Once the Freshers’ frenzy begins to take its toll, with queasy morning lectures and ever-present ‘hangxiety’ becoming less of a novelty and more of a headache, attempts to cultivate a more balanced routine emerge. However, for many students fending for themselves for the first time, socially encouraged binge drinking is not the only unhealthy habit that seems inextricable from the university lifestyle.
University culture also has a large impact on dietary habits and behaviours. This is not a hidden truth; Childmind has declared the cumulative aspects of the undergraduate lifestyle as a ‘perfect storm’ for the onset of eating disorders, with 20% of females and 10% of males reportedly suffering from anorexia and bulimia.
Whilst these statistics are staggering, they aren’t necessarily unsurprising to those currently working through the realities of the post-lockdown university experience.
Recent cohorts of freshers experienced COVID-19’s isolation period from the ages of 13-17, covering the years in which most eating disorders originate, according to Beat’s metanalysis alongside King’s College London.
The impact of restricting teenagers’ access to normal society in their developmental years has been undeniably detrimental. Exposed only to the internet’s portrayal of beauty standards and diet culture, along with the sensationalised expectation to ‘glow-up in lockdown’, the perception of success as obtaining the ‘perfect’ body infiltrated and reified the minds of an overwhelming number of young people.
In fact, when I spoke with them, Beat – the UK’s largest eating disorder charity – reported a quadrupling of helpline sessions by 2022, in comparison to before the pandemic.
Yet, as a significant proportion of the student population– either in recovery or still suffering from an eating disorder– emerged from lockdown and entered university life, did institutions dedicate enough to preventing further damage?
The unsteady Freshers’ lifestyle, where you must self-consciously establish yourself within a party of ten thousand, is the polar opposite of the COVID-19 lockdown. However, it can be equally as dangerous.
New-found independence also imposes new pressures. These include financial stresses on dietary decisions, the mental impacts of alcohol over-consumption, fostering new relationships, and adapting to unfamiliar academic structures.
Erin is a student at the University of Birmingham. Her experience reflects that of many other students. Where university seemed a ‘fresh start’ after the isolating lockdowns, Erin found that “you can’t just run away from your eating disorder”.
She considers her disordered eating to feel worse now at university than when she was first diagnosed. Feelings of loneliness were a core driver for her relapse.
This experience, unfortunately, is shared by many university students.
By 2023, Beat provided triple the amount of support to the COVID cohort than previous university populations; they provided over 12,000 helpline services to 18 to 20-year-olds as opposed to less than 4,000 in 2020.
The evidence for the dangerous impact of lockdown combined with the idealised debauchery of the Freshers’ experience is undeniable. So, why is it ignored?
The lack of initiative taken by institutions to prevent these problems has assisted in indisputable damage. As a result, hindsight reparation is now being called into action.
The University offers a multi-disciplinary Counselling & Mental Health Service, with staff exploring causal and precipitating factors contributing to eating distress or eating disorder. Now, the service is currently investing in specialist eating disorder training for counselling staff leading in this area. This includes Enhanced Cognitive Behaviour Therapy for Eating Disorders (CBT-E) and Compassion Focused Therapy for Eating Disorders (CFT-E).
UoM is working in partnership with the NHS Eating Disorder Service, which offers a fast track for first presentation of eating disorders, and specialist supervision to staff undertaking training.
Currently, students in crisis are required to access this support themselves by requesting a ‘first step’ consultation over the phone.
However, a structure reliant on self-referral does not present as congruous with the increased number of students struggling with a disorder commonly fraught with shame and self-regulated isolation.
Despite the University’s offered support, for many students it fails to appear as an inviting place of refuge. This is evident in Kath’s story, whose name has been changed for anonymity.
Having fallen into a vicious cycle of restriction and bulimia at the beginning of her first year, Kath told me of the isolation she felt within the enclosed white walls of Unsworth Park.
“The sick side of my brain thrived off of being invisible in such a large institution, but the other side of my brain begged for someone to notice how much I was struggling”.
She recalled being unable to concentrate in lectures, with an under-fuelled mind that “fixated on the number of calories consumed rather than the number of pages [she had] read”. Kath secretly hoped that one of her seminar leaders might pick up on her fading participation.
Eventually, after reaching a peak of anxiety over her physical health, the “logical” part of Kath set up a first-step phone consultation with the University “against the will of [her] disorder”.
However, this didn’t go entirely to plan.
