Carnegie Mellon University

Eating Disorder Concerns and Body Image Issues

The term "disordered eating" is used to describe unhealthy attitudes and perceptions toward food and weight.  Disordered eating behaviors may start in college or students might arrive with concerns.  These behaviors represent the start of an unhealthy relationship some people have with food. Behaviors that can result from unhealthy attitudes include skipping meals, frequent dieting, binge eating or exercising for the sake of burning calories.

Sometimes, disordered eating can be the precursor to a serious, life-threatening eating disorder. Eating disorders meet specific criteria, beyond disordered eating behaviors. Eating disorders do not discriminate on the basis of gender; men and women can both suffer from eating disorders.

Click on the links below to find out more information. Due to the complex nature of eating disorders, these pages contain general educational information and these guidelines are to be used as a starting point to getting help for yourself or a friend.

If you answer "yes" to any of these statements below, you may be at risk for an eating disorder.

  • I feel guilty after eating.
  • I believe I have no control over food.
  • I weigh myself more than three times a week.
  • I exercise excessively to lose weigh and become anxious if I cannot exercise according to my plan.
  • I use laxatives, diet pills, vomit, or diet excessively to keep weight off.
  • I hide my eating from others.
  • I crave foods and can't seem to eat reasonable amounts of food.
  • I think about food even when I'm not hungry and plan when I'm going to eat a large amount.
  • I wear several layers or big clothing styles to hide my body shape.
  • I think a lot about how many, calories, fats or carbs there are in most foods I eat.

Anorexia nervosa is a serious psychological disorder of deliberate self-starvation that culminates in excessive weigh loss. As the weight loss progresses, the person becomes more susceptible to stress fractures, infections and chemical imbalances that can affect heart and brain function. People with anorexia have an intense fear of weight gain and body image disturbances. They perceive themselves as fat and will continue to restrict and starve, despite an emaciated look and feeling sick.

 Some signs include:
  • Loss of at least 15% of body weight
  • Dieting with relish when not overweight
  • Claiming to "feel fat" when overweight is not a reality
  • Preoccupation with food, calories, nutrition, and/or cooking
  • Denial of hunger, refusal to eat with family and friends
  • Excessive exercising, being overly active
  • Frequent weighing, with intense fear of weight gain
  • Use of laxatives, diet pills and/or vomiting to control weight
  • Complaints of feeling bloated or nauseated when eating small to normal amounts of food
  • Loss of menstrual period
  • Dry skin and hair
  • Cold hands and feet
  • Constipation and digestive problems
  • General weakness
  • Social withdrawal
  • Perfectionist attitude 
Bulimia is more widespread than anorexia.  It involves recurrent episodes of binge eating followed by self-induced vomiting or purging through the use of laxatives, diet pills, diuretics (water pills), excessive exercising or fasting. Many times people might just exercise all the time instead of purge to get rid of food. Some bulimia suffers are hard to identify since they might be at a normal body weight and you see them eat at regular intervals. Sometimes the shame and guilt associated with these eating behaviors may make a person embarrassed or too ashamed to ask for help. Like anorexia, bulimia is a psychological problem.  Due to the rapid losses of fluid and electrolytes, associated with purging or sweat loss, bulimia is also life-threatening.

Some signs include:
  • Excessive concern about weight, body image and food
  • Eats large volumes of food and then "gets rid" of it by vomiting, fasting or exercising
  • Reliance on eating as a way to deal with uncomfortable feelings
  • Frequent episodes of binge eating followed by feelings of guilt or shame
  • Disappearing after a meal (to vomit in the bathroom)
  • Dental problems and irritation of throat
  • Digestion issues like bloating, constipation and diarrhea
  • Realization that eating pattern is abnormal
  • Lightheadedness and headaches
  • Irregular menstrual periods

