As college students return home for breaks, parents and caregivers often notice subtle—or not-so-subtle—shifts in their young adult’s eating habits, mood, or energy that may raise concern. These observations are valid and important, even when uncertainty lingers about whether changes reflect typical college adjustment or something more serious. Eating disorders frequently emerge or intensify during the late teens and early twenties, a developmental window marked by newfound independence, identity exploration, and heightened stress. Approaching these concerns with curiosity, compassion, and a willingness to seek professional guidance honors your student’s autonomy while prioritizing their health and well-being; early, collaborative intervention can significantly improve outcomes and strengthen family connection. Keep reading to learn how to recognize eating disorders in college students when they return home from school.
Key Takeaways From This Resource
- Breaks from college often make eating-disorder symptoms more visible to families.
- Warning signs can show up in any body size and often include changes in mood, food rituals, social withdrawal, and preoccupation with weight or exercise.
- Trust your instincts if something feels “off.” You don’t need proof or a formal diagnosis to seek an evaluation.
- A calm, compassionate conversation focused on concern, not weight or blame, can open the door to help.
- Effective treatment may include outpatient therapy, intensive outpatient (IOP), partial hospitalization (PHP), or residential care, with coordination between home, treatment team, and college.
Coming Home From College: Why You May Notice a Change
The first long break home—winter break, summer, or even a long weekend—is often when parents and caregivers notice that something isn’t right.
Away at school, your student may be eating on a different schedule, living with roommates, and juggling classes and social life. It’s easy for early warning signs of an eating disorder to stay hidden. Back at home, you’re suddenly seeing them at meals, noticing their routines, and hearing more about what life has really been like on campus.
Many eating disorders first become “full-blown” between ages 18 and 21, exactly the college years. Child Mind Institute+1 Early recognition and treatment can make a real difference in recovery.
If you’re wondering, “Is this normal college stress, or could it be an eating disorder?” you’re not alone. Eating disorders are serious illnesses, but they are treatable, and families play an important role in getting young adults the support they need.
Common Signs of an Eating Disorder in College Students
Eating disorders can affect people of any gender, race, size, or background—and you usually cannot tell who is struggling just by looking at them. Mayo Clinic What you can often see are patterns in behavior, mood, and daily life.
You may notice one or two of these signs—or many. None of them “prove” an eating disorder, but together they can signal a problem that deserves attention.
1. Changes Around Food and Eating
- Skipping meals or claiming to have already eaten (“I grabbed something earlier,” “I ate at a friend’s”)
- Cutting out major food groups (for example, suddenly refusing carbs, fats, or all animal products without a clear ethical reason)
- Very rigid “rules” about what, when, or how they can eat
- Picking at food, pushing it around the plate, or cutting it into tiny pieces
- Needing to eat alone, in their room, or only “after everyone’s gone”
- Episodes of eating very large amounts of food in a short period of time, followed by shame, secrecy, or promises to “make up for it”
2. Body Image and Weight Concerns
- Constant talk about weight, shape, fitness trackers, or “clean eating”
- Intense fear of weight gain, even if weight has not changed
- Distress about how clothes fit; frequent body checking in mirrors or photos
- Equating worth or success with the number on the scale or the size of their clothes
3. Exercise and Movement
- Feeling compelled to exercise every day, even when sick, injured, or exhausted
- Exercising to “earn” or “burn off” food
- Anxiety, irritability, or guilt if they can’t work out
- Prioritizing exercise over social events, sleep, or schoolwork
4. Mood and Daily Functioning
- Increased anxiety, depression, irritability, or emotional swings
- Pulling away from friends or family; spending more time alone
- Difficulty concentrating or a drop in academic performance
- Feeling out of control, ashamed, or “not good enough”
5. Physical Signs
Physical symptoms can vary widely and don’t show up for everyone, but may include: Mayo Clinic
- Feeling cold most of the time
- Dizziness, fainting, or near-fainting
- Fatigue, trouble sleeping, or restless sleep
- Stomach pain, constipation, reflux, or other digestive issues
- Changes in menstrual cycle or loss of periods
- Dry skin, hair loss, or brittle nails
- Dental problems or sore throat (in people who purge)
Important: If your student is fainting, has chest pain, severe stomach pain, can’t keep food/fluids down, or talks about wanting to die or self-harm, seek emergency help right away (call 911 or your local emergency number). For thoughts of suicide in the U.S., you can also call or text 988 for crisis support.
