Stress from the economic downturn, trouble coping with the transition to college, and general depression and anxiety appear to be hitting college students at rates never seen before on U.S. campuses.
College counseling centers are also seeing many more students with complex mental illnesses, such as clinical depression and bipolar disorder, center directors say.
In 1988, 58 percent of counseling directors nationwide reported seeing students with significant psychological problems, according to a survey conducted by Robert Gallagher of the University of Pittsburgh.
Over the past 10 years, more than 90 percent of directors reported seeing such students, with 93.4 percent this year, Gallagher wrote. Areas of concern include depression, eating disorders, suicidal thoughts and self-mutilation.
Showing posts with label college. Show all posts
Showing posts with label college. Show all posts
Sunday, January 3, 2010
Wednesday, September 16, 2009
Rethinking the Freshman 15 by Johannah Cornblatt
Haley Hogan, a recent Yale graduate who has suffered from anorexia, got used to seeing nutrition facts displayed at New York chain restaurants when she took a semester off last fall. But when she returned to Yale in the spring, she was shocked to find cards detailing calorie information all over her residential dining hall. "They're very triggering if you're in recovery from an eating disorder," Hogan says of calorie counts. "I felt almost violated that Yale had done this."
With more than 30 percent of college students falling into the American College Health Association's obese or overweight categories, Yale is not the only school trying to help students make smart food choices. But experts say the emphasis on calorie counts can backfire and lead to disordered eating, even among students with no history of food issues.
Dr. Richard Kreipe, a specialist in adolescent medicine whose research centers on eating disorders, says that while he has seen fewer cases of classic eating disorders like restrictive anorexia nervosa and bulimia nervosa in the past several years, the number of patients with eating disorders not otherwise specified (EDNOS) has "almost doubled" nationally in the midst of America's obesity epidemic. (An EDNOS, also called disordered eating, is an eating disorder that doesn't meet the strict diagnostic criteria for a full-blown eating disorder, but may include drastic weight loss, caloric restriction, binging, and purging.) Since 2000, the number of college students dieting, vomiting, or taking laxatives to lose weight has jumped from about 28 to 38 percent, according to the American College Health Association's annual surveys. Well-balanced caloric intake, with regular meals and physical activity—not dieting—is the best way to avoid obesity, says Kreipe, a professor at the University of Rochester Medical Center. That's why, in his view, calorie information doesn't benefit students. "Nutrition is not a simple thing that can be distilled down into a label," he says. "There's a tendency for people to overinterpret what a specific number means."
Last fall, Harvard removed cards with calorie information from dining halls. Writing about the decision on his blog, Ted Mayer, executive director of Harvard's dining services, noted that his staff needed to address "the challenge a quiet and surprisingly large contingent of our community faces with eating disorders." The dining staff now makes the information available on the Internet and at kiosks in the dining halls.
Going away to college makes all students vulnerable to weight gain and disordered eating, often at the same time. Students tend to experience a loss of structure when they go from high school to college. Studies have found that college students are less likely to eat breakfast or regular meals, and snack foods account for many often-unrecognized calories. All-you-can-eat dining halls and easy access to alcohol also make college students more susceptible to weight gain. At the same time, anxiety about gaining the "freshman 15" can trigger disordered eating—often well beyond the freshman year. Kreipe says that in a new setting surrounded by new people, college students are more likely to develop body-image issues, which can also lead to disordered eating.
Even overweight students, the prime targets of obesity-awareness programs, may get the wrong message. In a recent study, Dianne Neumark-Sztainer, a professor at the University of Minnesota School of Public Health, found that about 40 percent of overweight college-age women and roughly 20 percent of overweight college-age men engaged in disordered eating behaviors in an attempt to get thin. "People are concerned about the fat kids being fat and the thin kids having anorexia," she says. "But people aren't concerned about the disordered eating among the overweight kids." For under- and overweight people alike, eating disorders can lead to a host of health issues, including electrolyte imbalances, fertility problems, impaired brain development, bone loss, and, in severe cases, death. The study also showed that disordered eating behavior leads to further weight gain over time.
