Q&A
Catherine P. Cook-Cottone
Catherine P. Cook-Cottone, associate professor of counseling, school and educational psychology in the Graduate School of Education, is an expert on eating disorders (EDs).
How prevalent are eating disorders among college students?
Depending on what study you look at, rates vary. But generally, it is believed that as many as 15-30 percent of college females have eating disorders, with up to 50 percent having regular symptoms such as binging, purging, skipping meals and excessively exercising. There are fewer studies on college males, but rates for abnormal eating may be as high as 10 percent. In addition, college athletes—both males and females—have been at increased risk for EDs. In my research, I call it the "success at any cost" phenomenon, when winning becomes more important than health. Students may engage in eating-disordered behavior to make weight for crew, gymnastics, dance, wrestling, boxing—even sports that you wouldn't consider "weight-oriented," such as tennis, soccer or track, where student athletes may be pressed to be at a good game or performance weight. There seems to be some interaction between a student’s need to achieve, perfectionism and the need to accommodate others that mixes with the demands of a college athlete and the stress they experience from academics, as well as their sport. This aggregates and places them at unique risk for eating-disordered behavior.
How can faculty/staff recognize the signs of eating disorders among students?
Because EDs are secretive disorders, they often go undetected. Many students tell me it is as if they have two selves—the high-achieving, happy and accommodating self and the eating-disordered self. These students work hard to meet high standards, which they often set themselves. It is easy to assume they are doing as OK as they’d like us to believe. This is why it is important to look very carefully for risk factors and signs of eating-disorder symptoms. The earlier in the progression of an eating disorder that students get help, the better the long-term prognosis. Risk signs to look for: dieting and diet talk; obvious symptoms, such as skipping meals, purging through laxative or self-induced vomiting and compulsive and excessive exercise; excessively low body weight; poor body image; poor emotional regulation and difficulty tolerating frustration; compulsive perfectionism; accommodating behavior and a tendency to overextend.
What can faculty/staff do if they suspect a student has an eating disorder?
One-on-one expression of concern is a good strategy. When we intervene, we want to be careful that the student feels safe in our concern as opposed to feeling they are being accused of struggling or being judged because they may have a disorder. Say “I have noticed X, Y, Z and I have been worried about you. Do you have someone to talk to? I know some people who can help.” Our counseling services here at UB offer support and treatment for students with eating-disordered behavior. Also, many students receive therapy and medical care at home and visit on a regular basis for treatment.
—Sue Wuetcher
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