Updated on February 6, 2024
6 min read

Substance Abuse and Eating Disorders in College Students

Substance Abuse and Eating Disorders in College Students

College students with eating disorders often use substances to cope with issues and escape negative thought patterns. These issues may include constant worries about gaining weight and other daily struggles associated with poor body image.

The most common drugs college students abuse include:

Substance Abuse, Eating Disorders, and Mental Health

Anxiety Disorders Association of America’s report says substance abuse rates and addictive behaviors are high among this group. Additionally, college students face added stresses and pressures that can lead to these mental health issues:

  • Depression
  • Mood disorders
  • Anxiety

Eating disorders among young adults are a pressing concern as they can lead to severe mental health issues. Specifically, college students are at a higher risk of developing eating disorders, which tend to intensify between ages 18 and 21.

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Consequences of Substance Abuse

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: 

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’s also when people combine heavy drinking with disordered eating patterns.

It’s common for college students to binge drink, especially at parties and other social gatherings. 

Risks of Drunkorexia

Engaging in food restriction, purging (self-induced vomiting), and consuming high levels of alcohol poses significant risks, such as:

  • Increased risk of dehydration and electrolyte imbalances
  • Nutritional deficiencies and malnutrition
  • Damage to the esophagus, teeth, and mouth from frequent vomiting
  • Gastrointestinal problems, including acid reflux and stomach ulcers
  • Disruption of normal digestive processes
  • Increased risk of alcohol poisoning and overdose

For example, college students who do this have a higher chance of developing short-term and long-term health complications. That includes drug addiction. They’re also more likely to experience an overdose or alcohol poisoning, which can result in death.


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Eating Disorders in College — How Do They Form

College is an exciting time in every young adult’s life. However, risk factors and challenges arise as they learn to balance responsibilities and independence.

The freedom and exposure to new experiences — such as peer pressure, dating, and parties — make some students lose control over their lives. As a result, common eating disorders may emerge due to their desire to be in control and deal with painful emotions.

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Causes of Eating Disorders

Many young adults don’t know they have an eating disorder until health problems form later on. People are “finding themselves” in college and are usually unaware of their poor decisions to fit in.

There are many other reasons why dangerous eating habits like binge eating disorders can form during the college years, including:

  • Being unhappy with your weight or appearance
  • Significant life changes
  • 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

Symptoms of Eating Disorders

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

  • Constant fears associated with gaining weight
  • Obsessing over one’s weight to the point where it interferes with daily life, relationships, and activities 
  • Abusing diet pills to lose weight quickly
  • Overeating
  • Being overly conscious about how many calories you consume daily
  • Purposely not eating when hungry
  • Wanting to lose weight despite being in the ideal weight 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. Women are more likely to have body dissatisfaction than men.

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Common Types of Eating Disorders

College students and young adults deal with a few different types of eating disorders. These conditions affect the body differently, each with distinct eating disorder symptomatology requiring specialized treatment.

The most prevalent eating disorders include:

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 daily.

Anorexia nervosa is characterized by abnormally low body weight, excessive exercise, and long-term starvation. 


Bulimia is when a person overeats and then purges (self-induced vomiting). They may also refrain from eating for specific periods (fasting) or use laxatives to prevent weight gain. Excessive exercise is also common among people suffering from the condition. 

Binge-Eating Disorder

Binge-eating disorder is similar to bulimia because it involves consuming large amounts of food and feeling guilty afterward. The difference is that people who binge eat don’t purge after eating or use laxatives to avoid gaining weight.


The 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 inedible things with no nutritional value, such as paper or clay.
  • Restrictive food intake disorder: Refers to extremely picky eating and selective eating habits.

Potential Health Complications

Eating disorders can lead to co-occurring mental health issues and substance use disorders (SUD), negatively impacting physical health. These issues include:

  • Extreme concerns about body shape and size 
  • Infertility 
  • Amenorrhea (absence of menstruation)
  • Loss of bone mass 
  • Extreme muscle weakness 
  • Irregular and dangerous heartbeat
  • Decreased heart muscle size
  • Hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar)
  • Increase in A1C levels
  • Numbness in the body
  • Ketoacidosis
  • Hypoglycemia
  • Imbalance of electrolytes
  • Anemia
  • Insomnia
  • Osteoporosis
  • Seizures and convulsions
  • Liver or kidney damage
  • Multi-organ failure
  • Cardiac arrest
  • Death

Professional Treatment

Detecting eating disorders early and seeking treatment is necessary for achieving long-term recovery. The earlier the detection, the better chance students have of succeeding in school and avoiding a substance use disorder (SUD). 

Unfortunately, many are unaware of the available treatment options and support groups. So, they neglect treatment altogether or lose focus which keeps them from succeeding academically. 

Fortunately, many college health services offer programs that help assess and treat students with 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

Professional treatment and therapy are necessary if you’re struggling with an eating disorder and co-occurring mental health disorder. This is especially true if you have also developed a substance use disorder (SUD), alcohol use disorder (AUD) or are struggling with drug abuse.

Depending on needs, professional treatment may include:

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

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

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Updated on February 6, 2024

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