By Morgan Chapman
Alexa Casciano is a vibrant and dedicated student at UNC-Chapel Hill, who appears to have everything together. However, she fights internal demons every day regarding her body image.
At 16, she was diagnosed with an illness that led to a double lung reconstruction and brain surgery. Her recovery came with consequences. While in the hospital, Casciano lost her appetite and was losing weight fast.
Her relationship with food after leaving the hospital was forever changed. In the fall of 2021, Casciano was diagnosed with anorexia, bulimia and binge eating disorder.
“It was the triple whammy,” Casciano said.
After waking up at 7 a.m. to work out, she wouldn’t eat all day. Then at night, she would binge.
“After I had a really big binge, I would go on a scale to weigh myself,” she said. “Then I would freak out when I saw the pounds I gained and would make myself lose it the next day.”
Last year, her parents sent her to a nutritionist after noticing her struggle with eating disorders. The nutritionist was worried about Casciano’s condition and recommended an eating disorder specialist.
Her heart was failing. Her hair was falling out. Her Vitamin D levels were low, and the osteoporosis in her back was getting worse.
“My body was functioning, and I looked fine; but I was slowly dying on the inside,” Casciano said.
Typically, people diagnosed with an eating disorder are sent to a residential treatment facility. Casciano’s treatment plan was unique, because she didn’t spend her fall semester in a treatment facility. Instead, her parents stayed with her for two months in Chapel Hill.
“As a junior in college juggling the pressure of the Kenan-Flagler Business School, I was stressed out about having my classes in person after a year being virtual,” she said. “I would eat all my meals with my parents, making sure that I was putting enough food into my body.”
The earlier you catch an eating disorder, the easier it is to get out of it, Casciano said.
“The last thing you need to be worrying about in college is gaining 5 pounds,” she said.
The college routine of studying, exercising and partying obstructs an important need for a healthy lifestyle: eating.
Courtney Lewis, a clinical instructor at the UNC Center of Excellence for Eating Disorders, said college is a pressure cooker for developing eating disorders, especially for teenage girls.
“Going away to college is probably the first big change for a lot of people,” Lewis said. “You are faced with many pressures like setting your own structure, supporting yourself, eating on time, getting to class and studying.”
Wake Forest University’s student body has higher than average reports of disordered eating, according to the University Counseling Center’s latest Healthy Minds survey and American College Health Assessment data.
“There was unspoken pressure,” said Olivia Yabroudy, a UNC-CH student who transferred from Wake Forest. “It depended on how you perceive yourself. There are a lot of people walking around that are very skinny, wearing revealing clothes that make it evident they do not weigh a lot.”
Yabroudy said it is easier to fall victim to the mindset of trying to look like everyone else. She watched female students eat just a piece of toast or an apple before events to get drunk quicker and avoid looking bloated.
The University Counseling Center at Wake Forest did not advertise its services for eating disorders, which perpetrated the campus-wide problem. Yabroudy even said she wasn’t aware of eating disorder support on campus.
Lewis said the negative internal talk stems from the fear of gaining “the freshman 15.”
“This fear is doing more harm than good, because it distorts how people view their health and body image,” she said. “It becomes a very stressful cycle that many find extremely difficult to break.”
‘Spirals into a compulsive obsession’
During the COVID-19 pandemic, eating disorder diagnoses in teenage girls have skyrocketed. The UNC Center of Excellence for Eating Disorders received a 40 percent increase in calls since the start of the pandemic. Additionally, some of those with preexisting eating disorders experienced worse symptoms.
Many found themselves eating more while isolated and gaining, as Casciano calls it, “pandemic weight.” Eating disorder treatment depends on distractions, especially in the beginning. Lewis said the pandemic robbed people of those common distractions.
Many turned to social media as a coping mechanism during the pandemic, but the standard of beauty it promotes is often unattainable and unrealistic.
“I would post pictures of myself on Instagram while I was struggling with disordered eating. If someone said, ‘Oh my god, you look so skinny,’ then that would trigger me to keep myself looking that way by not eating,” Casciano said.
Jean Doak, psychologist and clinical director at the UNC Center of Excellence for Eating Disorders, said increased social media consumption is a cause of eating disorders in teenage girls.
“When I ask someone what the onset of their eating disorder was, many people say they were on TikTok or on YouTube watching videos on how to exercise and lose weight,” Doak said. “It starts pretty innocuous but then spirals into a compulsive obsession.”
‘You can’t sacrifice your health’
“Your body is the least important thing about you,” Casciano said. “You have to emphasize that there are so many other qualities that make you a great person.”
Alexa Casciano is grateful to be alive and healthy. She took away vital lessons from her eating disorder recovery. She encourages those struggling with eating disorders to reach out for help.
“You can’t sacrifice your health, happiness, or quality of life,” Casciano said.
Edited by Samantha Driscoll and Zachary Crain