Helping Your Child Navigate College in Recovery from an Eating Disorder

This February will mark an amazing anniversary of three years for our son’s recovery from an eating disorder. It started at just 12 years of age. After four residential stays and months of missed school, holidays and activities, it is still met each year with anxiety for my husband and me.

As we spent his senior year, last year, we relied heavily on his care team comprised of his therapist, our family therapist and dietician to help guide us through the college selection process. Questions plagued us daily. How far should we let him go away? Should we take a gap year and have him stay local? Should he attend a local college? How do we ensure recovery sticks? How do we set up him up for the best possible success to continue his healthy journey, ED-free?

We spent many months pondering and preparing for his current freshman year in college. Some of the steps we took were critical to continue his recovery path and help him matriculate into living on his own and taking care of himself. Once we got comfortable with the behaviors he was exhibiting ED-free, and his commitment to go away for college, we went into planning mode. He decided to attend a university thousands of miles from us, not far from where he had been in residential treatment. There was a familiarity there and a comfort in the space he wanted to call his new home.

Some of the steps that can help set your child up for success are the following:

• Hire a care team in the area the child is attending college. Make sure to have a therapist and dietician so there are frequent touch points and weight checks.
• Take a trip out a few months before college starts to meet the care team and set up expectations with your child. If physical travel is not possible, then Skype or Face time can be a great option.
• Have your child sign releases so the care team can speak to you. This is a vital point. I have many parents tell me their child is 18 and refuses. Our rule was simple. If you want to attend this university, you need to sign releases so there are guard rails to protect you and alert us if you are sliding or having any sign of a relapse. Not signing was not an option. We also had releases signed so his college care team could contact his hometown care team and vice versa. Having a connected team is great support and allows everyone to be on the same page.
• Have discussions about the transition with the hometown care team months before the child leaves for school. Dialogue about fears and behaviors and set up plans over the summer prior to model what the experience will look like. We had our son practice meal planning and we talked often about feelings over leaving. We also reviewed situations that could arise and discussed possible solutions.
• Once the student is there, ensure the first appointment is preset with the therapist and dietician before you drop them off. This sets the pattern of behavior you expect on day one. It also gives them a place to go when they are anxious or adjusting to their new life.
• Make sure to have your child see their local therapists over holidays. This again allows continuity and keeps them committed to their recovery plan. This should continue over the summer as well.
• If they are on medications, see if they can have them filled on campus at a local pharmacy. Set up monthly pill organizer to ensure they stay on track. Start this at least three months prior to them leaving so habits get started under your care.
• Walk the campus to understand the pattern of activity daily. How much walking will there be? Set up a meal plan that accommodates this prior to saying goodbye.

These steps are so critical to ensure your child has a support team there to catch them if they slip.

Even doing all these things, we had some days that frightened us. In the first three months, our son started to have some weight loss due to so much walking on campus and not overcompensating with snacks and meals for the calorie burn. This is normal, as any child adjusts to campus life, but we never had talked about it or pre-planned for it. In just a short time, he contracted bronchitis, got homesick and knew he had lost weight. ED
was knocking at the door validating potential failure and tempting him back.

Because we had this tight-knit care team, we were notified immediately. He also used his skills and called us saying he was scared and wanted our help. We went to our son, spent time talking and deconstructing his days to try and figure out what was out of line. We had food products ordered in to help him with planning meals and snacks. We reached back to his home town dietician for a conference call and guidance. He needed help working out how to get all his meal plan in during very busy days.

He quickly realized as he got better that the life he was living was the one he wanted to protect and fight for. In a few short weeks, he was back to restoring his weight loss. He just needed that support from us. Over the holidays, we reinforced his good behaviors and he went back the second semester ready to go.

The lesson in all of this is even when you put all the guardrails in place, the eating disorder will never fully be gone. In tough times and times of stress it is just a step away. You are never done working on recovery from the patient’s side or the parental side. Those safeguards are key. Your hope is that with life experience, support and maturity the child
continues to thrive and stay recovery-focused. With support and a solid plan, success is possible for this huge life transition.

Editor’s note: This story has been published with permission from the author’s son.