While most of us have heard about the "Freshman 15" — the stereotypical first-year weight gain among college students — a growing share of young adults are experiencing quite the opposite.
Some 10% to 20% of females and 4% to 10% of males in college suffer from an eating disorder, according to estimates from the National Eating Disorder Association.
JD Ouellette, a California-based eating disorder expert at Equip, a virtual counseling service, agreed that the rates of disordered eating have been increasing for some time among this age group, a trend the pandemic accelerated.
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"A recent study looked at 260,000 students, from a more diverse population than we often see, and saw a 13% increase in eating disorders between 2013 and 2021, with about 3% of that happening after the pandemic began," Ouellette told Fox News Digital.
Certain populations are more vulnerable to developing an eating disorder, she added.
That includes athletes and those who participate in "weight-sensitive" sports such as running, ballet and wrestling.
Fox News Digital talked with Dr. Melissa Spann, chief clinical officer at Monte Nido & Affiliates — an eating disorder clinic in Miami, Florida — about how the social and academic pressures of the back-to-school season can trigger disordered eating habits on college campuses.
"Heading back to school can be stressful even under the best of circumstances," noted Spann, who has a PhD in family therapy and is a certified eating disorder specialist and clinical supervisor.
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"Any time you're making major life transitions — middle school, high school, college, especially if you're going away from home for the first time — those are times of stress," she said.
On top of that, college students tend to compare themselves to other people as they try to fit in to look a certain way — "almost a reinvention of self," the doctor said.
"The pressure to perform academically and fit in socially can lead to unhealthy ways of coping, including behaviors indicative of eating disorders."
And as college students leave home and no longer have their old routines, it can be a challenge to find nutritious, filling foods and stick to a healthy meal schedule.
"College is a time when the home structure around eating, sleeping and exercising has disappeared, and for the first time, students must develop their own structure and routines to be sure health needs are met," said Ouellette. "Students may not realize they need to schedule meal breaks when picking their classes."
The dining hall can also be overwhelming in itself, with many choices and large crowds of people, she added.
Social dynamics can create a heightened risk for eating disorders as well, Spann pointed out.
"Within our social environment, individuals tend to receive positive feedback for losing weight," she said. "And that is actually one of the most critical points where an eating disorder can develop, because your body's going to hit a certain threshold where you have to engage in unhealthy behaviors in order to continue to lose weight."
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She added, "That positive reinforcement from the social environment is another trigger."
Social media contributes to the onset and development of eating disorders, Spann also believes.
"Even with the surgeon general's recent warning, we're just scratching the surface in understanding the impact of social media on mental health," she said.
"The algorithms that are produced by social media environments can lead kids and adolescents and adults down a really tricky rabbit hole of not just eating disorders, but also depression, anxiety and overall mental health distress."
When it comes to red flags for disordered eating, Spann noted that it's different at different ages.
"If you're talking about middle school or high school, when you're still living with your child, you should look for more subtle things, because dramatic weight loss occurs over a longer period of time," she said.
"What do mealtimes look like? Is your kid skipping meals or eating large amounts of food?"
Eating disorders aren't just about restricting intake, the doctor noted.
"It could look like engaging in binging and purging, binge-like behaviors, or excessive and compulsive exercise," she said. "So we want to look out for all those things."
Another red flag is if a child has developed certain rituals around food or eating.
"Some examples might be cutting food into small pieces or starting to cut out major food groups — like suddenly saying, ‘I don't eat any carbs,’" Spann said.
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If teens begin talking about following strict diets or starting an intense workout regimen that they haven’t done before, that could be another warning sign, she added.
For college-age kids who no longer live at home, Spann recommended regularly Face Timing and scheduling in-person visits for a visual check-in.
"It's important to actually lay eyes on them and dig a little deeper and see how things are going," she said.
The best thing a parent can do to help ensure healthy eating habits is to prepare their child before they head off to college, Spann said.
"If your kid has never cooked a meal for themselves — and if they’ve never navigated how to walk into a food hall and put food on their plate and find someone to sit with — they're going to struggle when they get to school," she said.
Spann suggested doing some "test runs" before school starts, so the child can get a feel for preparing food and meeting his or her own nutritional needs, whether that's in the dining hall or at a food market.
"I think families should proactively discuss the ‘how,’ ‘what’ and ‘when’ of getting their nutritional needs met," added Ouellette. "Don’t focus on weight control — instead, focus on regular eating habits from an ‘all foods fit’ perspective."
Parents should remind their kids that they're still supposed to gain weight at this time of life, she said.
"Make sure they know food is not simply fuel, but that it also fuels connection, culture, celebration and love."
It’s also important for parents to think about the language they’re using when they speak about their own bodies and eating habits.
"If you notice that your child is struggling with food, weight or body size, the first thing is to make sure you're using body-positive or body-neutral language in your home," Spann said. "And not only about your kid, but about yourself as well."
Parents should avoid talking about their own dieting, weight or clothing size, she said.
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"The reality is that weight is actually not a measure of health in the way that our standard medical system has taught us for so many years," Spann noted.
"And so we want to avoid talking about diet, weight and sizes, offering that self-compassion and then practicing what we preach when it comes to eating habits," she went on.
"Our kids hear how we talk about ourselves."
It’s also wise to cultivate mindful eating habits at home from a young age, she said.
"When kids go off on their own, they're going to mimic the environment they grew up in," Spann said. "Sit down and make dinner time an opportunity where you can connect with your family."
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Once students are living on campus, if they express concern that they’re not able to access the foods they want and need, the parent should step in with guidance, she advised.
"No matter what, if you have a kid who's saying, ‘The dining hall is not for me,’ the most important thing is to develop alternatives," Spann said.
If parents notice that their kids are displaying any warning signs for disordered eating, the teen may need to speak with a third-party expert.
"Even if you have the most open and healthy relationship with your kid, when it comes to something that is bringing any sort of anxiety or shame, they're not going to want to engage openly around that," Spann said.
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Most college campuses offer free counseling resources and nutrition services to students, she noted.
"Often, campuses will list the registered dietitian who helps run the dining hall, and they are often very familiar with college students, disordered eating and eating disorders," added Oullette.
Above all, don’t wait, the experts agreed.
"What we know about eating disorders is that recovery is possible, but early intervention is key," Spann said. "The longer it goes undiagnosed, the harder it is to treat."
"As soon as you're suspecting or feeling or wondering, then it’s time to start asking the hard questions."