Kath’s moment of panic had passed by the time the first step consultation was available, and the days in between had given her anxieties around speaking out time to raise their weaponry.
“I remember staring at my phone as it rang, thinking: what if my flatmates overhear the conversation? What if they just tell me to go through the NHS? I was scared that if I finally admitted that I had a problem, but they couldn’t actually provide support, I would just feel more helpless and alone than I had before”.
Additionally, Kath felt compelled to fight the disorder in private, wanting to refuse external help.
Despite this, on the second attempt to contact Kath, she picked up the phone.
‘The lady asked me what I wanted to speak about. I sat at my desk with my mouth open, but nothing came out. I was too busy arguing with my thoughts, unsure what she would actually be able to do about it… whether she would believe me. I just couldn’t do it”.
Kath followed up the phone call with an email apologising, saying that the connection must have broken and that she didn’t need a replacement appointment.
The emergence of such devastating personal case studies invites inquiry into the personal accessibility of the services provided.
In combination with the high financial costs of private help, and extensive NHS waiting lists referred to as the free alternative, the detrimental statistics indicate that many students like Kath are facing incredibly difficult struggles while feeling alone.
So I implore you, in the words of Beat Director Tom Quinn, to keep your eyes peeled for signs, look out for your friends, and encourage them to reach out for help, whether through the University or externally. Noticeable signs include becoming “stressed during mealtimes, fixated on their diet or exercise, […] spending much more time by themselves”.
As a student population, we must do better to talk openly about this disease that plagues so many of our age group and raise awareness about the support available. If this epidemic is to be conquered, we must do it loudly, and we must do it together.
Fortunately for Erin, who “signed up to every therapy going”, she confidently reports that she feels incredibly lucky, “living in a lovely house back at university”. And Kath, upon returning home, was able to accept the assistance offered by friends and family to get herself back into a healthy position.
“I am honestly not sure they will ever know how much they have helped me; I wouldn’t be able to be sat here back in Manchester today if it wasn’t for my friends and family. Deciding to commit to recovery is the best decision I’ve ever made. I am so grateful that I had people I love beside me as I took back control of my life,” she said.
If you feel you are struggling to any degree with your relationship with food, exercise, or body image, please speak out.
You are not alone.
There are support services available to help, others with similar experiences to listen to you, and friends or family to rely on. Taking that next step may feel terrifying and recovery impossible, but nothing is scarier than suffering in silence. No outcome is worse than spending your university years at war with your mind. Letting someone in and seeking help for yourself is the best decision you will ever make, so please refer to the services below if you are worried about yourself or somebody else.
Set up a ‘first step’ consultation: https://www.counsellingservice.manchester.ac.uk/get-help/
UoM Counselling & Mental Health Service helpline: 01612 752864
Health Assured 24/7 Helpline: Freephone: 0800 028 3766 or download the Wisdom app for live chat (Access Code for UoM students: MHA147866).
Beat Charity Helpline: 08088 010677
Beat Email Support: [email protected]
UoM Counselling & Mental Health Service also work in partnership with Manchester Metropolitan University to offer a targeted workshop and therapeutic group ‘Coping with Eating Distress’. The Greater Manchester Universities Student Mental Health Service also offer some targeted therapeutic interventions for eating disorder and eating distress.
The University of Manchester’s full statement is as follows:
The University offers a multi-disciplinary Counselling & Mental Health Service. Staff are trained in a variety of modalities and are each able to explore causal and precipitating factors contributing to eating distress or eating disorder. The service is currently investing in specialist eating disorder training for counselling staff leading in this area. This includes Enhanced Cognitive Behaviour Therapy for Eating Disorders (CBT-E) and Compassion Focused Therapy for Eating Disorders (CFT-E).
The service has a strong partnership with the NHS Eating Disorder Service which offers a fast track for first presentation of eating disorder. The Eating Disorder Service also offer specialist supervision to staff undertaking training in this area. UoM Counselling & Mental Health Service also work in partnership with Manchester Metropolitan University to offer a targeted workshop and therapeutic group ‘Coping with Eating Distress’. Here students are given the opportunity to gain insight into their individual challenges with food and eating and are introduced to alternative methods of self-regulation. There is an additional pathway into the Greater Manchester Universities Student Mental Health Service (GMUSMHS) if a student has a more complex mental health need which can include complexity around eating. GMUSMHS also offer some targeted therapeutic interventions for eating disorder and eating distress.
