Are students eating enough?

TW: At The Spectrum we believe in brining awareness and attention to mental health, especially on campus among students. Please note that this article mentions and talks about eating disorders and disordered eating habits; other mental illnesses, such as anxiety, depression, and Obsessive Compulsive Disorder; and discusses the prevalence of these conditions amongst NDSU students. If these topics are triggering, this article is not suitable for you. If this topic is triggering we recommend that you discuss this articles content with a licensed professional or trusted friends. If you struggle with an eating disorder, we encourage you to skip to the bottom three paragraphs where we have resources listed. 

As a Nutrition Science major, I am concerned about the way that people view food, eating, and nutrition in general and whether they have the financial capacity to even care about their nutrition. While I don’t know exactly the path that I wish to take once I am a Registered Dietitian, I do know that I want to help people. 

This semester, I am taking a class called Community Health and Nutrition. While we are only a week into the course, it is becoming increasingly clear that in order to help anyone, you have to be able to identify their needs. To accomplish this,  you have to be able to thoroughly and appropriately assess your target population.

Right now, NDSU is the community that I live in, and the longer that I am a student here, the more I grow to appreciate and care about the campus and the students that fill it. So, naturally, I grew curious about the student population and how they view different aspects of nutrition. 

Because of personal experiences of a friend having disordered eating, my own experiences of low income, and the ever-increasing prices of food in our country, causes of undernutrition is one of my main focuses at the moment. 

The more I hear of my friend’s story, the more I am shocked by how ignorant I was to think that my own experience was unique and somehow isolated. The more I learn and grow, the more apparent it becomes to me that so many people are struggling with food, whether it be finances or disordered eating.

I wanted to get a general idea of and bring attention to the possibility of this undernutrition issue amongst NDSU students and whether this was caused primarily by food insecurity and financial issues or disordered eating habits. 

Assessing the Population

Because of time constraints and limited resources, I conducted a very small survey amongst students in a single academic college. The survey was sent to all students in the college, graduate, and undergraduate. It was completely voluntary and consisted of three questions and one section for additional comments. 

The first question asked for the student’s year in college, the second question asked if the student had ever been diagnosed with an eating disorder, and the third question provided four statements describing relationships with food that ranged from healthy to struggling with avoidance of food and calorie obsession or food insecurity and an ‘other’ option.

‘Other’ allowed the student to then describe for me what their own relationship with food and eating was if they felt they could not identify with one of my prefilled answers.

Additionally, I define ‘avoidance’ and ‘avoidance behaviors’ as avoiding certain foods or food groups or sometimes even food in general as a result of the perceived healthiness or caloric content of the food. 

The Results

I sent this out as a Google Form and received forty-one responses. Of those who responded to the survey, seven were first-year students, fourteen were second-year students, six were third-year students, four were fourth-year students, and ten were fifth-year students and beyond.

Out of those students, two admitted to having a diagnosed eating disorder, while twenty-eight reported not having any sort of eating disorder. However, the other eleven admitted that while they were not diagnosed, they were decently certain that they had an eating disorder at some point in time. 

I then asked the students to take a look at their relationship with food and to identify whether they felt that relationship was healthy, mostly healthy with occasional struggle, or not healthy. I also left a space for students to explain their situation to me if they felt that it was more complicated than the options that I provided. 

Some of the results felt expected: two students were diagnosed with eating disorders (EDs), and two students selected, “I really struggle with food/eating. Calories and food take up the majority of my thoughts despite not eating much. I avoid many foods or compensate for binging with avoidance behaviors.”

However, the first student to admit that he or she had an ED did not select this answer. Instead, the student explained to me:

“I have a mostly healthy relationship with food/eating. I generally eat when I am hungry. I struggle still with avoidance behaviors. With this said, expenses of food still “get to me.” It’s really hard for me to buy things like nuts, meat, and dairy products because they are so expensive. 

I often feel like I’m in a scarcity mindset in regards to food even though I have enough food to eat at home because my fridge and pantry lack certain things that I enjoy and crave at times as a result of my penny-pinching.”

The other previously diagnosed student selected my prefilled answer, “I have a mostly healthy relationship with food/eating. I generally eat when I am hungry. I still struggle with avoidance behaviors.”

While these responses seem unexpected, as one might imagine these two students to be struggling the most, it is important to note that their diagnoses have hopefully led to weeks, months, or even years of treatment and healing. 

Students who have not been diagnosed with an ED may have struggled just as much as the students who were. However, because of a lack of a diagnosis, they were left untreated or to heal on their own.

The two students who admitted to actively struggling with their relationship with food were not diagnosed with an ED but were part of the eleven who admitted that they were decently sure that they had one at some point in their lives. 

