Editor’s note: This is Part 1 of a 2-part series. Read Part 2 here.
Hannah Allen’s life at Cal Poly looked to be on track. A student athlete with good grades, close friends and supportive parents, she was cheerful, social and appeared to be thriving.
In reality, she was losing control to Ed. He told her what to do, he was abusive, he threatened her life — and she kept him a secret.
Ed is what Hannah, 21, calls her eating disorder. Ed is bulimia — marked by an obsessive cycle of binging and purging.
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Hundreds of Cal Poly students are likely struggling with hidden eating disorders right now.
When Hannah’s symptoms were at their worst, she lied to her parents. She avoided eating with friends to hide her illness. She vomited multiple times a day, after every meal. She thought she didn’t deserve to consume calories if she hadn’t exercised. She thought she wasn’t worthy of food, or of love. She was trapped in a cycle of shame.
“Ed tells me and a lot of other girls lies. He’s that kind of whispering voice that you’re not good enough. He twists thoughts and the way you see yourself,” Hannah, a senior studying biological sciences and psychology at Cal Poly, said in an interview with The Tribune.
Like thousands of college students, she struggled for years in isolation.
“A lot of people feel in that grip because they’re scared. You think, ‘Everyone around me is so perfect. No one has these really big problems. No one deals with this. I’m the weird one,’ which is so not true,” said Hannah, who lives in San Luis Obispo.
A hidden problem on college campuses
An annual nationwide survey by the Healthy Minds Network found that 10 percent of college students surveyed in 2018 screened positive for an eating disorder, up from 5 percent who took the survey in 2013.
The first time Cal Poly participated in that survey, in 2016, 6 percent of participants met the criteria for an eating disorder, according to Sarah Joy Park, a Cal Poly-based psychologist who serves as the eating disorders treatment coordinator on campus.
That equates to more than 1,200 students with probable eating disorders on the San Luis Obispo campus, where a student culture of exercise and fitness can blur into unhealthy behavior.
Yet, Cal Poly and most other colleges provide students with limited education about the warning signs, risks or prevalence of eating disorders — and many schools don’t collect statistics on the public health issue.
According to a spokesman for Cal Poly, body image and eating disorders are covered in presentations for new students, and sports medicine staff talk with student athletes about disordered eating as aspects of overall health.
Hannah said eating disorders on campus are too common and remain hidden.
“I didn’t realize the girl next to me was struggling with the same exact thing, but I was too scared to talk about it and so is she, so everyone remains quiet,” Hannah said.
Now that she’s in recovery thanks to eagle-eyed parents, on-campus counseling and a new kind of treatment program, she is speaking up and sharing her story of new-found hope to help others who may be struggling with eating disorders.
Recovery, she said, “is the most liberating thing. You feel like you can live again. I want everybody who’s going through Ed to experience that — the amount of liberation and complete joy you feel after (recovery) is so entirely worth it. Everyone deserves to live.
“I just want people to hear they’re not alone,” Hannah said.
Watching weight as a student athlete
It started with restricting food.
Hannah had always managed a heavy load of activities, and according to her mom, Carmon Allen, she excelled in everything. Before college, Hannah was a senior captain on the cross-country team and class valedictorian at Homestead High School in Cupertino.
Eating disorders often develop or are triggered as a coping mechanism in times of transition or high stress, according to Libby Parker, a registered San Luis Obispo dietitian who specializes in eating disorders. It isn’t just about weight or appearance; eating disorders are often about having a sense of control.
While anyone — any gender, sexual orientation, age, race or social class — can develop an eating disorder, Parker said, adolescents and college-aged students are at higher risk than the general population.
And the risk is higher still for student athletes.
In a study of Division 1 NCAA athletes, more than a third of female athletes reported attitudes and symptoms placing them at risk for anorexia, according to the National Eating Disorders Association. Men are at risk too, particularly those involved in running or wrestling.
As a freshman at Cal Poly, Hannah was a walk-on athlete on the cross-country team, training hard several hours a day with her new group of friends. She wasn’t the fastest, and she was going to get cut from the team if she didn’t improve.
One of the coaches told her she’d run faster if she was thinner. When she asked what she could do to get on the traveling team, the coach told her she should work toward a goal weight that was 20 pounds lighter.
In hindsight, Hannah said, that advice was ridiculous. But at the time, she took it to heart.
“I don’t think I was fat. Maybe I was 5 pounds heavier than I should have been for a healthy running weight. But to hear that from the coach who I wanted to perform well for, and I was worried about getting cut, that’s a serious issue,” said Hannah, who doesn’t think any one person or situation caused her eating disorder. “I (badly) wanted to make the team. That was a motivator to pay attention to what I ate.”
It was after that coach’s comment that Hannah counted calories. Many nights, she went to bed hungry. And her weight fluctuated.
Her parents noticed that the hours she spent training and practicing were cutting into her study time. She wasn’t able to make time to talk to her professors during office hours, and her parents worried her grades were slipping. They said she needed to drop the team.
So Hannah quit, but the focus on food lingered.
