One of ECHO's greatest concerns is compulsive exercise, which is a common form of bulimia among Harvard students. Instead of purging to get rid of food in their systems, compulsive exercisers turn to intensive workouts.

According to the survey, 13 percent of women and 5 percent of men defined themselves as compulsive exercisers and 25 percent of women said the main reason for their exercise is weight control.

"It can get extreme and dangerous," an ECHO counselor says. "I had a friend who was a compulsive exerciser, and she would just go running all of the time. It becomes all consuming."

The second co-director cautions that while it is wonderful for people to want to exercise, when the thought of missing a day is inconceivable, something is wrong.

"When it becomes an extra burden rather than a joy, that's not a healthy restriction," she says.

The tension that surrounds food and exercise is an important topic to ECHO counselors, even though it may not fall under the traditional definitions of eating disorders.

"People can call us for a huge variety of issues," she says. "People don't think they can call if they want to talk about their friend, or gaining weight instead of losing weight."

Reacting to the Individual

Whatever students' concerns may be when they call, ECHO has a wide range of methods to help.

"We might run through a role-play with them. Some people talk to us for two hours," one of the counselors says. "If you wanted to talk to your roommate about it, try it out on me."

ECHO staff members say they let the callers and visitors explain their situation and then tailor advice to the individual.

Conversations often focus on finding professional help. If students need more than their peers, ECHO has referral numbers and can give callers medical information on various disorders.

ECHO staffers say their counseling is supportive but it is just a first step in getting more help.

"Our rule as a hot line is to be for anyone who needs someone to talk to. On the other side of a hot line you can't change anybody, but you can help them identify a feeling they've had but haven't put a name on," a co-director says. ECHO can help students make decisions, but can't make those decisions for them, she adds.

"It depends on what they're looking for. For some people, you just listen. You don't say much except to assure them that it's okay," the other co-director says. "If someone's looking for help we coach people through. It isn't formula."