Of the other nine students who identified themselves as being sure they’d experienced an ED, only one, a fifth-year or above, felt that he/she had a completely healthy relationship with food.

Three others, a second, third, and a fifth-year plus student, identified with a mostly healthy relationship, struggling only occasionally with avoidance behaviors. 

Four students, three of which were first-year students and one a fourth-year, admitted to struggling with food often. They think about calories often and employ avoidance behaviors more frequently.

The last student in this group, a second-year, described, “Most days I do not eat because I am too busy with work, classes, and homework. I never have time to eat and everyone tells me that it is unhealthy.

I also do not like eating because anytime I eat any type of food, even something small, my stomach hurts and I stop eating. I have not been diagnosed with anything for my stomach pain while eating though.”

Some ‘Other’ Statements

One student in their third year, admitted, “I struggle with eating too much.” They did not claim to have ever been diagnosed with an ED or believe that they had one, yet they admit to struggling to some degree with eating.

I think this student’s answer is especially important to note because we often think of eating disorders as exclusively restrictive behaviors. However, we know that even the definition of an ED characterized by restriction-bulimia nervosa-has a component of bingeing. 

This means that those with bulimia nervosa eat anywhere from normal to large amounts of food (bingeing) and ‘make up for it’ by making themselves sick or excessively fasting (purging). 

The Mayo Clinic explains, “People with bulimia may secretly binge — eating large amounts of food with a loss of control over the eating — and then purge, trying to get rid of the extra calories in an unhealthy way.” 

Excessive calorie consumption, especially when followed by feelings of guilt or self-loathing, is a disordered eating habit, too, one that is recognized by the National Eating Disorder Association,  and it is one that is typically overlooked.

Another second-year student admitted to me, “I struggle with calorie thoughts and avoidance but it is mainly OCD which I am diagnosed with and we work on making me aware and not spiral into anorexia.”

Again, I am very thankful for this response, as it provides another perspective on disordered eating habits. This student struggles with food because of another mental illness. 

The Center for Discovery, an ED treatment facility, associates Obsessive Compulsive Disorder (OCD), anxiety, depression, substance abuse, self-injury, and Borderline Personality Disorder (BPD) with increased rates of EDs.

Conclusion

In the end, there was not a single student that responded to my survey in a way that suggested that they were experiencing food insecurity and were not eating due to finances. Instead, I was shocked by the quantity of students who were experiencing a tense relationship with food. 

In fact, if I were to repeat this survey, I would want to separate the two struggles into independent polls. Reading some of the responses, I felt that even if students were struggling financially to get food, their compulsive thoughts about eating were more intense, and that is the voice that they maybe wanted more to be heard.  

Just under twenty-five percent of the students I surveyed agreed with a blanket statement of having a healthy relationship with their thoughts on eating. 

That means that if I were to generalize my findings, more or less, that seventy-five percent of students at NDSU have struggled or are currently struggling with some form of disordered eating or compulsive thoughts on eating.

The National Institute of Health has determined that the average age of onset for binge-eating disorder was twenty-one years old. The average age of onset for both bulimia and anorexia nervosa is eighteen-years-old. Therefore, the age group at risk is the age group of our student population, particularly but not exclusively our first-year students. 

The reported prevalence of these illnesses were below two percent. However, as the results of my survey would suggest, many more students experienced mild to severe issues with disordered eating but were not diagnosed. 

Again, this survey was conducted on limited time and resources, and I was only able to collect data on students in one academic college. If I were able, it would have been ideal to collect data from a larger and more diverse population of students.

Regardless, this is a significant number of students, and I don’t believe that it should be taken lightly. We have so many resources on campus that advocate for students’ mental health, yet this has somehow escaped us. 

The Green Bandana Project teaches us to recognize the signs that someone may be struggling with depression or anxiety and how to approach them to advise them to seek help. Very few of us, however, understand the signs of an ED and how to confront someone who may be struggling.

If you or someone you know is struggling, the National Eating Disorder Association (NEDA) has a twenty-four hour hotline available, along with other resources located on their website. 

NEDA:  (800) 931-2237, www.nationaleatingdisorders.org

Other resources and education material exists out there, too, such as Eating Disorder Hope at www.eatingdisorderhope.com and the Anxiety and Depression Association of America (ADAA) at www.adaa.org. 

If the numbers I got are even remotely close to representing the student population, some of you reading this article have likely struggled and/or are struggling right now. I encourage you to seek help and lean on these resources and those who care about you. You are very much not alone.

I don’t have the answers or the solutions right now. This is my own curiosity-fueled experiment of sorts, and I got some answers I didn’t quite expect. 

What I hope to have accomplished, however, is bringing some attention to a cause of undernutrition in NDSU students, and hopefully make those who have struggled in any way with food feel a little bit less alone.