Is My College Student Developing an Eating Disorder? What Parents Often Notice First

Written by Dr. Colleen Reichmann, owner and clinical director of Wildflower Therapy

The bags are packed. The dorm room shopping is mostly finished. She’s been talking about move-in day for months at this point. And whether this is her first year, or she is returning, this is a season that tends to feel full of possibility.

Sometimes, though, there’s another feeling that creeps in. And it’s something that is so tough for parents to contend with, because of course we’d all rather focus on the excitement and the milestone nature of this next step. But even still, sometimes, for parents, there is a nagging worry that keeps pulling you back to this thought: something just doesn’t quite feel right.

Maybe your child has become increasingly preoccupied with “eating clean.” They’ve lost weight over the summer and brush off your concern with, “I’m just trying to be healthier.” Or their weight seems stable, but meals have become a source of rising tension lately. They seem more anxious about what you’re serving-more rigid, maybe. Or maybe they just seem less like themselves lately, and you can’t quite put your finger on why- except for the fact that they’ve been expressing a lot of negativity about their weight and appearance. You can’t decide whether you’re overthinking things, or whether your instincts are trying to tell you something important.

If this sounds familiar, please hear me when I say this next part. You’re NOT alone, and as their parent, your instinct ARE important.

One of the hardest parts of recognizing an eating disorder is that it rarely begins with a dramatic change. More often, it starts with small shifts that are easy to explain away. A new workout routine. An interest in nutrition. Stress about college. A desire to “feel healthier.” Each change seems reasonable on its own, but over time they start to feel worrying, especially to parents, as they stack up. I’ll say it again, because of how important I believe this is- your instincts deserves attention- especially before a huge life transition like leaving for college.

College Is a Perfect Storm for Eating Disorders

The transition to college asks kids to navigate enormous changes all at once. Heck, you might remember how hard that first year was. New friendships. Academic pressure. Independence. Loneliness. Homesickness. Less structure. More comparison. Pressure in terms of drinking. Identity struggles. It’s seriously a lot to ask of anyone, let alone kids this age.

And for students who are naturally anxious, perfectionistic, people-pleasing, or hard on themselves, food can ever-so-slowly become something that feels controllable when everything else feels uncertain.

Not every student who develops an eating disorder looks obviously ill. In fact, many continue earning excellent grades, participating in sports, maintaining friendships, and insisting they’re doing just fine. It’s sadly one of the main reasons why so many eating disorders often go unnoticed until they’ve become deeply entrenched.

Parents Usually Notice Something Before They Have Words for It

One thing I hear often from parents is, “I knew something was off, but I couldn’t explain why.” And it sometimes has to do with food, but again, not always.

Maybe your child no longer enjoys going out for ice cream with friends. They seem irritable around meals or unusually distressed when plans involve eating out. They’ve become more isolated, more perfectionistic, or increasingly critical of their appearance. Or they just seem generally more anxious and down, and have been trying to eat clean or exercise in an attempt to address it. And while that mostly feels appropriate to you, their intensity and rigidity around that quest is still setting off your tiny alarm bells.

Sometimes parents tell me, “They’re constantly talking about protein now,” or “Everything has become about ingredients.”

And other times, it’s not what they’re saying at all, it’s solely about what they’re no longer doing. They’re skipping social events. They’re more withdrawn. Their personality seems…wilted? (maybe?)

These changes don’t automatically mean someone has an eating disorder. But they are worth paying attention to. Please please remember that you likely know your child remarkably well. (You’ve been by their side all these years, of course you do!) If your gut keeps telling you that something has changed, it’s always best to error on the side of listening when something as huge as leaving for college is looming.

“But They Say They’re Fine.”

This may be one of the most painful parts.

Many kids, teens, young adults, and even older adults genuinely don’t recognize how much the eating disorder has taken over. Others feel embarrassed or afraid that someone will make them stop. Some worry they’ll disappoint their parents. Others truly believe what they’re doing is healthy because our culture so often applauds restriction, weight loss, and extreme exercise.

As someone who has worked in this field for over a decade (and struggled with anorexia myself throughout college) please heed this advice: you do NOT need to wait until your child asks for help before seeking guidance around this for both yourself, and for them.

In fact, many families first reach out simply because they’re unsure what they’re seeing. They not necessarily looking for a diagnosis, they’re just looking for clarity. But that conversation can make all the difference. Again, it’s always better to error on the side of understanding and unearthing vs ignoring when it comes to this arena.

Early Support Is The Game Changer

One of the biggest myths about eating disorders is that someone has to become “sick enough” before treatment is appropriate. This always has me feeling like I could scream, because nothing could be further from the truth.

In fact, research shows that the earlier concerns are addressed, the less opportunity the eating disorder has to become deeply ingrained. Early intervention often means treatment is shorter, relationships experience less strain, and students have a better chance of continuing to engage fully in school, friendships, athletics, and the experiences that make college meaningful.

Remember, you don’t need certainty to ask questions. You don’t need proof to seek an evaluation. As their parent, your concern is enough.

If You’re Wondering Whether It’s Time to Reach Out…

If you found yourself on this website and this blog, (you can probably predict what I am going to say by this point) then I want to encourage you to consider that your instincts are telling you something. It’s likely best to just trust those instincts.

And hey, maybe everything is okay! Maybe your child is experiencing that very human anxiety and stress about this new chapter and big leap. Even if that’s the case, though, getting them connected to a therapist right now isn’t going to hurt. It might end up being more of a neutral experience, or further yet, still net positive, because they will have another trusted adult to connect with throughout the ebbs and flows of this first semester.

And, if it turns out that everything is not ok, and that your child is wrestling with the beginning of an eating disorder? Well, then getting them connected to a therapist will not only not hurt…it just might be the most protective and positively impactful (or even life saving!) step that you could take.

So long story made very short, if something keeps tugging at you, please please listen.

Eating Disorders Therapists in Philadelphia and the Main Line

At Wildflower Therapy, we specialize in helping kids, teens, and adults heal from eating disorders, disordered eating, body image concerns, anxiety, depression, and perfectionism. We have many clinicians who specifically specialize in working with college students. We understand how frightening it can feel to be the student who is struggling (as many of us have recovered from eating disorders ourselves) or a parent wondering whether your child is struggling. And we know how overwhelming it can be to know what to do next.

If your child will be attending Villanova, Saint Joseph’s, Temple, Drexel, UPenn, Bryn Mawr, Haverford, Swarthmore, or another college in the Philadelphia area, please know that we’re here to help, and can see them in person in Philadelphia or Devon. Or, if they are attending college elsewhere in Pennsylvania (and a handful of other states), we can see them virtually.

We are extremely experienced when it comes to helping people this age navigate the typical demands of college while also working to heal from an eating disorder. We take a very proactive approach, and connect students with dietitians when the need is there, and then coordinate communication with dietitians, as well as student health centers, and parents.

If you’re worried (even if you’re not sure your child would agree to therapy yet), we invite you to schedule a complimentary consultation call. Sometimes one conversation is enough to help you gain clarity in terms of next steps.

You don’t have to wait until things get worse to intervene. Sometimes the most important step is simply starting the conversation for them.