The Eating Disorders Support Team
The University of Connecticut’s Student Health and Wellness (SHaW) has established an Eating Disorders Support Team. Students with eating disorders may participate through self-referral, by referral from a friend, or by referral from another health care professional. Students who participate receive coordinated care that includes medical evaluation, psychiatric and psychological evaluation, nutritional counseling and women’s clinic services. Students may choose to start treatment with a brief course of individual psychotherapy offered at Student Health and Wellness – Medical Care. Some may go on to receive – or start with – longer-term individual therapy, which SHaW does not offer. Off-campus therapists who practice in the community are available for referrals and may choose to work in conjunction with SHaW. Student Health and Wellness also provides an on-going group therapy for those with eating disorders for a nominal fee. If more intensive therapy is required recommendations will be made and assistance with appropriate facilities provided.
What are Eating Disorders?
Eating disorders are not necessarily about food, but food is the tool that people with eating disorders abuse. Eating disorders have both physical and psychological symptoms. They are characterized by abnormal attitudes and feelings about food, weight and body shape, an extreme disruption in eating behaviors and weight management, and intense anxiety about body weight and size.
Eating Disorders usually refer to three different entities: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.
Anorexia Nervosa is characterized by restricted eating, self-starvation and excessive weight loss. There is a refusal to maintain weight at or above a minimally normal weight for age and height. An intense fear of gaining weight and an unrealistic fear of becoming fat also exist. Body image is distorted. An unhealthy concern with body weight, shape, and even a particular body area may persist (like “oh, my thighs are so huge”).
Bulimia Nervosa is characterized by recurrent episodes of overeating large amounts of food in a short period of time (the binge) followed by some form of purging, including self-induced vomiting, laxative or diuretic abuse, fasting, diet pills, or excessive exercise, intended to prevent weight gain. The attempt to prevent weight gain is often unsuccessful.
Binge Eating Disorder is characterized by recurrent episodes of binge eating that are not followed by inappropriate compensatory behaviors (purging) to prevent weight gain. It often presents with a sense of lack of control over eating during the binge, overeating large amounts of food in a short time period of time, and eating alone because of being embarrassed by the amount one is eating.
Medical Complications of Eating Disorders
Sometimes people do not realize the seriousness and potential life threatening effects that can occur from an eating disorder, as well as some of the adverse physical effects that may result. These may occur over time or very quickly and unexpectedly. They may include:
- Weakness and fatigue, syncope (fainting)
- Loss of menses (may or may not affect ability to conceive in the future)
- Osteoporosis (loss of bone density and fractures, Dowager’s hump)
- Life threatening heart arrhythmias
- Abnormal temperature regulation (always feeling cold)
- Depressed immune system
- Abnormal slowing of heart rate
- Life threatening heart arrhythmias
- Electrolyte abnormalities
- Swelling of the legs
- Facial bloating
- Decaying of teeth
- Permanent damage to colon
- Tears and ruptures of the esophagus
- Life threatening stomach rupture
Causes of Eating Disorders
Causes of eating disorders are many and multifaceted. Sociocultural, psychological, genetic, and interpersonal issues are all contributing factors. An eating disorder may begin as a natural way to lose weight or get into shape and escalate out of control. There is usually no way to predict who will escalate and who will not. Athletes, dancers, gymnasts, models are probably more susceptible, but not all of these people have eating disorders. Dieting and thinness are encouraged by our society and difficult to avoid. Women and girls especially are consistently taught that their self-worth, hence their self-image, is dependent on their physical appearance. If this often unreasonable expectation of thinness is not met it may lead to feelings of depression, anxiety, lack of control, and inadequacy. In order to cope with these feelings a person may turn to eating (or not eating) as a means to exert some control or happiness over their life. And in the susceptible individual this escalates out of control.
Moving to a college campus may also precipitate problems. There is a new level of physical competition among females, increasing independence over decision-making, and often confusion with the new environment and freedom. This often leads to the development of a simmering eating disorder or the exacerbation of one that already exists.
Do I Have A Problem?
There are many levels of eating disorders. Some general questions which may point to a need for further evaluation include:
- Do I weigh myself daily?
- Do I skip at least one meal a day?
- Do I count calories and fat grams?
- Am I currently or frequently on a diet?
- Have I lost weight? How much?
- Do I experience binge eating?
- Do I purge (vomit, use laxatives or diuretics) after meals?
- Do I exercise excessively?
- Do I exercise because I want to or because I feel I have to?