Binge Eating Disorder (BED) is an eating disorder. It is characterized by the consumption of large volumes of food in an uncontrolled manner that is not followed by self-induced vomiting, fasting or excessive exercise.  While there is no purging, there may be fasts or repetitive diets. Sometimes a person with BED can be overweight with several unsuccessful attempts at weight loss. Often the person feels anxious, tense, or depressed, and will attempt to relieve these moods by eating.
Some signs include:
  • A feeling that one cannot stop eating or control what or how much one is eating
  • Eating large amounts of food when not physically hungry
  • Eating alone because of being embarrassed by how much one is eating
  • Marked distress, disgust at oneself, depression, guilt
Nutrition to athletes, especially endurance athletes, is a critical part of training. Not only is nutrition important before extensive training sessions, but after as well. A properly balanced diet that provides adequate energy is highly recommended.  An athlete's initial performance improvement (due to weight loss through excessive training and restrictive diets) only acts to reinforce destructive training and eating behaviors. The thought that "more is better" is often used to rationalize behavior. For instance, one might think that if two hours of training is good, then four hours must be better. The same thing happens in rationalizing weight loss. "If two pounds of weight loss improved performance, then four pounds will improve it even more." Beware of this type of thinking.

When an athlete has severely reduced weight through improper dieting or excessive training, performance will markedly suffer. As the weight loss progresses, more severe problems may develop such as increased susceptibility to infections, stress fractures, pain and weakness in all muscles including the heart muscle. Most athletes do not realize that they are doing damage to their bodies as they continue to lose weight, train, and compete.

According to the National Eating Disorder Association, approximately 10% of eating disordered individuals coming to the attention of mental health professionals are male. The consensus is that males are clinically similar to, if not indistinguishable from, eating disorders in females. Gymnasts, runners, body builders, rowers, wrestlers, jockeys, dancers, stage performers, and swimmers are particularly vulnerable to eating disorders. Many times men suffer from body image disturbances since the "ideal" body shape for men is athletic, V-shaped muscular men that are also slender. Many marketing campaigns for fast foods or restaurants actually encourage men to have disordered eating behaviors, such as binge eating.   At the same time, men's magazines promote fad dieting and exercise as heavily and often in unhealthy ways just as the women's magazines.

A negative body image is a distorted perception of your shape - or body parts. You might be convinced that only other people are attractive and that your body size or shape is a source of personal failure. You might feel uncomfortable, ashamed, self-conscious, and anxious in your own skin.  A positive body image is an important piece in the recovery of eating concerns. Positive body image is when:

  • You see your body as it really is.
  • You accept and appreciate your body shape and understand that a person's physical appearance has little to do with his or her value as a person.
  • You don't spend and unreasonable amount of time worrying about the food you eat or what the scale says.
  • You feel comfortable in your body.

Source: Litt, Ann. Tulip Hill Press. The college student's guide to eating well on campus. 2nd ed. 2005, p 128.

Eating disorders can include some combination of disordered eating seen in anorexia, bulimia and binge eating disorder. While these combination behaviors may not be diagnosed as a full blown eating disorder, they are still very dangerous to your health and well-being and require professional help.

Information, screening, evaluation and treatment referrals are COMPLETELY CONFIDENTIAL on campus through both:

 Counseling and Psychological Services (CAPS) 

 University Health Services (UHS) appointments available at HealthConnect.

If you would prefer to receive treatment off campus, CAPS and UHS can provide you with a referral to a treatment program that would best meet your needs.

If you are concerned about a friend, you can help by letting them know that you are concerned about them.
Here are some guidelines to approaching a friend:
  • Speak to the person privately and allow time to talk
  • Tell the person that you are concerned about them and tell them specific observations that have aroused your concern
  • Be honest, direct and compassionate
  • Suggest professional help and give them resources that are available to them
  • Realize that the person may deny the problem and refuse to seek help
  • Reassure them that you are willing to talk about the problem with them when they want to
  • Don't play therapist or get into a struggle with them over the issue of food or weight
If you feel the person has problems that scare you, seek professional help to discuss your concerns. For example, if the person is suicidal, passing out or complaining of chest pain, bingeing and vomiting several times a day, you should seek advice immediately at Counseling and Psychological Services.