Colleges that focus solely on calorie counts are over-simplifying nutrition, says Neumark-Sztainer, who encourages collaboration between the eating disorder and obesity fields. More comprehensive information—like a nutrient density score—would better serve students. Such data would distinguish between items like a Coke, which is high in calories but low in nutrients, and avocado, which is rich in both calories and nutrients. Neumark-Szainer says the focus at college should be less on what people eat then how they eat. For example, students who eat with others are more likely to make healthy food choices and less likely to develop disordered eating—either eating too much or too little—than those who eat alone, she says.
There are other ways that schools can help students avoid unhealthy weight gain without provoking eating disorders. Colleges should provide opportunities for healthy physical activity that don't necessarily involve being on a sports team or going to the gym, Kreipe says. For example, schools might create walking trails or organize activities and social groups that focus on physically activity. Kreipe also recommends that schools make more healthy options—both in dining halls and vending machines—available. Above all, he says, colleges should be emphasizing portion size.
Some schools have tried to do just that. Last fall, Penn State converted one of its all-you-can-eat dining halls into a so-called "healthy dining hall," free from French fries, deep-fried chicken, or white bread. For each meal, Penn State's healthy dining hall features a model-portion plate, which consists of 50 percent fruits and vegetables, 25 percent grains, and 25 percent proteins. (The program is modeled on one at the University of North Texas.)
Still, Penn State provides caloric breakdowns in its healthy dining hall and in all other cafeterias on campus. "Healthy entrees," designated as those that container fewer than 400 calories and 10 grams of fat, are identified by a special check on the cards. Lisa Wandel, Penn State's residential-dining director, says it's the college's responsibility to notify students about what's in their food. "Would you pull labels off all the items in a grocery store?" she says. "We can't hide the fact that food has calories. I think it's better to provide that information so students can make educated choices."
Despite objections from students like Haley Hogan, Yale also plans to continue posting calorie counts in its dining halls this year. Rafi Taherian, executive director of Yale dining, says he expects that students will one day have access to real-time information about food through their cell phones or laptops. "I don't think we can hold the information back from them," he says. In fact, Rafi predicts that colleges, like some states and cities, will soon be required to provide students with nutritional data.
More important, it seems, is giving students the context to understand that information and making sure their education focuses on healthy behavior, not numbers on a scale.
With more than 30 percent of college students falling into the American College Health Association's obese or overweight categories, Yale is not the only school trying to help students make smart food choices. But experts say the emphasis on calorie counts can backfire and lead to disordered eating, even among students with no history of food issues.
Dr. Richard Kreipe, a specialist in adolescent medicine whose research centers on eating disorders, says that while he has seen fewer cases of classic eating disorders like restrictive anorexia nervosa and bulimia nervosa in the past several years, the number of patients with eating disorders not otherwise specified (EDNOS) has "almost doubled" nationally in the midst of America's obesity epidemic. (An EDNOS, also called disordered eating, is an eating disorder that doesn't meet the strict diagnostic criteria for a full-blown eating disorder, but may include drastic weight loss, caloric restriction, binging, and purging.) Since 2000, the number of college students dieting, vomiting, or taking laxatives to lose weight has jumped from about 28 to 38 percent, according to the American College Health Association's annual surveys. Well-balanced caloric intake, with regular meals and physical activity—not dieting—is the best way to avoid obesity, says Kreipe, a professor at the University of Rochester Medical Center. That's why, in his view, calorie information doesn't benefit students. "Nutrition is not a simple thing that can be distilled down into a label," he says. "There's a tendency for people to overinterpret what a specific number means."
Last fall, Harvard removed cards with calorie information from dining halls. Writing about the decision on his blog, Ted Mayer, executive director of Harvard's dining services, noted that his staff needed to address "the challenge a quiet and surprisingly large contingent of our community faces with eating disorders." The dining staff now makes the information available on the Internet and at kiosks in the dining halls.
