The Transition to University Life – And What It Means for Students With an Eating Disorder
The symptoms associated with eating disorders have been observed to increase at times of developmental transitions. Patients dealing with eating disorders use their eating or exercising habits as a coping mechanism to handle the stress that comes with changing and added responsibilities. While previous research has alluded to symptom exacerbations as a result of the transition to different schools or university, there has been no research done on how those with eating disorders experience this transition, or the means by which this transition affects students’ eating disorder behaviour.
The prevalence of the “diet culture” on university campuses has been studied extensively in past research. It is possible that this “diet culture”, coupled with the increase of control over one’s food intake in university, leads to an increase in eating disorder symptoms. To address this possible relationship, this study conducted fifteen qualitative interviews with students who self-reported an eating disorder to gain insight of their experience on campus.
This study recruited participants through posting fliers around campus, at community treatment centers, the student health center, and the eating disorder advocacy organization “Project HEAL”. The participants were all students at a university in Pennsylvania. The study was not limited to only students who had been formerly diagnosed with an eating disorder, as the study placed greater importance on the participant’s own perceptions, rather than formal assessment results. As this was the first research conducted on this topic, the researchers created their own interview questions, ranging from asking about methods of coping before university, to questions regarding whether their eating disorder has a role in their self-perception. However, focus was kept on the effect the university environment has on eating disorders, and the effect eating disorders has on the university experience. The participants were all female, and described a range of ED symptoms, including restricting, over-exercising, binge-eating, purging, and food aversion.
Overall, participants perceived that their university experience was disrupted by their eating disorder through affecting their ability to focus on academic responsibilities and leading to social isolation on campus. They spoke of the freedom of university leading to a loss of external accountability. Through the loss of supervision conducted by parents/treatment teams, as well as now being responsible for food preparation, many were able to “hide” the aggravation of their symptoms. In addition, the buffet-style of dining, as well as the accessibility to 24-hour gyms led to greater likelihood of indulging in harmful behaviour. Students were also able to skip lectures and engage in harmful practices, such as binging and purging.
In fact, participants were surprised at how easy it was to avoid exposure of their behaviour. Due to prevalence of the diet-culture on campus and in dorms, participants found themselves holding a more negative view of their body, which overpowered whatever positivity was associated with socializing over discussions of dieting and exercising. They ultimately felt “abnormal” in this culture, as they viewed their practices as a disease, rather than a diet. They were also unable to participate in any socialization taking place in the dining hall or involving alcohol. While participants originally believed that university would be a “new beginning”, many participants reported choosing a university close to the treatment centers they went to before or switching universities to regain the support of their families and treatment team.
These results bring into light the specific challenges faced by students experiencing eating disorders in university. This can lead to eating disorder specialists to consider these obstacles when providing care to current university students. It can also lead to healthcare professionals giving more effective guidance to future students about how to balance external accountability and pressures with self-responsibility. In addition, the transition from pediatric to adult care may also play a role in this change in behaviour, which can be further explored in future research.
Source:
Goldscehn, L., Lundblad, W., Fertig, A.M., Auster, L.S., Schwarzbach, H.L., and Chang, J.C. (2019). Navigating the university transition among women who self-report an eating disorder: A qualitative study. International Journal of Eating Disorders, 52(7), doi:http://dx.doi.org.myaccess.library.utoronto.ca/10.1002/eat.23071
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