Do you answer yes often? If so you might want to consider talking to one of the health professionals at Student Health and Wellness or your own provider to learn more.
How to Help Someone
How to Help a Friend
- Set a time to talk. Set aside a time for a private meeting with your friend to discuss your concerns openly and honestly in a caring, supportive way. Make sure you will be some place away from other distractions.
- Communicate your concerns. Share your memories of specific times when you felt concerned about your friend’s eating or exercise behaviors. Explain that you think these things may indicate that there could be a problem that needs professional attention.
- Ask your friend to explore these concerns with a counselor, doctor, nutritionist, or other health professional who is knowledgeable about eating issues. If you feel comfortable doing so, offer to help your friend make an appointment or accompany your friend on their first visit.
- Avoid conflicts or a battle of the wills with your friend. If your friend refuses to acknowledge that there is a problem, or any reason for you to be concerned, restate your feelings and the reasons for them and leave yourself open and available as a supportive listener.
- Avoid placing shame, blame, or guilt on your friend regarding their actions or attitudes. Do not use accusatory “you” statements like, “You just need to eat”. Or, “You are acting irresponsibly”. Instead, use “I” statements. For example: “I’m concerned about you because you refuse to eat breakfast or lunch”. Or, “It makes me afraid to hear you vomiting”.
- Avoid giving simple solutions. For example, “If you’d just stop, then everything would be fine!”
- Express your continued support. Remind your friend that you care and want your friend to be healthy and happy
- Provide your friend with the resources on UConn’s campus. Please refer to the right side of the webpage labeled “More Information”
Source: National Eating Disorders Association, 2006.
How Faculty/Staff can help a Student
If you have a close relationship with the student…
- Select a time to talk to the student when you are not rushed and also try to prevent interruptions. Do not make a decision or judgment about the student without first speaking privately with him/her.
- In a direct and non-punitive manner, indicate to the student all the specific observations that have aroused your concern. Allow the student to respond. If the student discloses information about problems, listen carefully, with empathy, and being non-judgmentally.
- Your responsibilities are not to diagnosis or provide therapy; it is the development of a compassionate and forthright conversation that ultimately helps a student in trouble find understanding, support, and the proper therapeutic resources.
- If the information you receive is compelling, communicate to the student:
- Your tentative sense that he or she might have an eating disorder;
- Your conviction that the matter clearly needs to be evaluated;
- Your understanding that participation in school, sports, or other activities will not be jeopardized unless health has been compromised to the point where such participation is dangerous.
- Avoid an argument or battle of wills. Repeat the evidence, your concern, and if warranted your conviction that something must be done. Terminate the conversation if it is going nowhere or if either party becomes too upset. This impasse suggests the need for consultation from a professional.
- Do not intentionally or unintentionally become the student’s therapist, savior, or victim. Attempts to “moralize”, develop therapeutic plans, closely monitor the person’s eating, adjust one’s life around the eating disorder, or cover for the person are not helpful.
- Discuss and provide the available resources at UConn to which the student can be referred. This information can be found on the right side of the website under “More Information”.
- If you have any questions regarding the resources available or approaching a student, please call any of the numbers under “More Information” which is found to the right side of the website.
If you do not have a close relationship with the student but have concerns…
- Contact any of the services involved in the Eating Disorders Support Team to discuss your concerns and to talk about how to better assist the student.
Source: National Eating Disorders Association, 2006.
Treatment of Eating Disorders
Treatment of Eating Disorders requires the care of professionals who have experience in their treatment. A multidisciplinary approach is generally most effective. This approach entails a combination of treatment from therapists, psychiatrists, nutritionists, and medical professionals. Treatment may or may not include medication. Ideally treatment will be tailored to the individual and may vary from person to person, drawing on individual resources, strengths and weaknesses, support systems, and severity of his or her symptoms.
Most treatment is done on an outpatient basis. However, hospitalization or more intensive out-patient treatment is recommended when an eating disorder has led to physical problems that may be life threatening. Some people may also require more supervision than weekly therapy can provide.
For any further information or referral please call one of the numbers below.
Confidentiality is assured.
- Medical appointments:
- Counseling & Mental Health Services:
- Nutrition Services:
For specific questions or more information please contact:
- Amy P. Dunham, MA, RD, CSSD
- National Eating Disorders Association (NEDA) is dedicated to expanding public understanding of eating disorders and promoting access to quality treatment for those affected along with support for their families through education.