At the University of Arizona's Campus Health Service, Gale Welter Coleman helps students battling eating disorders. It's something she feels passionate about, having dealt with these issues in her personal life for many years.
"I definitely was disordered," she said. "I wasn't full blown but yeah, personal background in lots of obsession with what am I eating, is it too much? Is it too little? How much am I exercising? Too much, too much, too much."
Now she works with a team of professionals to help students on campus. But many students come to college already dealing with these issues.
Arizona ranks second in the country for teens who have purged or used laxatives as a form of weight control, according to a 2013 survey by the Centers for Disease Control and Prevention.
The national average for this type of eating disorder among teens is 4.4 percent, Arizona's average is double that at 8.8 percent.
The same survey showed that the average percent of Arizona teens who admitted to not eating for a 24 hour period to lose weight or keep from gaining weight was 15.6 percent. The national average is 13 percent.
And our climate may have something to do with it.
"I think it's a factor," said Dr. Dianne Keller of the Sierra Tucson treatment center. "You know when you live in a place that has summer for six or seven months out of the year, where you're running around in summer clothing for over half the year, you're a little more exposed to people, are a little more body conscious."
Sierra Tucson has a 30-day eating disorder program that Keller says is extremely comprehensive. It includes meeting with nutritionists, personal trainers and even psychiatric care.
Keller also says eating disorders may be spreading to minority populations, and that could be a factor in Arizona's high numbers.
"We used to think of this as a little more of a Caucasian or Anglo issue," she said. "What we're seeing is there's a bit of a culture clash now. So children who were raised in non-white homes are starting also to kind of want to fit in with their peers, where previously they may have felt very comfortable in their bodies within their family situation."
Coleman says typically, the goal of achieving a certain look will only lead to losing your looks as your health diminishes.
"You're going to be injuring your GI tract, you're going to be dehydrated, you've got a lot of wear and tear on your esophagus, you've got electrolyte imbalance," she said.
Coleman says the UA has severalbody smart initiatives to help students battling eating disorders, or to prevent students from developing a disorder. They are also working on a Healthy Body Image survey.
Keller says comprehensive programs like the one offered at Sierra Tucson can help a person recover from eating disorders but often she says parents and family members can take that first step by starting a conversation.
"It lets them know that later they can come to you about that," she said. "And that's one of the most important things you can do as a parent is put it out there."
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If you or someone you know is battling an eating disorder, there are resources out there to help.
Sierra Tucson treatment center (18+): 877-959-8896
For UA students, call Counseling and Psych Services at 520-621-3334
For additional clinics and treatment centers, click here.