She wasn’t running as much. She had extra time and was no longer involved in the main activity of her friend group. When her former teammates went out to eat after training, she stayed home, thinking she didn’t belong.
It was in those gaps, she says, that Ed saw opportunity.
“I was thinking about how I wasn’t that fast anymore and I was eating too much relative to everybody else (on the team) and I was comparing my body and my leg size and doing really unhealthy things,” Hannah said. “I was so invested in (running), I didn’t know anything else. My whole life was that team.”
She was home alone the first time Ed made her vomit.
“I would isolate myself, and I took it out on the food,” Hannah recalled. “I would have two meals in one sitting, and then I would run down to the communal bathrooms and throw up because I was sick.”
That pattern became routine and habitual.
By summer, Hannah was purging multiple times a day.
With a goal of working in the medical profession, she spent the summer shadowing a surgeon at a hospital in Oakland and lived with her parents during the weekends. She told her parents she wasn’t feeling well and speculated that it was acid reflux. She ate a lot of Tums.
Do I have an eating disorder?
The consequences of an eating disorder like bulimia or anorexia can be serious, lifelong, and in some cases, deadly.
Of all mental illnesses, eating disorders have one of the highest mortality rates, multiple studies have shown. They’re associated with an increased risk of premature death caused by cardiac or respiratory arrest, a ruptured esophagus, or suicide.
Hannah was lucky. Her illness was caught early when her parents intervened after they noticed a key clue months after the symptoms first appeared.
Still, it took her through the school year to finally admit she was bulimic and needed more serious help. Denial is one of Ed’s most used tools.
In the meantime, her symptoms worsened under the stresses of college: a heavy workload, a pursuit of perfection and a sexual assault. Those around her didn’t know the depths of the inner turmoil.
There’s a five-question survey that was designed to help ascertain whether an eating disorder might exist before a thorough diagnosis by a medical professional. People who say yes to two or more questions are likely to have anorexia or bulimia, according to the authors of the survey, called SCOFF.
- Do you make yourself sick because you feel uncomfortably full?
- Do you worry you have lost control over how much you eat?
- Have you recently lost more than 14 pounds in a three-month period?
- Do you believe yourself to be fat when others say you are too thin?
- Would you say that food dominates your life?
“I remember looking online. I searched my symptoms. I was feeling sick all of the time. It was part of normal, everyday life. Bulimia came up and I thought, ‘I don’t have that,’ ” Hannah said.
The idea of eating disorders was foreign to her. She had been told to eat healthy and was warned about obesity, but bulimia and anorexia were not covered in her education.
When purging becomes normal
Before long, Hannah’s habit of throwing up after she ate became normalized. She even vomited in the kitchen sink in front of her father after eating a cupcake on her sister’s birthday.
“My dad looked over at me and was like, ‘What are you doing?’ and I was like, ‘I told you. I’ve been completely transparent with you that I’ve been sick,’ ” Hannah said.
That’s when her parents decided that Hannah was going to see a professional counselor.
Early treatment of an eating disorder greatly increases the likelihood of physical and emotional recovery, yet medical professionals say symptoms of eating disorders drastically vary between people and often aren’t recognized by medical professionals without specific training. The illness is under-diagnosed.
Parents have an opportunity to catch it, by noticing a change in their child’s behavior, but they’re often in denial, said Libby Parker, who became Hannah’s dietitian.
“They’ll notice eating patterns have changed, body weight has changed, a kid is looking more tired than usual,” Parker said. If parents do suspect an eating disorder, they should offer encouragement and support, including insurance or money for treatment.
Hannah’s parents had their suspicions about Ed.
They had researched Hannah’s symptoms, which she downplayed, and noticed the sickness Hannah described correlated to times of stress. Other than that, she was healthy. Something wasn’t adding up about Hannah’s story, so they talked with her openly about addressing the problem and getting help.
“My husband and I had the mantra since (our children) were kids, barring personal privacy issues, we’ve always been open about our feelings,” Carmon Allen, Hannah’s mom, told The Tribune in a phone interview. “If there is a bump in the road, we were encountering that as a group.”
“We didn’t push her. We were active. (We said) Let’s move forward and uncover this, look under every rock,’ “ Carmon Allen said.
Ed was no longer invisible to everyone in the family, but it would still take nearly a year for Hannah to admit he was in control.
“I didn’t see it,” Hannah said. “I know it sounds weird. How could you not notice that type of behavior is abnormal? But because it was built up and became such a routine, it was normal to get the pain after I ate.”
It was because of that intervention that Hannah began seeing a counselor as she started her second year at Cal Poly — the start of a roller coaster ride to recovery.
Ed did not go down without a fight and, for Hannah’s health, the worst was still ahead.
Coming tomorrow: Part 2 of Hannah’s story — a new trauma sends her spiraling as she continues her roller-coaster ride through recovery.
Dealing with an eating disorder?
If you think you or a loved one might have an eating disorder, help is available. Talk to a trusted medical professional, call the National Eating Disorders Helpline at 800-931-2237, visit the National Eating Disorders Association website at www.NationalEatingDisorders.org or contact crisis support via text (send NEDA to 741741).