In 1967, when Marcia Herrin lost 20 pounds in three months and her hair began falling out, her doctor told the then 16-year-old Montana native to “put olive oil in my hair to moisturize it,” she recalls. “I should have been told to eat more. But I hadn’t mentioned how little I was eating.”
Today, many doctors would know enough to ask. Yet recognizing the signs of an eating disorder, says Herrin—whose anorexia turned to bingeing before she overcame both in 1973—is just a small step on the long road to good health. Co director since 1987 of the Eating Disorders Education, Prevention and Treatment Program at Dartmouth College in Hanover, N.H.—among the most respected programs of its kind in the nation—Herrin, 47, puts her doctoral degree in nutrition to work helping students navigate that path. “College is such a high-risk time for anorexia, bulimia and binge eating,” she says. “Studies show that, with good treatment, 70 percent of people with eating disorders can be cured, but it may take years.”
Now married and the mother of two, Herrin says her own unaided recovery was “damn lucky” and urges others not to take a similar approach. “Most people don’t just get better,” she says. “I wasted years I’d like to have back.” Herrin discussed the problem of on-campus eating disorders with PEOPLE correspondent Tom Duffy.
Why is disordered eating so common among college students?
College is a time of major change. Students are suddenly on their own with food, usually for the first time in their lives, and often they gain weight and then diet, which triggers eating problems. If the disorder began before college, as is often the case, the stress of campus life can make it worse.
Who is most at risk?
Personality type—being driven and achievement-oriented—is a bigger predictor of who will develop an eating disorder than gender, economic status or ethnicity. And although eating disorder sufferers tend to be white, as the values of white culture—where thinness is an asset—become pervasive, more minorities are falling prey.
Do eating disorders strike men?
Much less often, but the incidence is rising. As women become less dependent on a man’s salary, men are basing their own attractiveness more on looks. I see lots of college men who are concerned about their weight and body shape.
Is bulimia more common than anorexia on college campuses?
A study on adolescent females found that between. 5 and 1 percent suffer from anorexia while 3 to 5 percent suffer from bulimia. But the disorder that affects more college students than any other—the American Psychiatric Association says 30 percent—is binge eating, which used to be known as compulsive overeating and has a lot of shame attached to it.
Do the media contribute to the eating disorder problem?
Yes. In movies, TV, advertising, it’s almost impossible to find beauty in different sizes. There are a host of reasons someone might be at risk for an eating disorder. But if media images changed, would we have fewer eating disorders? Most experts think—and I agree—that we would.
Do school sports programs play a role?
Usually, the positives of sports outweigh the negatives. But an athlete’s personality type is similar to that of someone at risk for an eating disorder—they’re driven to be the best. And athletes, like anorexics, learn to ignore body signals like pain and hunger.
Ideally, how should colleges handle student eating disorders?
A team approach using psychologists, physicians and nutritionists works best. At Dartmouth, students can enter our program from the route that’s most comfortable—we have athletic trainers, medical professionals, counselors and nutrition experts all trained to help. I think it’s every college’s responsibility to provide services or at the very least to provide referrals and help students figure out how to pay for treatment.
How much will most insurance companies pay for treatments?
It depends on the company. It’s tough for insurers because it’s expensive, it can take a long time, and we’re still working out what the best treatments are. It’s easier to get coverage for anorexia than bulimia because physicians can use body weight as an indication that this is a serious medical concern.
Should colleges be doing more to combat the problem?
Most schools now have some system for providing counseling or referrals, but many lack nutritional education and outreach programs. Eating disorders don’t get bad press for colleges the way alcohol abuse does, and sufferers aren’t demonstrating in front of the administration building, as happens around sexual-abuse and assault issues. So eating disorders are duking it out for budgetary attention.
Even if services exist, is it hard to get students to use them?
Often, yes. It may take a long time for kids to recognize they’re suffering from an eating disorder. Once they do, they worry about the stigma attached. They may worry that college administrators will find out, or they may be afraid of their parents’ reactions. We make a big deal about confidentiality here—no information is passed on to parents, coaches or school administrators without a student’s written permission.
Can students help each other?
They should be taught what to look for—weight loss, skipped meals, vomiting. If they suspect a friend has an eating disorder, they should express concern and suggest help. Most people deny they have a problem, so waiting a week and expressing concern again is good. If the student isn’t responsive, you can consult your school’s health services. But they can’t be the eating disorder police. At Dartmouth the eating disorder team won’t act unless we’re concerned the student’s health is seriously at risk.
How can colleges help students avoid eating disorders?
Nutritional counseling can help them work through minor food problems. But since disorders often begin in the early teen years, prevention should start earlier. If a child is chubby, the family needs to know that dieting is risky. Instead, the family should make sure healthy food is available and that the child remains physically active. Also, parents and doctors need to tell kids that they can expect to gain five or 10 pounds after high school—they’re still growing. We need to help girls view body size more as a given, like height. You may not like being shorter than a supermodel, but you accept it.
Can eating disorders be cured, or just controlled?
They can be cured. About one-third of people in treatment recover completely, another third learn to function at a very high level but still have some food issues, and a third continue to struggle with active eating disorders for a very long time. But I will work with people for as long as they want to. There are no lost causes.