Story by Pam Roe

Eating disorders are a growing epidemic on college campuses, according to the National Eating Disorders Association.

“For many young adults, these illnesses surface in high school and college because this is when stress levels increase,” says Phoebe Wan, psychologist at the MU Student Health Center. “They also have more control of their lives when it comes to personal choices.”

The complexity of treating eating disorders lies in the fact that they are a combination of medical and mental health issues that must be dealt with simultaneously because each drastically affects the other.

The stories that follow show how such disorders can develop, how they can be treated and where you can turn on campus for help.

An illustration of a name tag that says, "Hi! My name is: 'I liked having the label of "healthy eater"'" Illustration by Claire Richardson
Illustration by Claire Richardson

Prospering in secrecy

It all started in second grade when a teacher weighed all the 8-year-olds in front of the class. A little girl was ridiculed by her classmates for weighing 10 pounds more than the rest of them. That was the moment her eating disorder began to blossom.

Fast forward to high school. This same little girl, Maddy, was now on her high school dance team and continuously judged by her stage appearance. She started obsessively controlling what she ate to gain approval. Her eating disorder was now firmly established.

“When I came to Mizzou, I wasn’t dancing as much,” Maddy says. “To keep being that perfect person that society and the media throws at us daily, I started over exercising, counting calories and eating smaller portions and restricting snacks.”

She didn’t even have to hide her eating and exercising habits because, by society’s standards, Maddy was completely normal. But what appeared normal on the outside wasn’t normal on the inside. “I became anxious around food-related events,” she says. “And if anything disrupted my routine, I became even more anxious.”

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“In America, being thin is prized,” says Phoebe Wan, psychologist at the MU Student Health Center. “When we are young, we are taught to make comments about our weight or how our clothes fit. Then we start believing we are only lovable if we meet those criteria. And this becomes more apparent when someone engages in sports or activities that emphasize a low body weight.”

Wan says the young adults being seen at the Health Center fall are in two typical eating disorder categories – anorexia and bulimia.

Anorexia, restricting calories, is typically seen in pre-college students; where bulimia is seen in individuals from 16 to mid 20s.

The complexity of treating eating disorders lies in the fact that they’re a strong combination of medical and mental health issues. And they have to be dealt with simultaneously because each one drastically impacts the other.

“I liked having the label of the healthy eater; the one who went to the gym and exercised,” Maddy says. “I hated making mistakes and messing up in front of others. I needed to be the perfect role model all the time.”

But the spring she came home for a study abroad trip was the turning point.

“All through high school my mom worried about my weight,” Maddy says. “Since I was little, I had always been a little underweight and had odd eating habits. Our family ate out way too often when I was younger, and my parents gave me way too much freedom to eat whatever I wanted.”

When her parents picked her up at the airport, they instantly noticed she had come home skinnier than they had ever seen her. Her mom no longer thought Maddy had a problem, she knew it. She also realized she needed to find a solution.

“When mom confronted me about my eating habits, she was really serious,” Maddy says. “I had never seen her that concerned before.”

As a family, they decided to get Maddy into a live-in treatment facility. It was intense. It was introspective. But it was enlightening.

“I hadn’t realized I was trying to prosper inside secrecy,” she says. She stopped hanging out with friends to count calories or spend extra time in the gym. Even though she was eating three meals a day, her first recovery lesson was to increase the size of her meal portions and not restrict food outside those meals.

She learned how to add in snacks and allow flexibility into her life.

“I was anxious around any food-related event,” she says. “Do you know how many events we have in our daily lives that revolve around food? Birthdays, happy hour, tailgating, meeting up for coffee; the list goes on and on.”

Maddy moved through her treatment, and one of the final steps was to reach out to others to form a support group.

“I only told a few people who were close to me what I was going through,” she says, “It was hard telling them about my eating disorder, and even though I didn’t think it was possible, it has brought us closer together. They were my support system all along, I just didn’t see it.”

Now Maddy is enjoying college, hanging out with her friends and fully experiencing her life with more openness.

She is learning to deal with setbacks — because there will always be setbacks.

And Maddy quickly acknowledges if it hadn’t been for her parents, her story might have ended differently.

“It does take someone pushing you to get help because you’re stuck in your ways. You think how you’re living your life is so normal that it’s hard to believe you have a problem,” she says. “My parent’s intervening in my life saved me.”

