Over Thanksgiving weekend, as many families welcome university undergrads home for the first time since the school year started, university students may be grappling with health problems their parents don't know about.
Female students living away from home are three times more likely to report symptoms of binge eating than those who continue to live at home in their first year of university, according to a new study from the University of Alberta published today in the Journal of Youth and Adolescence.
Binge eating, or solo sessions of overeating, can progress into bulimia, an eating disorder that involves bingeing and purging - and is more common than anorexia, which often develops in younger teens.
But binge eating is increasingly being considered an eating disorder and a contributor to obesity, says Erin Barker, lead author and developmental psychologist.
"It often happens after a period of restricting [food intake]or a week or two," she says. "Then, maybe something stressful or negative happens. It's a coping mechanism."
The research, which did not look at bulimia or anorexia, suggests there could be something in the act of going to university that affects the prevalence of binge eating.
"There could be bumps in the road and for some people it might not be great," says Dr. Barker of going to school away from home. "It's not just about choosing your classes and adjusting to academics."
Previous research has identified a high rate of bulimia and anorexia among the university student population, with a focus on the risk factors of poor body image and low self-esteem.
Dr. Barker surveyed 101 first-year female students, some of whom were living at home and some away from home, about both their eating habits and how they felt they were fitting in to their new environments.
Students who had a pre-existing dissatisfaction with their bodies were three times as likely to report symptoms of binge eating than those without.
And if they were having trouble building social networks, students were 50 per cent more likely to show symptoms.
Even women who didn't have eating problems in high school were at an increased risk when faced with a stressful transition to university.
"In high school they may have had better social networks and coping skills that helped them avoid eating problems. Maybe they had body dissatisfaction then, which is likely, but it wasn't contributing to eating problems before."
Add in a new relationship with food - such as a dorm cafeteria instead of the family dinner table - and you have a recipe for self-destructive behaviour, Dr. Barker says.
Kim Maertz, training director of Student Counselling Services at the University of Alberta, says he is treating several patients dealing with the underlying problems that lead to binge eating.
Change is stressful, he says, and feeds into any negative cycle such as eating disorders and alcoholism.
"It's related to an inability to deal with their emotions," he says.
"And their emotions are particularly more volatile at these transition periods."
For parents, knowing this is a risk period can be a boon. "The sooner you can deal with an eating disorder, the better, because these become habitual and hard to change," Dr. Maertz says.
The implications of wolfing down an extra-large pizza alone can go beyond the so-called freshman-15 weight gain long associated with first-year university.
Binge eaters risk becoming bulimic if they start to compensate for overeating by forcing themselves to vomit, taking laxatives or exercising excessively.
But Dr. Barker cautions that overeating on occasion is not necessarily a red flag.
"Eating a lot at Thanksgiving isn't binge eating," says Dr. Barker, who did the research as part of her PhD at the University of Alberta and who is now at Beloit College in Wisconsin.
"Binge eating isn't social - it's something people do alone because they're embarrassed."