Substance Abuse and Eating Disorders in College

Eating disorders commonly develop in college. Substance abuse rates are also higher among this group. And, young adults who self-medicate with drugs or alcohol have a higher chance of developing long-term health problems. Read the article to learn more and when to seek treatment.
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Eating Disorders in College — How Do They Form

College is an exciting time in every young adult’s life. However, there are also challenges that arise during this stage of life as they learn how to balance responsibilities and independence. With freedom and exposure to new experiences — such as peer pressure, dating, and parties — some students develop a feeling of loss of control over their life. As a result, eating disorders may emerge due to one’s desire to be in control and deal with painful emotions.

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According to a 2007 report from the Anxiety Disorders Association of America, college students face added stresses and pressures that can lead to mental health issues. These issues include depression, mood disorders, and anxiety, among others.

In addition, young adults with eating disorders are also more likely to develop mental health issues. Substance abuse rates are also higher among this group. 

Eating disorders are more likely to develop in college. In fact, “full-blown” food-related disorders typically form between 18 and 21 years of age.

Causes & Symptoms of Eating Disorders

Many young adults do not know they have an eating disorder until health problems form later on. This is because people are “finding themselves” in college, so they are usually unaware of the poor decisions they are making to fit in. There are many other reasons why dangerous eating habits can form during the college years, including:

  • Being unhappy with your weight or how you look
  • Major life changes, which can lead to the development of a disorder
  • Peer pressure and comparing yourself to others
  • Trying to live up to society’s unrealistic expectations
  • Getting involved in new romantic relationships
  • Attending parties and wanting to fit in with others

Signs and symptoms that an eating disorder has formed or is likely to form include:

  • Constant fears associated with gaining weight
  • Obsessing over your weight to the point where it interferes with daily life, relationships, and activities (e.g., avoiding social situations where food is involved)
  • Abusing diet pills to lose weight quickly
  • Overeating even when you are full or not hungry
  • Being overly conscious about how many calories you consume on a daily basis
  • Purposely not eating when you are hungry
  • Wanting to lose weight even if you are in the ideal weight range for your height and age
  • Low energy levels and fatigue
  • Severe mood swings

About 30 million people in the U.S. have an eating disorder, with around 20 million of these being women. This is because women are more likely to have body dissatisfaction than men.

Common Types of Eating Disorders

There are a few different types of eating disorders that college students and young adults deal with. All of these disorders affect the body differently and require specialized treatment. The most prevalent eating disorders include:

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Anorexia Nervosa

Anorexia is a common eating disorder that involves starvation and a loss of appetite. People with this disorder constantly obsess about their weight and what they eat on a daily basis. An abnormally low body weight, excessive exercising, and long-term starvation are all symptoms of anorexia. 

Bulimia

Bulimia is when an individual overeats and then purges (self-induced vomiting). They may also refrain from eating for certain periods of time (also called fasting) or use laxatives to prevent weight gain. Excessive exercising is also common among people with bulimia. 

Binge-Eating Disorder

Binge-eating disorder is similar to bulimia because it involves consuming large amounts of food and then feeling guilty afterward. Unlike bulimia, people who have binge-eating disorder do not purge after eating or use laxatives to avoid gaining weight.

Others

Other types of eating disorders that negatively impact young adults include: 

  • Body dysmorphic disorder — a mental health disorder that involves obsessing over appearance and flaws
  • Pica — chewing or eating things that are not edible or have no nutritional value, such as paper or clay
  • Restrictive food intake disorder — this disorder refers to extremely picky eating and selective eating habits
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Substance Abuse and Eating Disorders in College Students

In many cases, college students who have eating disorders also turn to substances to cope with certain issues and escape negative thought patterns. These issues may include constant worries about gaining weight and other daily struggles associated with poor body image. Common drugs college students abuse include alcohol, marijuana, prescription stimulants (e.g., Adderall), and party drugs (e.g., cocaine and ecstasy). Crystal Meth is also popular because of its cost and availability.