“Normal” College Changes vs. Red Flags
Some shifts are common in the college transition, different meal times, more take-out, fluctuating sleep, or trying new exercise classes. What’s more concerning is rigidity and distress:
- They seem highly anxious if plans change around food or exercise.
- Their world is shrinking, grades, friendships, and hobbies are all taking a back seat to food, weight, and body image.
- You sense shame, secrecy, or panic when food is involved.
If you’re asking yourself, “Is this bad enough to get help?” that alone is a sign it’s worth talking to a professional.
How to Talk With Your Student if You’re Worried
Starting the conversation may feel intimidating. You don’t have to say it perfectly. Aim for calm, curious, and compassionate.
Before You Talk
- Choose a relatively calm moment. Maybe a walk, a drive, or time at home without a lot of distractions.
- Try to regulate yourself first: a few deep breaths, a short walk, or writing down what you want to say can help.
- Keep your goal simple: share your concern and open the door, not to diagnose or argue.
What to Say
Use “I” statements and focus on what you’ve observed:
- “I’ve noticed you seem really anxious around meals lately, and I’m concerned about you.”
- “I’ve seen you skipping meals and exercising even when you’re exhausted. I care about your health and wanted to check in.”
- “Coming home, I’m noticing you seem more stressed about your body and food than before. How has it been for you at school?”
Try to:
- Listen more than you talk. Give space for their perspective.
- Validate feelings. “That sounds really overwhelming,” “I can hear how stressful this has been.”
- Express teamwork. “You don’t have to figure this out alone. I want to help you find support.”
Avoid:
- Comments about weight, appearance, or “looking healthy/unhealthy.”
- Threats (“If you don’t eat, you can’t go back to school”) as a first step.
- Oversimplifications (“Just eat,” “Just stop worrying about your body”).
What to Do Next: Getting an Evaluation
You don’t need to know what type of eating disorder is present to reach out for help. In fact, early evaluation is one of the most powerful tools for prevention and recovery.
1. Schedule a Professional Assessment
Look for providers or programs that specialize in eating disorders, not just general nutrition or therapy. A comprehensive evaluation often includes:
- Medical assessment (vital signs, labs if needed)
- Psychiatric/psychological evaluation
- Nutritional assessment
- Screening for co-occurring conditions such as anxiety, depression, OCD, or trauma
You might start with:
- Your student’s primary care provider or pediatrician
- A specialty eating-disorder program
- An eating-disorder therapist or dietitian
National organizations like the National Eating Disorders Association (NEDA) and the National Institute of Mental Health (NIMH) provide directories and screening tools that can help families understand whether it’s time for an evaluation.
2. Explore Levels of Care
Depending on the severity of symptoms and medical stability, recommendations may range from:
- Outpatient care (weekly therapy, dietitian, and medical follow-up)
- Intensive Outpatient Program (IOP) – several days per week of group and individual support
- Partial Hospitalization Program (PHP) – structured day treatment while living at home or in nearby housing
- Residential or inpatient care – 24-hour support in a structured environment
Coordinating Treatment and College
One of the hardest questions for families is: “Can my student stay in school?”
There isn’t a one-size-fits-all answer. Factors include:
- The level of care recommended
- How much symptoms are impacting academics, social life, and daily functioning
- Availability of treatment near campus vs. near home
- Your student’s physical safety and mental health risks
Some possibilities:
- Remain enrolled with local treatment
o If outpatient or IOP is recommended and there are strong supports on campus and at home. - Take a medical leave of absence
o If PHP or residential care is recommended, or if school stress is a major driver of symptoms. Colleges often have processes for medical leaves, accommodation letters, and gradual return plans. - Hybrid or step-down plans
o Start with a higher level of care during break, then transition to lower-intensity treatment with accommodations when returning to school.
A good treatment team will collaborate, with your permission, with campus counseling, disability services, and academic advisors to support a safe, realistic plan.
How Galen Hope Can Support Families of College Students
At Galen Hope, we recognize that college years can be especially vulnerable for both eating disorders and other mental health conditions. Our team provides:
- Comprehensive assessment for adolescents and young adults
- Evidence-based treatment that addresses eating disorders and co-occurring concerns like anxiety, depression, OCD, and trauma
- Multiple levels of care, including structured day treatment and intensive programming, to tailor support to each person’s needs
- Strong family involvement and coordination with home communities, outpatient providers, and schools or universities
Our goal is to welcome complexity, not turn it away, and to help young people and their families find a path toward lasting recovery and reconnection.
