As a high school freshman, Alexa Larson’s every thought was occupied by her weight.
“I didn’t have time for friends. I didn’t have time for activities,” Larson said. “I didn’t really have any goals in life other than to get through the day and wake up lighter than I had before.”
A three-month stint in an Oklahoma residential center gave Larson her life and personality back from her eating disorder that first arose in middle school, she said. Now, the 20-year-old UF advertising junior freely eats former “fear foods” like peanut butter and dedicates more time to theater than the gym.
When Larson got to UF, she was surprised by how often classmates talked about dieting and weight loss, she said. Knowing where the end of that “pointless” road led, she avoided it.
But not everyone arrives at university with that lesson already learned. As a result, college has long proved a catalytic time for developing eating disorders — illnesses of obsession with food that may take the form of anorexia, bulimia or binge eating.
Since 2013, eating disorders on campus have risen steadily. About 17% of college women and 10% of men were identified as likely to have one in the Healthy Minds Survey for 2023. The figure was over seven percentage points lower for both groups 10 years ago.
Larson would offer any classmate struggling with an eating disorder a simple warning, she said. “You can try,” she said. “But it's either gonna end up with you being dead or going back to your original set [weight] point.”
Self-image outside appearance
College is a prime time for people to start heavily comparing their bodies to their peers, UF clinical and health psychology associate professor Rebecca Pearl said. Young adults have a high risk of developing “internalized weight stigma,” Pearl’s primary research focus.
People with poor body image don’t like their body, but people with internalized weight stigma don’t like themselves because of their body, Pearl said.
“Even though they can recognize that they're successful in their careers … because they cannot control their weight, they feel like a total failure in life,” Pearl said. “They feel worthless, they don't know why their loved ones are with them. It's really this deep-seated self-loathing.”
To combat the phenomenon, Pearl recommends looking to places other than one’s appearance for self-esteem.
Research is unclear whether losing weight actually reduces internalized stigma, she said. So, instead of following fad diets, she advocates focusing on school, friends and hobbies and practicing self-compassion to heal a damaged relationship with food.
Unseen struggles
Weight stereotypes also impact who receives treatment for eating disorders, said Rachel Leder, a UF psychology doctoral student. People with larger bodies who meet the criteria for anorexia or bulimia often don’t get diagnosed because they don’t fit the cliché of an eating disorder patient.
“It's seen as a positive of, ‘Oh, you're losing weight. Awesome, great job,’” she said. “Not understanding that that person could be severely restricting their eating.”
The stereotype can also lead people with higher weights to not recognize something going on with themselves and seek treatment, she said.
Complimenting weight loss puts thinness at the forefront of what people believe they should strive for in their day-to-day life, Leder said. Reducing body-based comments around being skinny, feeling bloated or wearing a certain clothing size can all help curb diet culture, she said.
“People forget that food is fuel”
People with binge eating disorder, the most common form of eating disorder in the U.S., also often go without themselves or others recognizing their issue, said Hannah Stahmer. As the sole dietician serving students through UF Health, the most common complaint she hears from students is “stress eating.”
When people go all day without eating, they get stressed and hungry and eventually, instead of sitting down to make a balanced meal, they grab fast food or a snack that can snowball into a binge, Stahmer said.
“When you skip a meal, there’s a hunger deficit there — your body still needs fuel,” she said. “People say, ‘Well, I’m not hungry,’ and I’m like, ‘Yeah, but at 10 o’clock at night, you’re going to eat everything that’s not nailed down to that kitchen.”
To address binge eating, Stahmer recommends targeting the root of the problem, which is rarely food, she said. Stahmer often spends as much time talking with students about sleep as she does nutrition, she said, since unusual sleep patterns lead to unusual eating patterns. Undereating can cause long-term health effects like trouble getting pregnant later in life or osteoporosis, a bone-weakening disease, she said. People who struggle with binge-restrict cycles, including those who may not “look” physically unhealthy, can also experience low energy and iron levels.
“People think the less you eat, the better you are in this world,” Stahmer said. “The ‘girl dinners,’ and who can eat the least amount of food is a winner. And we forget that food is our fuel.”
Pressure at the dining hall and the gym
‘Calorie counts are posted next to each dish in UF’s dining halls, a move Stahmer doesn’t agree with and said she has pushed back on for years.
Schools including Northwestern University and Yale University have moved calorie information to an online-only format after acknowledging the numbers can be triggering to students with eating disorders and impede recovery by encouraging restriction.
But when 20-year-old UF fine arts and digital arts and sciences sophomore Samantha Gallagher came to college and started eating at the dining hall, her primary concern wasn’t nutrition information, but social pressure.
Having to eat around other people and feel judged for how much or how little she ate caused major anxiety for Gallagher, she said.
“I would hide away in little corners because I would feel shame,” she said. “I’d go up to a station and I’d be like, ‘If I don’t get some of those awfully cooked vegetables, they’ll think that I’m unhealthy … I still don’t ever go to another place for seconds, because that’s so embarrassing.”
As a woman, Gallagher said, she’s struggled with body image issues due to unrealistic beauty standards from a young age. But inserting meals at the dining hall as a predetermined part of her schedule has helped her develop a balanced, consistent nutrition routine, she said.
Syd Watkins, the campus dietician for UF’s food provider Chartwells, said her team is aware of concerns around calories in dining halls. She encouraged students to see calories as just one piece of information used to evaluate food — not the whole nutritional picture.
Watkins likes to keep healthy meal recommendations simple: Make sure to have a carb, a protein and a colorful fruit or vegetable with each meal, she said.
As a “dietitian who does not cook,” some of her favorite simple snack suggestions for college students include yogurt and granola, jerky, hummus with pita chips or smoothies.
At the end of the day, most foods fit into a healthy diet, and she encourages students to enjoy foods they love without guilt to support both physical and mental health, she said.
“A healthy relationship with food all starts with a healthy relationship with self,” she said.
As a former professional softball player, she also emphasized the importance of a balanced relationship with exercise. Particularly in men, a group less stereotypically susceptible to eating disorders, trying to gain muscle to keep up with friends can turn gym culture toxic, she said. Going to extremes of eating a certain amount of calories and protein, taking supplements and even steroids are all ways students may try to get the results they want, at risk to their long-term health, she said.
For Matthew Bushee, an 18-year-old UF political science freshman, body image struggles or fear of the “freshman 15” haven’t impacted his experience on campus, he said. But as a regular gym goer, Bushee does notice the toxic effects of gym culture among his male peers, he said.
“It’s very, ‘I’m only doing this to look better for others,’” he said. “That really goes against why you should be doing it, which is just to feel better … Do it for yourself, and not because you want to achieve a certain image.”
Contact Zoey Thomas at zthomas@alligator.org. Follow her on X @zoeythomas39
Zoey Thomas is a media production junior and the Fall 2024 Enterprise Health Reporter for The Alligator. She previously worked on the University and Metro desks. Her most prized assets include her espresso machine, Regal Unlimited movie pass and HOKA running shoes.