Young adults who self-medicate with drugs or alcohol in college are more likely to face long-term health consequences. This may include developing conditions such as: 

  • A substance use disorder (SUD) or alcohol use disorder (AUD), which require professional and specialized treatment to overcome successfully 
  • An anxiety disorder, such as generalized anxiety disorder (GAD), or other mood disorders
  • Antisocial behaviors and isolation, which can lead to behavioral problems and/or depression
  • Impulsive decision-making

What is “Drunkorexia?” 

Drunkorexia is a common term used to describe eating behaviors that involve eating less food to heighten and speed up the effects of alcohol. It is common for college students to binge drink, especially at parties and other social gatherings. When they combine heavy drinking with disordered eating patterns, this is a symptom of “drunkorexia.” 

Restricting food intake or purging (self-induced vomiting) and drinking high levels of alcohol is extremely risky. For example, college students who do this have a higher chance of developing short-term and long-term health complications. They are also more likely to experience an overdose or alcohol poisoning, which can both result in death.

Graphic of woman going through withdrawal.

Potential Health Complications

Not only can eating disorders lead to co-occurring mental health issues and substance use disorders (SUD), but they can also negatively impact your physical health. In particular, potential health complications that can arise from an untreated eating disorder include:

  • Extreme concerns of one’s body shape and size Infertility (inability to get pregnant)
  • Absence of menstruation in women
  • Loss of bone mass 
  • Extreme muscle weakness Irregular and dangerous heartbeat
  • Decreased heart muscle size
  • Low blood sugar or high blood sugar
  • Increase in A1C levels
  • Numbness in the body

  • Ketoacidosis
  • Hypoglycemia
  • Imbalance of electrolytes
  • Anemia
  • Insomnia
  • Osteoporosis
  • Seizures and convulsions
  • Liver and/or kidney damage
  • Multi-organ failure
  • Cardiac arrest
  • Death

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Professional Treatment

Detecting eating disorders early and seeking treatment is necessary for achieving long-term recovery. Although, many young adults in college are not aware of the treatment options and support groups available to them, so they neglect treatment altogether. As a result, students struggling with food-related illnesses cannot focus properly, which may keep them from succeeding academically. 

Fortunately, many college health services offer programs that help assess and treat students with eating disorders. The earlier these disorders are detected, the better chance students have of succeeding in school and not developing a substance use disorder (SUD). 

Many universities in the U.S. offer educational services for eating disorders. These services may include:

  • Educational programs, body image workshops, and events (e.g., National Eating Disorders Awareness Week)
  • Individual counseling services run by staff practitioners who specialize in eating disorders
  • Academic programs and classes focused on eating disorder awareness
  • Peer advisors and residence life programs
  • Online informational resources for students
  • Services for the athletic department, which screens college athletes who may have symptoms of an eating disorder

Treatment For Co-Occurring Disorders

If you are struggling with an eating disorder and co-occurring mental health disorder, professional treatment and therapy are necessary. This is especially true if you have also developed a substance use disorder (SUD) or alcohol use disorder (AUD). Depending on needs, professional treatment may include:

  • Interpersonal therapy
  • Cognitive behavioral therapy (CBT)
  • Motivational enhancement therapy
  • Family therapy
  • Group therapy
  • Mood stabilizers, antidepressants, and/or antipsychotics
  • Residential treatment at an inpatient facility

College students and young adults with a food-related disorder should seek professional help immediately. Neglecting to do so can lead to many negative physical and mental health issues later on. Find treatment today.

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Resources

“Anorexia Health Risks and Medical Complications.” McCallum Place, www.mccallumplace.com/anorexia/risks-factors-stats/.

“Eating Disorders on College Campuses - A National Survey of Programs and Resources.” National Eating Disorders Association. February, 2013.  https://www.nationaleatingdisorders.org/sites/default/files/CollegeSurvey/CollegiateSurveyProject.pdf

“Substance Abuse and Eating Disorders.” National Eating Disorders Association, 6 Feb. 2020, www.nationaleatingdisorders.org/substance-abuse-and-eating-disorders.

“Types of Eating Disorders.” Anxiety and Depression Association of America, ADAA, adaa.org/eating-disorders/types-of-eating-disorders.

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Updated on: June 24, 2020
Author
Alyssa Hill
About
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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