Opinion | The hidden cost of disordered eating at Stanford

Opinion by Sarina Deb
Feb. 8, 2023, 9:43 p.m.

In a survey of the Stanford student body conducted in 2020 by Mila Camargo ’22 M.A. ’23, 92.1% of students** said they would modify their body (i.e. lose weight, gain muscle or change the size/shape of specific body parts) if they could. In that same survey, 67.7% of participants indicated that Stanford culture exerts pressure to look a certain way.

While most would not recognize these issues from the outside, as president of Students Against Eating Disorders (SAED), a club dedicated to promoting healthy relationships with food and our bodies, I have witnessed firsthand the prevalence of disordered eating and its toll on Stanford students. So many of us are suffering silently due to stigma and the misconception that we are alone in this challenge.

Over 100 participants have signed up for our peer-led support groups since the program’s start at the beginning of last school year. More and more students come to us reporting negativity in their relationship with food, their bodies and themselves. Because I struggled with an eating disorder throughout high school and college, I thought I already understood the heavy burden eating disorders pose. But each week, when I facilitate the support group, I am consistently struck by how much students are impacted by these all-consuming disorders, often triggered by diet culture comments from their peers, stressful life events, academics and challenges with other mental health issues.

The prevalence and impact of eating disorders at Stanford shouldn’t be a surprise. Some factors in college can increase students’ susceptibility to eating disorders, from navigating dining halls with so many options to living in an unstructured environment away from parents and families for the first time. This challenge likely contributes to the fact that eating disorders typically begin between 18 and 21 years of age, and between 10 and 20% of women and 4 to 10% of men in college suffer from one of these disorders. Rates are also on the rise in light of the pandemic, with research demonstrating substantial increases since the start of the pandemic for overall incidence (15%), hospital admissions (48%) and emergency department visits (11%). 

At Stanford, community members often talk about the infamous “Duck Syndrome,” in which students hide their struggles. With that comes the pressure to seem happy and healthy, not just academically, but holistically. “Wellness” fads such as intermittent fasting and ketogenic diets have become more popular among college students. At the same time, students I have talked to are feeling pressure to restrict calories or engage in other disordered behaviors, such as purging or compulsive exercise, in order to control their shape or weight.

“The impact of disordered habits on campus is really hard to quantify,” Sarika Lansberg ’25 said. “One example is that gym culture can be toxic on campus, with people spending all of their time working out to an unhealthy extent.”

The severity of this issue cannot be understated. Eating disorders have the highest mortality rate of any psychiatric diagnosis. 20% of people suffering from anorexia will prematurely die from complications related to their eating disorder, including suicide and heart problems, and another large portion will unfortunately never fully recover.

This is also a challenge that impacts a multitude of intersectional identities. There’s a common misconception that these illnesses only impact middle-to-upper-class cisgender white adolescent girls, but that couldn’t be further from the truth. Men also struggle with eating disorders, which often go unaddressed due to stereotypes and stigma. And clinicians may be less likely to adequately recognize eating disorder symptoms, make a diagnosis and prescribe appropriate treatments for ethnic minority communities. A 2020 study also found that LGBT adults and adolescents experience greater incidences of eating disorders and disordered eating behaviors than their heterosexual and cisgender counterparts.

Despite these significant challenges and their prevalence, Vaden Health Center at Stanford only has one licensed therapist at their counseling center, Counseling and Psychological Services (CAPS), that specializes in eating disorders. Eating disorder care teams are usually multidisciplinary, consisting of a primary care physician, a therapist and a nutritionist. And while there are valuable resources available at Vaden Well-Being in the form of nutritionists and well-being coaches, there’s a current lack of awareness and conversations about these resources and how we can bolster and promote them. The barriers to accessing care are thus twofold: there are limited resources, and there is a lack of discourse around eating disorders and a stigma associated with seeking care, which may lead to reluctance to ask for help.

That’s why strengthening support for students who may be struggling with eating concerns is paramount, from both a cultural lens and an administrative perspective. This is an issue that deserves — and quite frankly, needs — more attention from Stanford’s administration, student leaders and everyone on campus.

Students Against Eating Disorders has trained ResEd staff, including resident assistants and fellows, on what eating disorders can look and feel like and how staff can appropriately respond to a student voicing or demonstrating concerns with eating and body image. We’ve also put on panels, conducted social media outreach and tabled to spread awareness.

While doing this work is immensely rewarding, addressing this crisis requires far more resources than what one student group can provide. Stanford needs to increase resources for addressing eating and body image concerns, which should look like hiring additional counselors that specialize in eating disorders to meet the needs of all of its students and funding initiatives that aim to prevent and respond to eating disorders.

And we as students need to spread awareness about the prevalence and dangers of these issues, support those who may be experiencing disordered behaviors and be conscious of the language that we use. Eating disorders are unfortunately competitive, in that sufferers are constantly trying to be the “sickest,”  so talking about diets and calories or fat shaming others can have a longstanding and immense impact on someone who might be vulnerable. 

According to Elias Applebaum ’25, who has recovered from anorexia nervosa, one way that we can promote a culture of wellness is through “holding each other accountable and having constructive conversations.”

“We need to be supportive without enabling people to hurt themselves,” Applebaum said. He especially stressed the importance of destigmatizing conversations around disordered eating for men.

“We need to be able to look at the ways we endorse hypermasculinity for men, and the ways that this promotes disordered eating,” Applebaum added.

If we take a stand together, perhaps we can work towards a Stanford where the number of students who want to change their bodies goes significantly down from 92%. Until then, many students will continue to struggle in silence.

**Note: The results of this survey data are disaggregated and the survey has not been linked in order to preserve the privacy of individual participants.

If you are struggling with an eating disorder, there are resources available.

The National Eating Disorder Hotline is (800) 931-2237.

Vaden Health Center and CAPS website have resources available for students impacted by disordered eating and body image concerns. You can call CAPS at (650)-723-3785. You can also make an appointment for a medical checkup or to meet with a nutritionist or well-being coach at your Vaden Health Center portal.

Sign up for Students Against Eating Disorders Support Group here.

A previous version of this article incorrectly stated that Students Against Eating Disorders had trained R&DE staff. They had trained ResEd staff.

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