CTA: Schedule a consultation
FAQ: Home From College & Eating-Disorder Concerns
1. My student lost weight this semester. Is that always a sign of an eating disorder?
Not always. Some students lose or gain weight because of schedule changes, different food options, illness, or sports. What matters more is how the change happened, how fast, and whether it’s accompanied by distress around food, rigid rules, or personality shifts. If you’re noticing several red flags—or you’re just uneasy—it’s reasonable to seek an evaluation.
2. They say they’re “just being healthy” or “just trying to be fit.” Should I still worry?
Pursuing health can be positive, but when “health” becomes rigid, anxiety-provoking, or tied to self-worth, it can overlap with disordered eating. Watch for all-or-nothing thinking (“I blew it, I might as well starve tomorrow”), cutting out many foods, intense fear of weight gain, or compulsive exercise. Those are reasons to check in and possibly involve a professional.
3. Do all eating disorders involve being underweight?
No. People with eating disorders can be underweight, within the “average” range, or in larger bodies. Focusing only on weight can delay diagnosis and care. Look at behaviors, thoughts, and distress—not just the number on the scale. Mayo Clinic
4. Can my student stay in college while getting treatment?
Sometimes, yes—especially with outpatient or IOP treatment and strong supports. In other situations, a medical leave or time away from school is the safest and most effective option. A specialized treatment team can help you weigh the risks and benefits and communicate with the college about leaves, accommodations, and return-to-campus plans.
5. What if my student refuses help?
It’s common for people with eating disorders to feel scared of treatment or to minimize symptoms. You can:
- Keep expressing concern and care, without ultimatums as a first step.
- Emphasize that an evaluation doesn’t lock them into any specific treatment.
- Offer to go with them to the first appointment or help with logistics.
- Set firm boundaries around what you can and cannot support (for example, not funding certain choices if safety is at risk).
If you’re truly worried about their safety, talk with a professional (doctor, therapist, or eating-disorder specialist) about next steps.
6. When is it an emergency?
Seek urgent or emergency care if your student:
- Faints, has chest pain, or is struggling to breathe
- Can’t keep food or fluids down
- Shows signs of severe dehydration or weakness
- Talks about wanting to die, self-harm, or not wanting to be alive
In these situations, call 911 or your local emergency number, go to the nearest emergency room, or contact your local crisis line (in the U.S., call or text 988).
A Final Word for Parents and Caregivers
If your college student has come home and you’re seeing signs that worry you, you’re not overreacting. Eating disorders are serious, but they are also treatable, and early action matters. You don’t have to have all the answers, reaching out for a professional assessment is a powerful first step.
Your calm concern, steady presence, and willingness to seek help can become part of the foundation for your student’s recovery.
About Galen Hope
Galen Hope provides individualized, evidence-based treatment for eating disorders including: anorexia nervosa, bulimia nervosa, binge-eating disorder (BED), and compulsive overeating/loss-of-control eating, as well as co-occurring mental-health conditions. Led by co-founders Dr. Wendy Oliver-Pyatt (psychiatrist) and Dr. Amy Boyers (clinical psychologist), our multidisciplinary team integrates CBT/CBT-E, DBT-informed skills, mindful eating and nutrition therapy, and medical/psychiatric care to reduce urges, restore flexible eating, and rebuild a healthy relationship with food.
We treat adolescents and adults of all genders across residential and intensive day treatment (PHP/IOP) levels of care, with optional 24/7 clinically integrated housing. Our model is weight-inclusive and shame-reducing, emphasizes frequent individual therapy and skills groups, robust family involvement, and support for reintegration into everyday life.
Locations: South Florida; serving individuals nationwide and beyond.
For more information about Galen Hope, please call 866-304-2955 or visit www.galenhope.com.
Key Statistics
- About 9% of the U.S. population, nearly 28.8 million people, will experience an eating disorder in their lifetime. ANAD
- Estimates suggest that 10–20% of women and 4–10% of men in college are living with an eating disorder, and rates are rising. Child Mind Institute+1
- In a national sample of more than 260,000 undergraduates, eating-disorder risk increased from 15% in 2013 to 28% in 2020/2021. sciencedirect.com+1
These numbers highlight why college breaks are such an important time to notice signs and act early.
References:
- National Eating Disorders Association (NEDA). Eating Disorder Statistics & Research; Resources for Students.
- Daly M, Costigan E. Trends in eating disorder risk among U.S. college students, 2013–2021. Psychiatry Research. 2022. sciencedirect.com+1
- ANAD (National Association of Anorexia Nervosa and Associated Disorders). Eating Disorder Statistics. ANAD
- Mayo Clinic. Eating disorders: Symptoms and causes. Mayo Clinic