Information for Students with Eating Disorders

Eating, exercise, nutrition, and body image concerns are common among both male and female college students. Questions in these areas can be a part of normal development and maturity. At times, however, these concerns can turn into medical and/or psychological problems and illnesses that can range from mild to serious, and even life-threatening conditions. We encourage you to seek help right away if you have concerns in these areas, or any symptoms associated with disordered eating.This can help prevent life threatening conditions and harm to your health, AND help keep you on the right track to success at the U of L. Campus Health Services (CHS) as well as other services listed below are here to help you find your best path to recovery and success.

What if I already know I have an eating disorder and intend to enter the Uof L while still in recovery (i.e. not yet in remission)?

If you have been diagnosed with disordered eating (e.g. Anorexia, Bulimia, Binge Eating Disorder), please consider the following expectations:

What you CAN expect:

CHS can provide a thorough medical, psychiatric and nutrition evaluation.
CHS will help coordinate care for counseling services either on or off campus.

CHS and all University of Louisville health providers will be honest, open and up front when your safety and stability are of concern. As with any illness, if you are found to be a threat to harm yourself (or others), appropriate referrals may be made to University of Louisville officials, as per the Student Code of Conduct.

If your health status is deemed stable and safe (from a medical, psychological and/or nutritional standpoint) to continue your studies while receiving routine outpatient care, your providers at CHS will help coordinate and provide follow-up care.

If your health status is NOT deemed stable and safe (from a medical, psychological and/or nutritional standpoint) to continue your studies while receiving routine outpatient care, then CHS will recommend referral to an intensive outpatient program (IOP), residential eating disorders program, or an inpatient facility, depending upon the level of your stability and risk to your safety. We will not support or encourage you to put your studies before your health.

What you should NOT expect:

You should NOT expect anyone at the University to put your academic success before your health: That's a dangerous and non-productive way to approach your academic endeavors.

Do NOT expect to receive intensive outpatient (IOP), residential, or inpatient eating disorder treatment on campus or in Louisville. Unfortunately, these  intensive programs do not exist in the city. The nearest such programs/facilities are Cincinnati, St. Louis, Indianapolis and Nashville. 

Please consider the above seriously if you are/your student is entering the University of Louisville with ongoing disordered eating. We take your success AND your health seriously as you cannot have one without the other!

What resources are available to me in order to receive and evaluation and/or care for an eating disorder while at UofL?

Medical Services:

You may see a primary care provider at Campus Health Services if you are concerned that you might have an eating disorder. CHS providers will complete a comprehensive medical evaluation to determine whether you are healthy enough and safe enough to continue as a patient receiving out-patient medical services from our providers, or if you need referral for more intensive care. We work closely with our psychiatric and counseling colleagues to diagnose and coordinate care for these and other illnesses.Click here for more information.

Psychiatric Services:

As part of a comprehensive evaluation, Campus Health Services provides psychiatric evaluations for disordered eating. You can expect that if you are diagnosed with an eating disorder, you will be referred for a psychiatric evaluation as well as for nutritional and psychological care. Click here for more information.

Nutritional Services:

An integral part of your care and evaluation for disordered eating includes a nutrition evaluation and the expectation that you will continue to work with a dietician as part of your ongoing treatment and recovery. This can be arranged on campus by contacting CHS or by clicking here. The UofL dietician will determine if you need more intensive care which would require referral to a provider outside of the U of L.

Counseling Services:

Providers at the University of Louisville Counseling Center (ULCC) work closely with Campus Health Services to provide outpatient care for students, and ULCC provides supportive mental health treatment for students coping with eating disorders. If a student is experiencing disordered eating or has been diagnosed with an eating disorder, we strongly recommend they have a medical assessment prior to seeking services at ULCC. However, ULCC clinicians will refer clients to Campus Health Services or their primary care provider during treatment if it is deemed clinically necessary. Per ULCC policy, students requiring more intensive treatment or specialized services than the Center can provide will be referred out to the community for services. Decisions to refer out are made on a case-by-case basis and are determined by the therapist’s clinical judgement, client needs, consultation with other treatment providers, and demand for services. Click here for more information 

Fitness Services:

U Fit is a student-to-student service offered by the CHS Health Promotion office, with coaching taking place at the SRC. It may be recommended for particular types of eating disorders.  U-fit will help you determine your current fitness level, develop an exercise routine for you, and coach you on how to properly follow the workout regimen. U-FIT offers a multitude of services such as: FitTest & Coaching, Fitness Consultations. Click here for more information

What resources are available outside of the University of Louisville?

