How to prevent eating disorders

How to prevent eating disorders Living with someone who regularly starves, binges, or purges can be very
stressful. Emotional reactions range from panic to resentment, and concrete
confl icts range from hoarded food that goes rotten to messy bathrooms.
Roommates may be tempted to silently accommodate the eating disordered
student or to ostracize her. Some roommates become the “food police,” watching
and interrogating the student about her intake.
Working with roommates about normal emotional reactions is important.
Many friends say things like, “I can’t be angry with him, he can’t help it,” when
in fact they’re furious, feeling put-upon and impotent.
It’s oft en helpful and sometimes necessary for students with an eating disordered
roommate to establish ground rules, for example that foods should be
replaced and bathrooms should be cleaned immediately (Siegel et al., 1988). If
rules are repeatedly broken, a residential staff person can be brought in to assess
the diffi culty and to determine whether the living situation is workable.

Given contagion eff ects, eff orts at outreach and prevention run
the risk of turning into “how to” sessions. Programs must be designed cautiously,
highlighting the damaging eff ects of the illness rather than dramatizing
the symptoms.
Although it is the most common approach to outreach, psychoeducation is
not eff ective in preventing eating pathology. Th e most eff ective interventions
target established risk factors like the thin-is-ideal internalization or body
dissatisfaction. Th e most eff ective prevention programming targets at-risk
groups, uses an interactive (as opposed to didactic) format, and consists of
multiple rather than single sessions (Stice & Shaw, 2004).
Certain academic departments are more likely to have at-risk students.
Th ese include the performing arts (particularly dance and acting), broadcast
journalism, nutrition, and psychology, as well as highly competitive graduate
programs like law and medicine. In addition to programs that address these
students, it helps to educate the faculty to recognize warning signs and refer
to the counseling service.
Getting students to attend eating disorder programs is a challenge. Th e “eating
disorder” label is tantamount to a “Keep Away” sign. Much more eff ective is publicizing programs related to “nutritional health,” in which some eating
disorder information is included. Students fl ock to any program they think
might off er weight loss tips. Covert prevention is the name of the game.
Another approach is to make the focus be “how to help a friend.” Given
the high incidence of eating disordered behavior on college campuses, many
vulnerable students also have friends who are struggling. Th is can become a
“teach what you need to learn” intervention.
Eating Disorders Awareness Week, in February, is generally a time for
outreach on college campuses. Relatively inexpensive programs like College-
Response and EDAP (Eating Disorders Awareness Program) sell kits with
advertisements, screening tools, and informational brochures.