Going away to college makes all students vulnerable to weight gain and disordered eating, often at the same time. Students tend to experience a loss of structure when they go from high school to college. Studies have found that college students are less likely to eat breakfast or regular meals, and snack foods account for many often-unrecognized calories. All-you-can-eat dining halls and easy access to alcohol also make college students more susceptible to weight gain. At the same time, anxiety about gaining the "freshman 15" can trigger disordered eating—often well beyond the freshman year. Kreipe says that in a new setting surrounded by new people, college students are more likely to develop body-image issues, which can also lead to disordered eating.
Even overweight students, the prime targets of obesity-awareness programs, may get the wrong message. In a recent study, Dianne Neumark-Sztainer, a professor at the University of Minnesota School of Public Health, found that about 40 percent of overweight college-age women and roughly 20 percent of overweight college-age men engaged in disordered eating behaviors in an attempt to get thin. "People are concerned about the fat kids being fat and the thin kids having anorexia," she says. "But people aren't concerned about the disordered eating among the overweight kids." For under- and overweight people alike, eating disorders can lead to a host of health issues, including electrolyte imbalances, fertility problems, impaired brain development, bone loss, and, in severe cases, death. The study also showed that disordered eating behavior leads to further weight gain over time.
Colleges that focus solely on calorie counts are over-simplifying nutrition, says Neumark-Sztainer, who encourages collaboration between the eating disorder and obesity fields. More comprehensive information—like a nutrient density score—would better serve students. Such data would distinguish between items like a Coke, which is high in calories but low in nutrients, and avocado, which is rich in both calories and nutrients. Neumark-Szainer says the focus at college should be less on what people eat then how they eat. For example, students who eat with others are more likely to make healthy food choices and less likely to develop disordered eating—either eating too much or too little—than those who eat alone, she says.
There are other ways that schools can help students avoid unhealthy weight gain without provoking eating disorders. Colleges should provide opportunities for healthy physical activity that don't necessarily involve being on a sports team or going to the gym, Kreipe says. For example, schools might create walking trails or organize activities and social groups that focus on physically activity. Kreipe also recommends that schools make more healthy options—both in dining halls and vending machines—available. Above all, he says, colleges should be emphasizing portion size.
Some schools have tried to do just that. Last fall, Penn State converted one of its all-you-can-eat dining halls into a so-called "healthy dining hall," free from French fries, deep-fried chicken, or white bread. For each meal, Penn State's healthy dining hall features a model-portion plate, which consists of 50 percent fruits and vegetables, 25 percent grains, and 25 percent proteins. (The program is modeled on one at the University of North Texas.)
Still, Penn State provides caloric breakdowns in its healthy dining hall and in all other cafeterias on campus. "Healthy entrees," designated as those that container fewer than 400 calories and 10 grams of fat, are identified by a special check on the cards. Lisa Wandel, Penn State's residential-dining director, says it's the college's responsibility to notify students about what's in their food. "Would you pull labels off all the items in a grocery store?" she says. "We can't hide the fact that food has calories. I think it's better to provide that information so students can make educated choices."
Despite objections from students like Haley Hogan, Yale also plans to continue posting calorie counts in its dining halls this year. Rafi Taherian, executive director of Yale dining, says he expects that students will one day have access to real-time information about food through their cell phones or laptops. "I don't think we can hold the information back from them," he says. In fact, Rafi predicts that colleges, like some states and cities, will soon be required to provide students with nutritional data.
More important, it seems, is giving students the context to understand that information and making sure their education focuses on healthy behavior, not numbers on a scale.
Tuesday, September 15, 2009
Muscling the mirror by Quentin Williams
Male students suffering from muscle dysmorphia, a body-obsessive disorder, struggle to see past a distorted self image.