You may choose to receive care outside of Campus Health Services and the UofL Counseling Center. It may also be determined that the level of care you require can only be found outside of what we are able to offer on campus. If that is the case, and you have seen one of our providers, we will help you coordinate the transition to higher intensity care.  This includes transition to Intensive Outpatient (IOP), Residential or Inpatient treatment.

Please note, however, that IOP and residential care are NOT available in Louisville. This should be taken into serious consideration if you come to UofL with an eating disorder that is not in remission.

General Information about Eating Disorders

What are Eating Disorders?

Anorexia, Bulemia and Binge Eating Disorders are the 3 most common types of eating disorders.

All of these eating behaviors can present serious, sometimes life-threatening health problems and require professional evaluation and treatment.

Someone experiencing anorexia may:

  • Feel an intense fear of gaining weight
  • Consistently take efforts to prevent weight gain despite being at a low weight
  • Restrict energy intake leading to a significantly low weight (below minimally normal given age, sex, development, and physical health)
  • Have a distorted body image
  • Engage in intense or excessive exercise, dieting, fasting, or laxative abuse
  • Experience an interruption in their menstrual cycle due to weight loss and inadequate nutrition.
  • Experience hunger but feel in control when they resist the urge to eat

Someone experiencing bulimia may:

  • Engage in binge eating—eating large portions of food at one sitting, often in  response to emotional/environmental stressors, or dieting.  These episodes are often characterized by a feeling of being out of control of their eating.
  • Purge (force oneself to vomit) after binging, to alleviate the discomfort and guilt created by food intake
  • Have a distorted body image
  • Engage in intense or excessive exercise, dieting, fasting, or laxative abuse

Someone experiencing binge-eating disorder:

  • Tends to eat much more than is needed to maintain a healthy body
  • Generally eats in response to emotional or environmental stressors as well as responding to intense hunger from deprivation and dieting. These episodes are often characterized by a feeling of being out of control of their eating.
  • Usually has dieted repeatedly in the past and has experienced shame about food and body
  • Feels discouraged and views their ability to handle their problems as inadequate

Not all eating disorders look the same. Here is a list of less common eating disorders:

Anorexia Athletica
Not a formal diagnosis, usually part of anorexia, bulimia or obsessive-compulsive disorder. The person exercises beyond the requirements for good health.

Body Dysmorphic Disorder
A subtype of Obsessive-compulsive disorder. Excessively concerned with appearance. These sufferers are at an elevated risk for despair and suicide. Many undergo multiple plastic surgeries.

Muscle Dysmorphia ('bigorexia')
Opposite of anorexia. People obsess about being small and underdeveloped; and believe their muscles are inadequate.

Orthorexia Nervosa
Not an official eating disorder diagnosis, but the concept is useful. It describes “a pathological fixation” on eating a “proper” or “pure” or “superior” food. These people believe that they are superior to people who eat ìimproperî foods (non-organic or junk foods) as opposed to food from health food stores. They also obsess about the proper way to prepare foods. This is related to an obsessive-compulsive disorder.

Night-Eating Syndrome
Most of the daytime calories are eaten late in the day or at night. They feel guilty about how many calories they ate the night before and often delay the morning meals.

Nocturnal Sleep-Related Eating Disorder
Thought to be a sleep disorder, not an eating disorder. The person sleep-eats, and may sleep walk as well.

Rumination Syndrome
The person eats, swallows, and then regurgitates the food back into the mouth where it is chewed and swallowed again. This process may be repeated several times over for several hours per episode. It may be voluntary or involuntary.

Gourmand Syndrome
The person is preoccupied with fine food, including its purchase, preparation, presentation, and consumption. Exceedingly rare, thought to be caused by an injury to the brain.

Pica
A craving for non-food items such as dirt, clay, plaster, chalk or paint chips.

Cyclic Vomiting Syndrome
Cycles of frequent vomiting, usually found in children. May be related to or share neurological mechanisms with migraine headaches.

Chewing & Spitting
The person puts food in his/her mouth, tastes it, chews it, and then spits it out. This is a calorie control behavior seen in anorexia. The person can experience the enjoyment of food but avoid the calories by not incorporating the nutrients into the body.

General Resources for patients, parents/family to find more information and help with eating disorders:

https://www.nationaleatingdisorders.org/

https://www.nimh.nih.gov/health/publications/eating-disorders-new-trifold/index.shtml