An illustration of a prize cup with a quote inscribed on it: "In America, being thin is prized." — Dr. Phoebe Wan, psychologist, MU Student Health Center. Illustration by Claire Richardson
Illustration by Claire Richardson

It’s all in the numbers — calories, grades and weight

“You got a B on that test – a flippin’ B. A failing grade. I thought you studied? Couldn’t you do better than that?”

The toxic voice kept repeating these words in Taylor’s head.



She repeated the word to herself. Quietly a balanced, gentler voice cuts through the harsh, mean words from the toxic voice.

“You studied. You might not have done as well as you wanted, but it’s just one test. You’ll do better next time.”

Slowly her anxiety recedes.

During therapy for her eating disorder, Taylor has come to understand her diagnosis is all about the numbers – calories, weight, grades. However, it’s also about the labels.


What are the warning signs of an eating disorder?

  • Preoccupation with weight, food, calories, dieting and/or body image.
  • Development of abnormal, secretive, extreme or ritualized eating habits.
  • Withdrawal from friends and activities.
  • Evidence of binge eating, such as the large amounts of food disappearing.
  • Evidence of purging behaviors, including frequent trips to the bathroom after meals, self-induced vomiting, periods of fasting, or laxative, diet pill or diuretic abuse.
  • Compulsive or excessive exercising.
  • Discoloration or staining of the teeth.
  • Feelings of isolation, depression, anxiety or irritability.

The signs listed may indicate an eating disorder, but they are not all-inclusive. If you are concerned about someone and they are not demonstrating these warning signs, speak with them or seek the guidance of a professional.

“It was such a good feeling to be the role model for being skinny or eating healthy,” the Mizzou junior says. She was diagnosed with an eating disorder in high school. “Fitting into that ‘perfect’ picture of what society expects was really important to me and it’s the last thing I need to look at and deal with for my recovery.”

Generally speaking, there are specific traits attached to each of the eating disorders. Those with anorexia tend to be perfectionists; impulsive people lean toward bulimia. And the labels and societal norms are an enormous factor.
As the years went by, Taylor hid herself away doing homework and controlling her weight by allowing herself to only eat certain foods. The toxic voice was loud, overbearing and insistent in the years before treatment. But even after treatment, Taylor still hears it, even though it’s quieter.

“I think my food issues started because I didn’t want to be like my parents –overweight,” Taylor says. “I lost a lot of weight when I got braces,” Taylor says, “and when they came off I made a decision not to gain weight.”

She looks back and wishes her parents had been aware of the signs of her eating disorder. “Looking back, I give my mom and dad props,” Taylor says. “I put them through hell and back again. I wish they had known they weren’t talking to me, they were talking to my eating disorder.”

In treatment, which she underwent during a winter break at Mizzou, she learned coping mechanisms to deal with the toxic voice. Developing a “balanced” voice was one of those tools. “This new voice is about your worth as an individual and learning that you are a priority — taking care of yourself first,” she says.

With that tool in hand, Taylor had to look deep to realize she wasn’t being authentic with herself and others. “I was hiding,” she says. “Hiding from my emotions, avoiding choosing my own path in life and not setting my own boundaries.”

So she learned to use another tool, mindfulness. Figuring out she couldn’t control everything in her life, but accepting each moment and dealing with it in a strategic way was eye-opening. “I learned to embrace life; every aspect of it,” she says.

”I also learned that eating disorders are all the numbers — calories, grades and weight. Now that I know I am important, I have to be gentle with myself.”

Balance and communication, two more tools, play key roles in Taylor’s life after treatment. She strives daily to bring balance to studying, self care, family and friends as well as eating. This type of balance also applies to each person in her support group.

“Each person has a role to play and it took me a little while to figure that out,” Taylor says. “Finding the one or two things that each person could help me with was the key. They’re strengths lie in who they are and their relationship with me.”

She talks to them about everything; eating plans, anxiety, thoughts. “Before treatment and my support group, I would criticize myself so harshly I didn’t realize I was doing things that were killing me.”

Today, she can feel the setbacks coming on when her anxiety and frustration level increase. In the past, she turned to alcohol and anger. Now her coping mechanisms are journal writing, coloring, yoga and talking with friends.

“Now I recognize that toxic voice is always there,” Taylor says. “It’s a challenge to make choices about my eating and exercising habits every second of every day, but I’m worth it.”

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