For some men, body image is a major concern that can turn into an unhealthy obsessive disorder called bigorexia, also commonly known as muscle dysmorphia. This disorder affects many college men as they make the transition from adolescence into adulthood.
“Muscle dysmorphia is very similar to anorexia, where someone who is stick thin will look in the mirror and see the person they were when they weighed 200 pounds,” said Tricia DePoe, fitness coordinator of the IBC Student Recreation Center, adding that someone who struggles with muscle dysmorphia disorder could be very muscular and symmetric.
“Others will look up to him,” she said, “but this guy looks in the mirror and he keeps seeing the kid that was 150 pounds and without the muscle on him.”
Ralph Longo hadn’t heard of the disorder but seems to exhibit some of the characteristics of it.
“As someone that works out a lot and that goes to the gym a lot, my body is something that I’m always looking to improve,” said Longo. “I really just want to get bigger, more muscular, more defined.”
Longo spends a good portion of his day counting calories, mixing shakes and working out to achieve his goals. At 5 feet, 10 inches and 180 pounds, Longo ingests more than 2,500 calories and about 200 grams of protein a day to put on more mass.
“I usually take two protein shakes a day,” Longo said. “I take one shake right after my workout and one after I eat. Each shake has about 48 grams of protein in it.”
The nature of bodybuilding requires very strict dietary and fitness routines, which often promote a culture where this disorder is praised. Men with bigorexia are characterized by a complete preoccupation with muscle development, to the point that they will miss important social and professional commitments in order to exercise. They can also experience a lack of satisfaction with food, due to overeating and experience a noticeable change in mood when gym or meal schedules are thrown off.
Sophomore Robert Bishop is also familiar with the disorder.
“One friend of mine has been going to the gym for a while now, and pretty much all of his life is dedicated to the bodybuilding,” Bishop said. “He doesn’t even compete. He just wants to look good.”
Bishop, a political science major, is also on a mission to improve his physique, but his approach is a little more balanced, he said.
“Bodybuilding, for me, is just a hobby. The most important things in my life are school, family, religion, and then working out is just a hobby,” he said. “I try to make sure that those values come first.”
After spending two years working at the IBC, DePoe has developed theories about bigorexia.
“You’ll find that some men strive to be like the guys in the fitness magazines or the athletes that you see on TV. What they don’t see when they look at these images is that that athlete or those fitness models get paid to work out,” DePoe said.
The disorder is rooted in the images held in the men’s minds. DePoe said that as weight fluctuates, we don’t necessarily see the change.
“With anorexia, when you lose 20 pound, you look at yourself like you were when you were 20 pounds heavier, whereas everyone else is like, ‘Oh, you look great,’” she said. “And it also [works] the other way around. Someone who strives to put on muscle mass will look at [him or herself] in the mirror [and] still see the skinny kid from high school.”
Bishop was that guy, he said.
“When I was a freshman in high school, I was really skinny, and I wanted to go out for safety on the football team, so I knew that I had to gain weight,” he said. “Now that I don’t play football anymore, my goal is pretty much to focus on bodybuilding.”
Today, Bishop can be found at the IBC almost everyday.
The IBC is holding a body composition challenge to give clients a little extra motivation to stay balanced. In addition to equipment, the IBC offers a wide variety of services to assist students towards their fitness goals – including yoga, Pilates and circuit express sessions, nutrition and diet counseling and more.
DePoe recommends beginners take one or two of the group fitness sessions to learn the basics.
“We don’t have personal training,” she said, “but we have group fitness leaders who are there to make sure you have proper form, that you are doing [the exercise] right, to answer any questions.”
Quentin Williams and Monica Sellecchia can be reached at quentin@temple.edu and monica@temple.edu.
For some men, body image is a major concern that can turn into an unhealthy obsessive disorder called bigorexia, also commonly known as muscle dysmorphia. This disorder affects many college men as they make the transition from adolescence into adulthood.
