Image: Lauren Stach (left) and Caroline Pritchard (right) have both suffered from eating disorders with little support on the University of Minnesota campus. They think that an eating disorder support group would provide some of what is missing for students suffering and those in recovery. (Courtesy of Lauren Stach and Caroline Pritchard)

Without treatment options on campus or consistently offered support groups, students feel isolated and lost in their eating disorder recovery

By Shannon Brault, Bel Moran and Megan Phillips 

A wave of relief washed over Lauren Stach when she received a diagnosis of anorexia nervosa during winter break of her first year at the University of Minnesota Twin Cities. 

She had been struggling for months with an eating disorder that affected every part of her life. The diagnosis confirmed why she didn’t have control over her thoughts and actions. It was a real, diagnosable mental health condition that was treatable. 

“I think deep down I knew I couldn’t keep going down the path I was on,” said Stach, who credits a friend for convincing her to confide in her mother about how difficult life had become. “It was going to end really badly for me.” 

After consulting with her therapist and her doctor, Stach made an appointment at the Melrose Center, an eating disorder treatment clinic with several locations throughout the Twin Cities. The waiting list was long. So she sought support at Boynton Health on campus to see what they could provide while she waited. 

Boynton told her to schedule an appointment with The Emily Program, another Twin Cities eating disorder clinic, or Melrose, which she had already done. Beyond that, there was nothing Boynton could offer. 

“I was kind of left hanging,” she said. “It takes a lot of courage to ask for help, and if you are just met with a nonanswer or someone who really can’t provide you the support you need, it can deter you from asking for help in the future.” 

Boynton Health’s position on eating disorder treatment is clear: As one of the two main mental health providers on campus, and the one that provides medically oriented mental health care, Boynton does not treat eating disorders. Instead, it offers referral services to outside providers for specialized clinics in the Twin Cities. That is also true for Student Counseling Services (SCS). 

“Eating disorders require a lot of wraparound care, including appointments with nutritionists and potentially a family therapist, psychiatry and medical intervention,” Matt Hanson, interim director at Boynton Mental Health Clinic, said. “We just don’t have that built into our system here at Boynton, but there are places in the community that specialize in that care.”

Both Boynton and SCS say they lack staff specializing in eating disorders. It is especially important to rely on specialized clinics, their managers say, because eating disorders are among the most deadly mental health conditions. 

A 2020 report published in a collaboration with the Harvard School of Public Health and others found that 10,200 people die in the United States from an eating disorder annually. That equates to one person every 52 minutes.

Yet students with eating disorders say both Boynton and SCS could do more by offering consistent, regular, peer-attended support groups, similar to what other universities offer. Such groups, if properly structured and overseen, could offer encouragement and help during the most vulnerable periods when students are waiting for treatment or transitioning from treatment back into regular life. 

“I think an eating disorder recovery group [at the University] would be super, super helpful,” Stach said. She said interacting with peers offers an important level of camaraderie, understanding and support that’s difficult to find with just clinicians. “I know I’m not the only one on this campus struggling with it.”

A safe space for lived experiences

In Stach’s experience with support groups during treatment, she said one of the most rewarding parts of the groups was that she could help others through suggestions and sharing what had helped her with situations. In turn, others could help her when she was struggling and didn’t know what to do. 

Jillian Lampert, a trained eating disorder dietitian and the chief strategy officer for Accanto Health, which is made up of the Emily Program and the Veritas Collaborative, said growing research supports the value of peer support for eating disorders, especially when people are in treatment. Such research includes a 2020 report that said “support groups provided a safe space [for participants] to share their lived experience, that it reduced stigma and isolation and, improved participants’ motivation and engagement.”

Lampert said these support groups could be helpful during times of transition after treatment as well. “It’s a great idea, as long as the support group leaders are trained,” Lampert said. “There’s a couple of good models out there for eating disorder support group training so that the support group leaders are trained to be able to manage that.”

Other universities offer more 

Both Boynton and SCS said they offer support groups on occasion, but by late spring semester no support group is offered through either office. 

Students on the Twin Cities campus who think they might have eating disorders can find limited help from Boynton and SCS before they are referred elsewhere. 

SCS counselors will work with students who are experiencing “eating concerns and disordered eating,” but if these issues progress into an eating disorder, students would be referred outside of the University to an eating disorder specialty clinic, Michelle Bettin, interim director of student counseling services said in an email. 

At Boynton, Hanson said students are encouraged to come into the mental health clinic to discuss concerns related to disordered eating, eating disorders or body image. “We can assess their current thoughts, emotions, and behaviors related to food, weight or shape and provide a diagnosis if applicable,” Hanson said in an email. At that point, he said, clinicians discuss referral to off-campus specialized resources and will provide financial planning assistance for Melrose, he said.

Other Big Ten universities also refer students to specialized clinics. Yet many have built more integrated support options that offer support to students on campus during times of transition into and out of treatment, according to the schools’ websites. 

