Little white scars litter Rachel’s body, reminders of sadness, anger and confusion. She has a few new marks, too; a long red scab runs up her forearm and several smaller nicks and cuts are peppered across the tops of her hands.

Rachel, an Iowa State sophomore, also makes herself vomit, a common eating disorder called bulimia. Disorders like Rachel’s are drawing national attention this week, designated Eating Disorder Awareness Week.

When asked about the marks and her eating habits, Rachel, who’s identity is being kept confidential, brushes it off.

To her, cutting her body and making herself vomit is no big deal. “It’s just the way I deal with things. This is just me,” she said. “I think it started around ninth grade. In eighth grade I would try to go three days without eating anything, but I couldn’t do that and I’d end up eating a whole bunch. By ninth grade I was making myself throw up.”

Rachel doesn’t like to talk about her problems. Most of the time she tries to make a joke of them, or delay a response. Rachel doesn’t want other people to notice; she doesn’t want them to worry about her.

“It’s not like I’m doing permanent damage or anything. I wouldn’t consider this really hurting myself because it’s going to go away. The cuts are going to heal,” she said.

Rachel began cutting herself when she was a senior in high school.

“I did it because I hated myself,” she said. “Afterwards, I’d feel like I’d accomplished something or won some how. I do it usually because there was something I couldn’t stop thinking about and I’d just go crazy. I’d pull my hair out and bite my fingers.”

After a while, she began using razor blades. Rachel claims it doesn’t hurt much. She tries to put the cut marks in places where others won’t see.

But Rachel’s story may be somewhat unique. Experts say body mutilation isn’t necessarily connected to an eating disorder.

Nonetheless, Rachel’s problems are surprisingly common.

“Eating disorders are a big problem. Some studies indicate that about 80 percent of all women are dieting and dissatisfied with their bodies. It’s unacceptable that that many people are suffering from being unhappy with their bodies,” said Suzanne Zilber, a psychologist at the Student Counseling Service.

Zilber and Brooks Morse, another Student Counseling psychologist, host an eating disorder group every Monday night. Discussions focus on self-esteem, family issues, trust and dealing with feelings and relationships.

Rachel said when times were particularly bad, she would vomit a few times a week.

“Sometimes I’d do it even when I hadn’t eaten a whole lot. I’d do it just because I was so upset,” she said. “I’d feel mad or sad or someone had been mean to me. I’d just hate myself. I’d feel like I had to do something, but not to them.”

Rachel began seeing a therapist after her friends wouldn’t let her brush off their concerns any longer. Her eating disorder eventually came out in therapy.

“I went to a therapist for about four months, and she didn’t help. I’d lie to her and tell her that everything was fine and I didn’t do that kind of stuff anymore,” she said. “There’s nothing for me to talk about. I mean, what can they do? They can’t tell me something that’s going to make it all get better. This is just how I deal with stuff. It’s just me.”

Denial is often a problem, Morse and Zilber both said, and something people sometimes struggle with even while in therapy.

“Once the person is ready to work on the issue they can get help and recover. They can stop,” Morse said. “Counseling can help when a client is ready to be helped. In counseling you learn other ways of dealing with negative feelings other than cutting or purging.”

Eating disorders, like Rachel’s, are especially prevalent on college campuses.

Rachel said when she looks at herself in the mirror she sees a fat person. It doesn’t matter that no one else thinks she is fat. It doesn’t matter that other people think she is beautiful, intelligent, caring and funny.

“Being fat is like being in the lowest class in America. In some ways there is nothing worse than being fat. One of the worst things one guy can say to another is, ‘eeewww, you went out with a fat girl?'” Rachel said.

But Rachel said she realizes she has unhealthy eating patterns.

“A lot of times I eat too much. I eat until I’m about to f – – king explode. I eat until I feel like I’m going to puke,” she said. “I eat what tastes good, not necessarily what is good for me, and that just makes me feel worse.”

Rachel’s mind set, Morse said, is not unique.

“Eating disorders are real ineffective ways of weight management. By purging you don’t get to keep any of the nutrients, but you do keep the calories because most of them are absorbed by the time you purge,” Morse said.

Rachel has stopped seeing her therapist but she hasn’t stopped cutting herself and making herself throw up.

She is reluctant to go back into therapy. Rachel is convinced she doesn’t have a “real” problem.

“I don’t want to be one of those people who creates problems for themselves. I want to keep it to myself. I just don’t see it as that big of a deal, I guess,” she said.

But Morse said an eating disorder is a big deal, and it can happen to anyone. There are, however, several personality characteristics that people with eating disorders often have.

“Many have an all-or-nothing way of thinking. They are perfectionists and many have low self-esteems. But I consider an eating disorder a bio-psycho social issue. I believe there are four components,” Morse said.

“One is biology. It comes into play when the person is dieting and starving themselves. Another is culture and the attitudes we have about body size and products like dieting aides,” Morse added. “The psychology of the person and how they deal with issues in their life is part of it, and the last is the social aspect. That may include their family and events in their life.”