“Muscle dysmorphia is very similar to anorexia, where someone who is stick thin will look in the mirror and see the person they were when they weighed 200 pounds,” said Tricia DePoe, fitness coordinator of the IBC Student Recreation Center, adding that someone who struggles with muscle dysmorphia disorder could be very muscular and symmetric.
“Others will look up to him,” she said, “but this guy looks in the mirror and he keeps seeing the kid that was 150 pounds and without the muscle on him.”
Ralph Longo hadn’t heard of the disorder but seems to exhibit some of the characteristics of it.
“As someone that works out a lot and that goes to the gym a lot, my body is something that I’m always looking to improve,” said Longo. “I really just want to get bigger, more muscular, more defined.”
Longo spends a good portion of his day counting calories, mixing shakes and working out to achieve his goals. At 5 feet, 10 inches and 180 pounds, Longo ingests more than 2,500 calories and about 200 grams of protein a day to put on more mass.
“I usually take two protein shakes a day,” Longo said. “I take one shake right after my workout and one after I eat. Each shake has about 48 grams of protein in it.”
The nature of bodybuilding requires very strict dietary and fitness routines, which often promote a culture where this disorder is praised. Men with bigorexia are characterized by a complete preoccupation with muscle development, to the point that they will miss important social and professional commitments in order to exercise. They can also experience a lack of satisfaction with food, due to overeating and experience a noticeable change in mood when gym or meal schedules are thrown off.
Sophomore Robert Bishop is also familiar with the disorder.
“One friend of mine has been going to the gym for a while now, and pretty much all of his life is dedicated to the bodybuilding,” Bishop said. “He doesn’t even compete. He just wants to look good.”
Bishop, a political science major, is also on a mission to improve his physique, but his approach is a little more balanced, he said.
“Bodybuilding, for me, is just a hobby. The most important things in my life are school, family, religion, and then working out is just a hobby,” he said. “I try to make sure that those values come first.”
After spending two years working at the IBC, DePoe has developed theories about bigorexia.
“You’ll find that some men strive to be like the guys in the fitness magazines or the athletes that you see on TV. What they don’t see when they look at these images is that that athlete or those fitness models get paid to work out,” DePoe said.
The disorder is rooted in the images held in the men’s minds. DePoe said that as weight fluctuates, we don’t necessarily see the change.
“With anorexia, when you lose 20 pound, you look at yourself like you were when you were 20 pounds heavier, whereas everyone else is like, ‘Oh, you look great,’” she said. “And it also [works] the other way around. Someone who strives to put on muscle mass will look at [him or herself] in the mirror [and] still see the skinny kid from high school.”
Bishop was that guy, he said.
“When I was a freshman in high school, I was really skinny, and I wanted to go out for safety on the football team, so I knew that I had to gain weight,” he said. “Now that I don’t play football anymore, my goal is pretty much to focus on bodybuilding.”
Today, Bishop can be found at the IBC almost everyday.
The IBC is holding a body composition challenge to give clients a little extra motivation to stay balanced. In addition to equipment, the IBC offers a wide variety of services to assist students towards their fitness goals – including yoga, Pilates and circuit express sessions, nutrition and diet counseling and more.
DePoe recommends beginners take one or two of the group fitness sessions to learn the basics.
“We don’t have personal training,” she said, “but we have group fitness leaders who are there to make sure you have proper form, that you are doing [the exercise] right, to answer any questions.”
Quentin Williams and Monica Sellecchia can be reached at quentin@temple.edu and monica@temple.edu.
Tuesday, September 1, 2009
Two college seasons - one rant: By Laura Collins
The ED world is buzzing with the same chat that always goes on in August: parents and clinicians looking for referrals to eating disorder treatment for a student leaving for college. These emails, listing symptoms and medical state, break my heart. They often use the word "motivated" and "charming" as if patients need to be pleasing in order to garner a clinician's attention.
