Transitioning to college when in recovery from an eating disorder can be challenging. While most young adults relish the freedom and independence inherent in moving away from home the additional stress of being away from loved ones and trusted treatment professionals can be detrimental for those in recovery from an eating disorder.
A longitudinal study published in the International Journal of Eating Disorders in 2001 concluded that the symptoms of disordered eating and attitudes towards body image and food were established in most individuals with an eating disorder before they went to college. The researchers also noted that dieting behaviors and low self-esteem were common amongst many young people both prior to and during college. Whilst it is true that eating disorders emerge for many individuals who are predisposed to them when they first move away from home and attend college, there is also consideration to be given to the sufferer in recovery that is embarking on this stage of life.
Parents/caregivers and sufferers in recovery should begin planning for the college departure as far in advance as possible. It is preferable that the sufferer is fully weight restored before they go. They should also be able to eat with minimal supervision in a variety of settings. Eating disorder behaviors such as bingeing, purging, and overexercising should be under control. If you are a parent and there is any doubt in your mind that your child is not in a good psychological or physical state to embark on moving away to college you should encourage them to wait. A student with anorexia nervosa should have been eating properly and independently for at least six months prior to going away to college.
If you are a parent of a teenager who is in recovery from an eating disorder, or if you are a recovering sufferer yourself, making a detailed safety plan might help you move safely through the transition to college life. The plan should cover the following points:
- A signed contract from the person in recovery and the parent/ caregiver that states that during the college term times that are spent away from home the person in recovery will continue to prioritize their recovery and adhere to the agreed treatment plan. This should cover regular mealtimes and food consumption, appointments with treatment providers and check-ins as agreed. The contract form of agreement is often an effective tool to help people in recovery make sure that they do not grow complacent with their recovery efforts. Complacency can lead to relapse and sufferers should understand that the contract is designed to help them through their recovery rather than to put pressure on them.
- The person in recovery should sign a release form that allows their information to be shared amongst the college health centers and their caregivers/ parents.
- Assuming that the person in recovery is weight restored when they leave for college, arrangements need to be made for a bi-weekly weigh-in so that a check can be made for any signs of weight loss. A college doctor or nurse might be available to facilitate this, but it is preferable that you find a local specialist in eating disorders. University services alone may not be equipped to deal with eating disorder related treatment and you should make sure that you have the situation covered before the term starts. It should be pre-agreed that this weigh-in result will then be communicated to the parent or caregiver at home. Moving away to college is a very stressful transition for many and the potential for weight loss, even if not intentional, is large. The person in recovery should agree before leaving to have regular weight checks.
- A daily plan for extra-curricular/self-care activities such as yoga can be beneficial and should be looked into before the term starts.
- There should be a planned and pre-agreed protocol should weight loss or relapse occur. Preferably caregivers and the person in recovery should agree that the individual will withdraw from college and return home should any weight be lost or should relapse occur. For a person who is recovering from an eating disorder, any amount of weight loss can trigger a relapse and this should always take priority over college grades and term times.
- Communication is key. Those in recovery need to understand that they are not suddenly on their own when they leave home, and that they can talk to parents, caregivers and friends with regularity. Parents need to learn that once the necessary checkpoints are in place they can trust that their son or daughter will continue to succeed in recovery.
With a good amount of pre-planning, relapse potential can be lessened and both parents and recovering sufferers should be able to relax with the understanding that there is an extended support system in place. Should any signs of distress become apparent, the college student should return home; college can wait and the health of the individual should take priority over education.
Written by Tabitha Farrar – 2014