is important to remember that those with eating disorders benefit greatly from their loved ones' support when recovering from an eating disorder. Simple things such as weekly check-ins, words of affirmation or quality time can make a big difference in a patient's outlook on recovery.

COVID-19 presents many challenges for those recovering from an eating disorder, such as the inability to see loved ones, participate in social interactions or establish a routine. Luckily, with the help of technology, many eating disorder patients were able to use Zoom to see loved ones and participate in new forms of social interactions, such as Zoom patient dinners and grocery runs.

Additionally, the closing of many eating disorder recovery centers during the spread of the virus caused many patients to have to continue their recovery at home. Without the benefit of in person health care, many patients found recovery at home difficult and Zoom therapist sessions to not reap the same benefits as in person sessions.

Now that treatment centers and hospitals are organized to combat the virus and vaccinations are widespread, eating disorder treatment centers and recovery clinics throughout the world are back up and running smoothly, even with the onset of the omicron variant. 

At the University, the Eating Disorders Consultation and Treatment Team through Student Health and Wellness can help students find medical care for eating disorders or negative body image. Additionally, the Maxine Platzer Lynn Women’s Center as well as Counseling and Psychological Services provide eating disorder recovery support for students. Some other alternative resources are the National Eating Disorder Association Helpline and the various eating disorder treatment centers in the greater Charlottesville area, including Prosperity Eating Disorder and Wellness and Thriveworks Charlottesville.


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