It all begs the question: Why would a student with an active eating disorder be going to college? Really - I'm serious. I don't understand why this is acceptable. This is a life-sucking, potentially disabling or lethal illness: an anosognosic condition that thrives on secrecy and freedom from monitoring.
I know the tremendous pressure on parents by social expectations, by the young person's insistence that everything will be all right and that this is all he or she "lives for." I know the guilt and disempowerment of being told by professional advisers that we must 'let go.' I also know parents just get tired, and our egos get involved in the accomplishments of our children.
But you know what? We're parents, and that is a lifelong position. We have a right and a responsibility to do what is right for our child according to our unique and loving judgement. No one can tell us (and no one will take responsibility later) whether college is safe or advisable.
I put my money where my mouth is on this one: my daughter relapsed slightly after her freshman year and we withdrew support for college until she was not just well but quite well. She did not like that. We did not like doing it. But I believe it was our job to do it, and her longterm health and recovery depended on it. When she was ready, she went back and thrived (and had a treatment team for maintenance).
I've dealt with two universities as a parent - neither were in a position to protect or support my daughter's mental health. They said they could and would, but that isn't realistic. Looking back I don't know why I entertained the idea that they could. This is not diabetes or a vision problem where the patient is motivated and able to reliably self-monitor. Schools are not parents.
No team of providers on or off campus is going to be able to provide the kind of accountability and monitoring and personal support that a parent provides and an eating disorder patient deserves. No one at the dorm is going to watch out for or call the parents of a student unless the situation is so far gone that irreparable damage is done. We can't expect it and we can't get angry that they don't do it.
If you are not 100% confident of your child's recovery, committed to staying in the picture more than your child and school may like, ready to visit frequently, and have an expert team in place and in communication then why is college more important? If you feel pressured, or exhausted, or trapped, keep this in mind:
During November break is when I get the most emails and calls - from families who now realize their hand-wringing worries were well-founded and a shaky recovery is now an derailing relapse.
Recovery - full recovery - first. School can wait.
It all begs the question: Why would a student with an active eating disorder be going to college? Really - I'm serious. I don't understand why this is acceptable. This is a life-sucking, potentially disabling or lethal illness: an anosognosic condition that thrives on secrecy and freedom from monitoring.
I know the tremendous pressure on parents by social expectations, by the young person's insistence that everything will be all right and that this is all he or she "lives for." I know the guilt and disempowerment of being told by professional advisers that we must 'let go.' I also know parents just get tired, and our egos get involved in the accomplishments of our children.
But you know what? We're parents, and that is a lifelong position. We have a right and a responsibility to do what is right for our child according to our unique and loving judgement. No one can tell us (and no one will take responsibility later) whether college is safe or advisable.
I put my money where my mouth is on this one: my daughter relapsed slightly after her freshman year and we withdrew support for college until she was not just well but quite well. She did not like that. We did not like doing it. But I believe it was our job to do it, and her longterm health and recovery depended on it. When she was ready, she went back and thrived (and had a treatment team for maintenance).
I've dealt with two universities as a parent - neither were in a position to protect or support my daughter's mental health. They said they could and would, but that isn't realistic. Looking back I don't know why I entertained the idea that they could. This is not diabetes or a vision problem where the patient is motivated and able to reliably self-monitor. Schools are not parents.
No team of providers on or off campus is going to be able to provide the kind of accountability and monitoring and personal support that a parent provides and an eating disorder patient deserves. No one at the dorm is going to watch out for or call the parents of a student unless the situation is so far gone that irreparable damage is done. We can't expect it and we can't get angry that they don't do it.
If you are not 100% confident of your child's recovery, committed to staying in the picture more than your child and school may like, ready to visit frequently, and have an expert team in place and in communication then why is college more important? If you feel pressured, or exhausted, or trapped, keep this in mind:
During November break is when I get the most emails and calls - from families who now realize their hand-wringing worries were well-founded and a shaky recovery is now an derailing relapse.
Recovery - full recovery - first. School can wait.
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