By: Mona Farahbakhsh, Dietetic Intern Reviewed by Dina Skaff, Registered Dietitian, Certified Intuitive Eating Counselor
*Content Warning: mention of potential triggers, numbers implying weight/weight gain.
As a loved one grows up and starts planning for college or university, you may feel excited and proud, but also nervous. Having a loved one with an eating disorder may add additional concerns and apprehensions about how and when to prepare for this transition. Each individual’s journey is unique, and there is no “right time” or “right approach” to prepare for this transition. However, by planning ahead and helping your loved one develop tools to promote their health and wellness, starting college or university may feel more manageable for both of you. This blog post explores considerations and strategies to help support your loved one during this transition.
Is Your Loved One Ready for this Transition?
Starting further education can feel exciting, but it can also feel very stressful. The transition may feel too difficult for some who are on a healing journey. Adding stressors can hinder the healing process. For some, it can trigger past behaviours and add additional challenges during recovery.
Before the big school transition, it is important to reflect on where your loved one is on their path to wellness, and if they’re ready to make this change. You will need to consider how your loved one could react in certain situations. Things that feel natural for many people may feel difficult for someone with an eating disorder. They may need to navigate situations like a busy dining hall, eating without support, or a roommate who owns a scale. These are just a few scenarios that your loved one may encounter which could present challenges. The following resource, Transition to Campus Life Assessment Checklist, may be a helpful tool during your reflection.
Challenges on Campus
Campus life can be fun, but it can also be difficult and unpredictable. Individuals leave familiar aspects of life and must adapt quickly. They face increased pressure by “fitting in” with peers, excelling in classes, and adapting to a more independent lifestyle. New experiences, lack of sleep, dramatic changes in routine – all of these experiences can contribute to stress and lead to overwhelm. Some might feel a loss of control, which can put an individual living with an eating disorder at increased risk of relapse.
Preparing for Postsecondary
If your loved one is ready to head off to college or university, it can be helpful to support them in preparing for this transition. As an analogy, think about houseplants. They thrive indoors, in nourishing soil, with just enough light and water. Now imagine you took a houseplant and moved it outside. During this transition, some of the nourishing soil fell out of the pot. Outside, there is too much light, and it’s too hot. You’re not able to water it as often and it becomes dry. Little pests start to chew on its leaves. The plant begins to wilt and needs more support and nourishment. Imagine if you considered what the plant might need before the transition. So instead, you added fertilizer to the soil before moving it. You added a cover to protect the plant from the sun and pests. You set up an automatic watering system and left stakes for the plant to lean on if it needed extra support. The plant may still feel stressed in the unfamiliar space, but it is better prepared for the transition and, hopefully, will continue to blossom.
It’s important to use this same thinking when helping a loved one prepare for a big transition, like attending college or university. There are three steps that can be helpful:
There are many high-stress situations associated with starting school. When situations are unexpected, they can be more difficult to handle. To better prepare for these high-stress situations, you and your loved one can come up with a list identifying potential stressors. These will be unique to each individual and could be general situations associated with higher education, like attending a busy lecture or writing a midterm. For those recovering from an eating disorder, it’s also important to consider nutrition related stressors like eating in a busy dining hall, unfamiliar food choices, or lack of in-person meal support.
It’s also a good idea to predict potential triggers. Triggers can lead to negative or critical thoughts, which can cause unsafe behaviour. Triggers will be different for everyone. Hearing their peers talk about the “Freshman 15” could trigger some. Seeing certain foods in the dining hall or trying on new clothes could trigger others.
After predicting potential stressors and triggers, the next step is to create a plan. A plan can help reduce uncertainty and give your loved one a greater sense of security. Plans should focus on ways to support your loved one during this transition and be tailored to their individual needs. It could include a list of people that your loved one could connect with for various types of support, focusing on supporting their nutrition and wellness. The plan could indicate the predicted stressors and list corresponding actions caregivers can do to help support their loved one’s needs. For example, if your loved one predicts that they will struggle with meeting their nutritional needs, a support person could plan to send meal and snack text reminders, prepare snacks, or create meal plans based on the cafeteria menus. If your loved one predicts they will experience high levels of stress when eating in a busy area, a support person could plan to video call during meals, research to-go meal options, or help to find quiet places to eat on campus. If your loved one predicts that they could feel triggered by a “Freshman 15” conversation with peers, the plan could list ways for your loved one to change the conversation topic or text a support person to help them leave the situation. Creating and following a plan that focuses on supporting your loved one’s needs and prioritizes their nutrition, health and wellness can be a helpful tool in preventing a relapse.
