Eating Disorders and Over-Exercise in Collegiate Recreation (Part I)

September 15, 2014

Eating Disorders and Over-Exercise in Collegiate Recreation (Part I):

A Reflection on the Last 15 Years

Adrian A. Shepard, MS, RCRSP

Recreation Management Program Faculty, Madison College

The following information has been inspired by and extracted from the 2014 NIRSA Annual Conference & Exposition presentation, Eating Disorders and Over-Exercise: Reflection on 15 Years of Experience, conceived by the late Karen Miller from the University of Nebraska-Lincoln and presented by Cathy Jewell from the University of Nebraska-Lincoln, Katie Kage from the University of Northern Colorado, Jill Urkoski from the University of Kansas and Adrian Shepard from Madison College.

Editor’s Note: This is Part 1 of a two-part series.

Collegiate Recreation has evolved from primarily intramurals and club sports to include aquatics, outdoor/challenge education, fitness, wellness, environmentalism and sustainability. With this growth comes great opportunity for recreation professionals to expand their knowledge and help meet the emerging needs of those they serve on a holistic level.

Research continues to show the positive impact Collegiate Recreation has on student recruitment, retention, academic performance, life skills development and wellbeing. However, this opportunity to impact others isn’t without challenges. In particular, (especially in fitness and facility operations), understanding what steps to take when there is a concern for students who may be struggling with high-risk behaviors such as eating disorders and over-exercise. Eating disorders have the highest mortality rate of any mental illness, and according to the U.S. Department of Health and Human Services, 95% of those with eating disorders are between the ages of 12 and 26. The Renfrew Center Foundation for Eating Disorders found that of this population, nearly 25% of college-age women engage in bingeing and purging as a weight management technique.

Contrary to popular believe, such behaviors aren’t limited to females as 10-15% of males struggle with anorexia or bulimia (Carlat and Camargo, 1997). Research also indicates that over one-half of females and nearly one-third of males attempt to control their weight by skipping meals, fasting and taking laxatives (Neumark-Sztainer, 2005). Media and perception complicates matters by reinforcing unhealthy behaviors as the body type portrayed in advertising as ideal is possessed by just 5% of American females (Renfrew Center Foundation for Eating Disorders, 2003). As people attempt to lose weight, 35% of “normal dieters” progress to pathological dieting. Of this population, 20-25% progress to partial or full eating disorders.

As a result, campus personnel have dedicated more time and effort towards identifying program participants and recreation facility patrons who could be at risk (Shisslak, C.M., Crago, M., Estes, L.S. 1995).

A 1998 study expounding upon exercise behavior and reasoning conducted by Miller et al. centered on a survey administered to campus recreation participants with the hypothesis that colleges would be a place for primary and secondary prevention of eating disorders. Four distinct groups emerged including:

  • Low-weight wanting to lose more weight
  • Those wanting to bulk up
  • Medically obese with the desire to lose weight
  • Normal weight wanting to lose weight

Findings indicated approximately 12% of respondents met the criteria for Anorexia Nervosa and 24% were labeled at-risk for eating disorders. Therefore, conclusions and recommendations suggested chronological steps to aid in primary and secondary prevention of eating disorders such as:

  • Identify the problem
  • Educate all staff
  • Work with other campus entities in prevention and intervention process
  • Develop a policy
  • Use qualified professional staff

Furthermore, a 2009 North American study, supported by the NIRSA National Center, conducted by Shepard et al. set out to gauge the need for and interest in best practices for addressing instances of over-exercise and eating disorders in the campus recreation setting.

Additionally, the study identified barriers institutions face when posed with scenarios related to such situations. Study results were as follows:`

  • Seventy-eight percent of respondents indicated the potential for collaboration within their own division;
  • The primary barrier was knowledge of the subject matter;
  • Ninety-eight percent of respondents agreed or strongly agreed that best practices for addressing instances of over-exercise and eating disorders would help their department.

Part 2 in the series addresses the scope of practice and the role of the recreation professional in the initial intervention process, and the collaboration with qualified campus personnel.



Carlat, D. Camargo. (1997). Review of bulimia nervosa in males. American Journal of Psychiatry, 154.

Miller, K., Horacek, T., Dodge, A., Cox, N. (1998). Eating disorders and over-exercise: how should campus recreation respond?. Recreational Sports Journal, 22(4), 8-21.

Neumark-Sztainer, D. (2005). I’m like, so fat! New York: The Guilford Press, 5.

The Renfrew Center Foundation for Eating Disorders (2003). Eating disorders 101 guide: A summary of issues, statistics and resources.

Shepard, A. (2011). Campus recreation in the 21st century: addressing over-exercise and eating disorders. Risk Management for Sport and Recreation, 6(2), 5-8.

Shepard, A., Barnes, A., Click, S., Peden, S. (2011). Assessing over-exercise, anorexia, and bulimia in campus recreation. Recreational Sports Journal, 35(1), 55-60.

Shisslak, C.M., Crago, M., Estes, L.S. (1995). The spectrum of eating disturbances. International Journal of Eating Disorders, 18(3), 209-219.

Sullivan, P. (1995). American Journal of Psychiatry, 152(7), 1073-1074.


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