Ohio State University’s website says it offers a team of qualified individuals within their Student Health Services programming called the Eating Concerns Consultation Team (ECC). Students are able to meet with a licensed therapist, a physician and a nutritionist who will work together to set up a treatment plan, which may take them off-campus with a referral, but the initial process and the aftercare take place at school and are accessible to students. The team also offers resources for friends and family of those suffering from an eating disorder, providing aid with intervention when necessary.

Pennsylvania State University provides multiple separate, on-campus and situation-specific resources for students’ needs within its Healthy Eating and Living Support program, according to the school’s website. Within it, students have access to outpatient eating disorder treatment at University Health Services, a free registered dietitian at their on-campus Nutrition Clinic, individual or group therapy with the university’s Counseling and Psychological Services and they offer help coordinating insurance coverage at off-campus facilities with their case management services. 

The University of Wisconsin-Madison has noted an increase in eating disorders on its campus. While its care depends, like Boynton’s, on case managers referring students out to specialized  care centers, its University Health Service offers a drop-in peer support group overseen by licensed professional counselors.   

AccessU: More than Stress made attempts to reach all three programs for more detailed information, but no one was available for interviews. 

Social media support: better than nothing

Like Stach, Caroline Pritchard, a third-year strategic communications major, struggled with an eating disorder in silence for months during her first year of college, and said she didn’t feel support was within easy reach on campus. 

When she was finally considering asking for help, she went to Boynton’s website and saw only the referral option but didn’t feel ready for a specialized clinic. Even so, she made a phone call and encountered a long wait time for an appointment which resulted in her not going through with the process at all. 

She was alone once again with her eating disorder, not knowing what to do. 

When Pritchard was forced to move home during the beginning stages of the COVID-19 pandemic spring of 2020, she felt like she could no longer hide that she was struggling. She confided in a therapist in her hometown who helped her in her journey to recovery. 

What she found in her recovery process was that there was tremendous value in sharing her story with peers. She posted her eating disorder story on Instagram and said she received waves of positive feedback and people thanking her for being brave enough to share her raw experience. It made her wish, once again, that there was a support group on campus for those who need it, she said. 

“I feel like just having that community and just being able to talk about your experiences and relate to them but then get through them together would have been really nice,” Pritchard said.

Pritchard considers herself mostly recovered, but the eating disorder can still get triggered at times. In those moments, without a support group or a treatment team at hand, she turns to friends and her boyfriend for help — people who have not been through the pain she is feeling. That leaves her feeling worried, she said. 

“I feel like I’m burdening people that have no idea about it when I’m talking [to them],” Pritchard said. Talking to her boyfriend is often challenging for them both, she said: “He doesn’t really know what to say to me…and he doesn’t want to misstep his words to say something that would make it worse for me.”

She continues, “I feel like it’s unfair for me to expect him to know what to say at that moment. I feel like [support groups] would be a really great place to have those kinds of conversations.” 

Eating disorders “thrive in secrecy”

The transition back to school after an absence or treatment is another difficult part of the recovery process – and, as studies have suggested, an organized support group, even online groups, can be beneficial for students during these phases.

Stach relapsed into her eating disorder, which she says was in part due to the pandemic. After completing a 15-month-long internship for her biosystems and bioproducts engineering major at a pulp and paper mill in Cloquet, Minnesota, Stach arrived back at school without many of her old friends around her leaving her feeling isolated. 

Some studies on relapse of eating disorders show that 35-41% of patients treated for eating disorders relapse within 18 months, with the highest rate of relapse being associated with anorexia nervosa. 

Studies also show that the COVID-19 pandemic has exacerbated eating disorders among young people and college students. Overall, there has been a steady increase in eating disorders over the last decade, but a 2021 study found that eating disorders increased by 15.3% in 2020. 

When Stach returned to campus and as the fall semester progressed, she said her mental health was worse than it had ever been. She thought she could “power through” and get through the struggling on her own considering there weren’t resources around her that she could fall back on on campus. 

Eventually, into the start of the spring, she found she couldn’t focus on anything or even get out of bed. She knew she needed to go back to treatment, although this time she was sent to inpatient treatment. She had to drop all of her classes at the midterm and take a step away from school altogether. 

Inpatient treatment was helpful, she said. But she said her return to school after treatment was more challenging and a bigger adjustment than the first time she went through treatment her freshman year when she lived in the dorms. 

“I think it was almost harder to come back because [treatment] is an environment built to help you succeed,” she said. “You’re surrounded by mental health professionals and other people going through the same thing. And then you’re kind of thrown back in the same environment where you were sick without the support you had every day. And it’s really, really challenging.”

Stach has now built support through good friends on campus who understand her situation and make time to cook with her. Being more open about her struggles has made it easier to find that backing, she said, but she still believes a formal peer support group is crucial. 

“Eating disorders thrive in secrecy and just not really knowing anyone or having any support definitely made it worse,” Stach said. “And I really think that a peer support group could be a prevention tool to prevent relapse or even prevent the eating disorder from progressing.”