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How to Help Someone With an Eating Disorder in College

The first step is seeing that it's not just dieting

Writer: Rae Jacobson

Clinical Expert: Allison Baker, MD

The first step to helping someone with an eating disorder is to recognize that it’s a mental health problem, and not just foolish dieting. It can also have serious medical consequences.

Eating disorders can have a severe impact on physical health, with effects ranging from tooth decay to fatal heart attacks. ED sufferers are significantly more likely to attempt or commit suicide and many also engage in other self-harming behaviors such as cutting and struggle with isolation, depression, and anxiety.

“People need to understand the reality of having an eating disorder,” urges a 24-year-old woman who is now in recovery. “This is not vanity. I was sick and my sickness could truly, honestly have killed me, but people still thought I could turn it off. They thought I was just doing it because I wanted to look better.”

Allison Baker, MD, a child and adolescent psychiatrist, notes that this is not an uncommon misperception. “If we could move past the idea that these are willful decisions that are made rationally rather than real illnesses that need treatment and our understanding and support, we would be in such a better place.”

Talk about it

“The majority of college age kids want to connect with their family and friends about their mental health,” says Dr. Baker. “Don’t be afraid that you’re going to make a situation worse or cause something by bringing it up. Avoiding and ignoring usually leads to things getting worse, not better.”

That said, it can be hard to open a dialogue about such a serious issue. Try to be calm and non-judgmental. Instead of focusing on her appearance, stick to how you are worried about her unhealthy behaviors and the harmful effect they are having on her. The National Eating Disorders Association (NEDA) recommends using “I statements” like “I am concerned” or “It makes me afraid” instead of “you statements” like “You need to stop,” which can make people feel guilty or defensive.

Also, be prepared to listen. People with eating disorders often deny that they have a problem, or have complicated feelings about getting better. It is important to take her feelings into account and make her feel heard. If you need to, revisit the conversation later. For you to be helpful you will need to be supportive and persistent.

These talks can be intense and emotional, and are best done in person. If your child is going to a college away from home, it is worth making the trip to visit her as often as you need to.

Here are some more tips for having a productive conversation. NEDA also has an online Navigator Program that helps people with eating disorders or their family and friends with individualized support and guidance about recovery.

Don’t wait

Seeking eating disorder treatment is the first step to recovery and the sooner someone gets into treatment, the better. The longer one lives with an eating disorder, the tougher it is to shake, and the more likely she is to relapse later.

Help on campus

College campuses are required by law to provide basic mental health services. College counseling services are usually included in tuition and can be very good. They can also provide referrals for more specialized care if necessary. Some schools may also have active, student-run ED support groups or other helpful programs.

If your child is feeling overwhelmed, you can help him—boys develop eating disorders too — by researching the treatment options at his college. Some schools may even let you make an appointment for him, although you shouldn’t expect to receive any medical information from his doctor because of privacy concerns.

Online assistance

There are some great communities for people with eating disorders online. Finding a place to get support or participating in real world meet-ups can be a good way to bolster recovery. NEDA has forums that offer a great window into the world of online ED support.

Like any good thing on the internet, there are also ED sites that have a dangerous dark side. Avoid anything labeled as “pro-ana” (pro-anorexia), “pro-mia” (pro-bulimia), or “thinspo,” Far from providing assistance, these “thinspiration” sites promote eating disorders by posting things like pictures of extremely thin bodies or tips on how to starve more effectively.

NEDA‘s site offers a range services and supports including a comprehensive guide to which colleges offer what services, as well as links to support groups nationwide, and a helpline.

Financial help

For more severe eating disorders, more comprehensive or in-patient treatment is sometimes necessary. Since residential programs can be very costly, there are also organizations that offer support. Founded by two women in recovery, Project Heal provides treatment scholarships on a case-by-case basis. They also offer a large online community that is open to anyone seeking support and advice. NEDA’s site also offers treatment coverage resources, forums, and advice on accessing affordable treatment options.

This article was last reviewed or updated on January 24, 2023.