Follow the plan carefully and consistently. Whether the plan includes planning out meals and snacks based on class schedules, having text check-ins during meals or sending health appointments reminders, be available, present, and patient with your loved one. Have frequent check-ins with your loved one as they explore campus life. Communicate with love and care and be supportive, understanding, and open-minded. Your loved one will be less likely to open up if they feel judged, neglected or guilty. Affirm their qualities and abilities (that are unrelated to food or physical appearances). Encourage them and make sure they know you care, value, and love them. Remember, nothing matters more than your loved one’s safety, health and wellbeing.
Selecting a Supportive School
It’s worthwhile to consider the services available on campus to make sure that your loved one can receive the support they need. When choosing a school, you and your loved one may want to reflect on things like health and wellness services available to students, the distance the school is from home, if your loved one has friends or family attending the school, the residence rooms available and meal plan and dining hall options. Depending on the needs of your loved one, different factors will need to be prioritized. For some, choosing a school close to home comes first. For others, meal plan options or types of rooms in residence could be their primary concern. Discussing these factors with your loved one and their care team can help with making a suitable choice.
The transition to university or college can be a big life change leading to increased stress. As there are correlations between life changes and eating disorder relapse, it is important to ensure your loved one is prepared and supported during this transition.
A few key points when considering this transition include:
Determine if your loved one is ready for this change. Someone’s readiness depends on many individual factors. Recognize where they are in their recovery when considering if it’s the right time for this transition.
If your loved one is ready, advanced planning can help support their success during the transition to further education.
When choosing a school, consider the services available to students to make sure that your loved one can receive the support they need.
Remember, everyone’s journey is different. Some people may be ready to leave the nest and begin further education immediately. But this doesn’t mean it’s the right time for everyone. Many songbirds leave their nest before they can properly fly. Hawks wait until their wings are developed before taking off. Despite this, both birds are excellent flyers.
If you or your loved one are looking for support to prepare for the transition to campus life:
Conroy, C. (2003). Suddenly Semestered: Food & Weight Concerns on Campus . NEDIC. Retrieved February 27, 2023, from https://nedic.ca/download-file/1559579929.887003-89/
FREED, Eating Disorder Service. (n.d.). Preparing for University: A guide for Those Recovering from an Eating Disorder. FREED. Retrieved February 27, 2023, from https://freedfromed.co.uk/img/guides/Preparing_For_University-FREED.pdf
Keffer, K. (2023, February 6). How long do baby birds stay in the nest and more bird nests facts. Birds and Blooms. Retrieved February 27, 2023, from https://www.birdsandblooms.com/birding/attracting-birds/bird-nesting/how-long-baby-birds-stay-nest/
Kelty Mental Health Resource Center. (2016, September). Parents Survive Thrive Guide - Kelty Eating Disorders. Kelty Eating Disorders. Retrieved February 27, 2023, from https://keltyeatingdisorders.ca/wp-content/uploads/2016/09/BCMH026_EatingDisorder_FullGuide_v6-Web.pdf
Morris, J., & Nahman, C. (2020). Chapter 12 - Transitions. In New to Eating Disorders (pp. 84–92). essay, Cambridge University Press.
Muhlheim, L. (2015, October 19). Is your young adult with an eating disorder ready for college? Eating Disorder Therapy LA. Retrieved March 2, 2023, from https://www.eatingdisordertherapyla.com/is-your-young-adult-with-an-eating-disorder-ready-for-college/
Ravin, S. K. (2014, June 5). Guest Post: Relapse Prevention. FEAST. Retrieved March 2, 2023, from https://www.feast-ed.org/guest-post-relapse-prevention/
Sclisizzi, K., Wilton, K., & Jasper, K. J. (2014, February). Managing Triggers while Recovering from an Eating Disorder. NEDIC. Retrieved February 27, 2023, from https://nedic.ca/download-file/1540817057.908429-52/