I recently spoke at the University of Kentucky College of Law and Emory School of Law. At the beginning of the talk as I always do, I provided my “résumé of dysfunction.” Part of that résumé, in addition to problem drinking and drug addiction, is my recovery from eating disorders.

I struggled with both traditional and exercise bulimia for over 20 years. I spent my three years at Pitt Law knee deep in bulimia, wrapped around severe body image issues and Body Dysmorphic Disorder.

While at Pitt Law, I was binging and purging sometimes multiple times a day, while also running excessive distances for the sole purpose of offsetting any calories I had eaten that day. These behaviors were more important to me than class or grades. You, however, would have not known that I had an eating disorder at a glance. I was of “normal” weight by accepted metrics. It is a myth that eating disorders can be diagnosed solely by appearance. There are many different types of the disorder and symptoms, not just the stereotyped image of the emaciated man or women with ribs showing.

During the events at Kentucky and Emory Law, when I stated that I was in recovery from bulimia, I saw expressions change and knew for some, I was the first male they had ever seen, in-person, talk about having an eating disorder. When I asked if that was the case, multiple hands went up. I then stated that eating disorders have the highest mortality rate of any psychological illness. It was the first time many had heard this statistic. These reactions are not unusual. Eating disorders are often seen by the general public as mysterious and something only women experience.

Eating disorders are also generally not at the top of the list in terms of what we deal with on a day-to-day basis in law school, even though we know statistically that students deal with it. A recent study of mental health issues in law school published by the Journal of Legal Education found 27% of law students (18% of male respondents and 34% of female respondents) screened positive for eating disorders. Yet only 3% of respondents had actually been diagnosed.

It is not just the most well-known eating disorders that students may be struggling with. Binge Eating Disorder is on the rise. Maybe a law student is substituting alcohol for food on a regular basis (which I did), which can be a type of eating disorder known as “Drunkorexia.”

These are disorders that required trained professionals to screen for and diagnose. While many universities have such professionals who screen for eating disorders and organizations that raise awareness, this is generally not the case with law schools. Nor should we expect this. While we want to be able to notice things and have options available when we do, it is simply not realistic to expect faculty and administrative staff to be knowledgeable in every mental disorder out there.

What we end up seeing as a result, however, are only the most extreme, weight loss-based cases being noticed by staff, professors, and classmates. We also have the intertwined issues of a highly driven population in which healthy relationships with food and body image are simply not “on the menu,” so to speak. Why is this so important for law schools to address on some level? We know that the longer an eating disorder goes on, the harder it is to successfully treat. I am definitely an outlier in successfully going into recovery in my mid-40s.

So what can law schools do? The first thing is to understand that eating disorders are not just defined by appearance, they are defined by many different types of behavior. If there is a larger university in the mix, be sure to understand what they are doing with regards to eating disorder screening and awareness and be willing to be a part of that conversation. Have an eating disorder point of contact with the larger university. If it is a standalone law school, talk to someone in the medial professional/counseling community about how to better understand the issues so at a minimum, some tools can be given to the law student population. With more knowledge, comes expanded ability to identify issues.

When you are talking about a law student “wellness week,” make this part of the discussion in a non-threatening way. Wellness encompasses so many things including a healthy relationship with food, with our bodies, and understanding that the stress of law school and the practice of law can be a strong trigger for destructive relationships with food possibly leading to eating disorders.

Finally, if you are a Lawyer’s Assistance Program that allows law students to participate, what are you doing to be sure you are up to date on the latest eating disorder information, so you do not get caught up in stereotypes and misinformation? This is pure speculation, but my guess is that if I went to many assistance programs and asked what their current understanding is, there is a very high probability that it will be not a lot, or based on outdated literature. Reach out out me and I will point you to the current data and science.

February 26th begins Eating Disorder Awareness Week. Let’s take a little time to think about these issues and how we can do better to include them in the law student wellness conversation. One of the deadliest symptoms of eating disorders is silence.

Eating Disorder Resources

Brian Cuban (@bcuban) is The Addicted Lawyer. Brian is the author of the Amazon best-selling book, The Addicted Lawyer: Tales Of The Bar, Booze, Blow & Redemption (affiliate link). A graduate of the University of Pittsburgh School of Law, he somehow made it through as an alcoholic then added cocaine to his résumé as a practicing attorney. He went into recovery April 8, 2007. He left the practice of law and now writes and speaks on recovery topics, not only for the legal profession, but on recovery in general. He can be reached at brian@addictedlawyer.com.