HARTFORD, Conn. — Monica Rodriguez Roldan, a sophomore, at Trinity College in Hartford, Conn., is puzzled by what she observes at her cafeteria table.
"I'm not from here. I'm from Spain, and I have been raised with the idea you eat when its lunch time, you eat when it's breakfast time," she says. "It doesn't really matter how hungry you are, you have to eat."
But in the U.S., when she sits down for lunch, many of the girls announce that they're not hungry, or that they don't eat at lunch time or dinnertime.
"Should we eat only when we get hungry?" she says. "Or should we eat on a regular schedule?"
Her question is addressed to a panel of experts at a recent Trinity lunchtime discussion on dieting, exercise and eating disorders.
Renee Bourdeaux, a West Hartford, Conn., registered dietitian, tells her that the "U.S. does not have the market on how to eat properly. That's one thing that we do not do very well is eat well and teach those behaviors and instill that in our children."
While it's not clear that anyone at Roldan's table has an eating disorder, it is true that eating disorders such as anorexia or bulimia, disordered eating and extreme or unusual diets are common across college campuses — particularly among young women.
There are various estimates, but according to National Eating Disorder Association, 20 percent of college students have anorexia, bulimia or a binge-eating disorder. Most are women. Some studies have shown that 50 percent to 60 percent of college students have disordered eating patterns which are loosely defined as irregular or unusual, sometimes obsessive habits.
Colleges have recognized the issue, and many have established programs designed to raise awareness about good eating habits, to identify signs of eating disorders, and to inform students about services available on campus.
"That's probably why there are more reports of eating disorders on campus and people trying to seek help," says panel member Paula Holmes, clinical director of the eating disorders program at the Institute of Living.
It is helpful when students get the message from schools that admitting they have a problem doesn't mean they will need to leave school and that services on campus or in the nearby community are available, she says.
Why do eating disorders often come up in college-age students? Barry Schreier, director of counseling and mental health services at the University of Connecticut, says it may be related to the loss of the structure that they had at home.
At college, the student is away from her comfort zone, experiencing new levels of stress and without family support right there. In addition, there is peer pressure to meet the ideal thin body image. "There are the comparisons, the competitiveness," says Holmes.
An eating disorder is not about the food. It is about anxiety, says Elaine Petrosky, a treatment manager who works with Holmes at the Institute. "It's about how to manage stress, low self-esteem, depression."
At Trinity, Jennifer Jimenez, who is coordinator of a group called PHAB (Promoting Healthy Awareness of the Body), helped to arrange the lunch panel because eating issues are "a topic that is really important and present in our lives, especially on campus, but not something easily talked about. There is a very big stigma attached to having eating disorders and negative body images in general.
"I think having programs on campus makes it easier for people to educate themselves and just feel more comfortable with speaking about these very personal topics," says Jimenez. "They might not be people who are experiencing issues with negative body images, but they might know other people, their own friends or others back home."
At the University of Connecticut, Rachel Gitter is a senior intern with a program called SHAPE (Students Helping to Achieve Positive Esteem). She wrestled with an eating disorder during her freshman year at another smaller college.
"When I came to UConn, I was in a better place," says Gitter. "Someone had helped me, and I wanted to help others. Most of our members have either struggled with an eating disorder themselves or have friends and saw them struggle. A lot of them have personal connections."
As part of SHAPE, peer educators present programs in classes and in residence halls on eating disorders and answer questions about warning signs and what to do if you suspect a friend has a problem.
They show movies such as "Real Women Have Curves" and participate in a national "Fat Talk Free Week" when "fat talk" is banned. "Fat talk is when girls go around saying, "my thighs are so fat. I hate this about my body," says Gitter.
At Qunnipiac University, Tami Reilly, assistant athletic director for the fitness and wellness program, says that if she sees a young woman doing double or triple exercise sessions at the gym, it's a warning sign.
"I may try to find out a name and give the counseling office a heads up," says Reilly. "I'll say I'm a little concerned about this person, is this person on your radar? Chances are they already are."
C.C. Curtis, director of student wellness and alcohol drug education at Connecticut College, says they'll look for "red flags: chronic dieting, skipping or all of a sudden disengaging at mealtime. 'I already ate' or "I'm not hungry.' Everything starts revolving around weight and food ... Eliminating entire food groups. Exercising more ..."