By Nikki Rollo, PhD, LMFT

It’s that time of year again. Summer is in full swing, but Fall is right around the corner. Late August and September brings with it the ritual of students returning to high school and college campuses. For some students this can be an exciting time of reconnecting with peers, meeting new teachers, getting new supplies and clothing, signing up for clubs or trying out for sports.

For those students who have either spent the summer in treatment or are working on recovery from an eating disorder, the return to school may have quite a different meaning. As September approaches, these students may be filled with worry and concern about those very things that others may find exciting such as:

  • Peers and Socializing (will I fit in? will they wonder where I was all summer? Will they notice what or how much I am eating? How will I explain what is going on with me?)
  • New Clothing (will my clothes fit? will people notice changes in my weight?)
  • New Teachers (do I need to explain what is happening with me? Will I need to enlist their support?)
  • Clubs (what if I don’t have time for clubs because I need to attend my therapy and nutrition appointments and be sure I stay on my meal plan?)
  • Sports (can I participate in sports? Am I well enough? What will it mean to take time off?)
  • Cafeteria or Dining Hall (will the choices be overwhelming for me? Should I pack my own food? How will I plan to make appropriate selections and complete my meals?)

These are some examples of the ways in which a student with an eating disorder may experience the various aspects of campus life as stressors rather than as exciting opportunities, whether in high school or college. Eating disorders may thrive in these competitive and high-pressure and achievement-oriented environments.

According to the National Eating Disorder Association, data from one college over a 13-year period showed an increase in eating disorders in females from 23% to 32% and 7.9% to 25% in males. SAMHSA indicates that over 90% of those with eating disorders are between the ages of 12 and 25.

An eating disorder impacts all aspects of a person’s life and this is very evident in the life of a student where the school environment is often characterized by achievement, competition and overall high pressure to perform at a certain level. The school setting is the container not only for classroom learning but also for socializing, life learning, developing friendships, engaging in hobbies and sports, and a place where both community and independent meals and snacks are eaten during the day. In the college setting, these challenges may be even more magnified as the student may be leaving home to live in a dorm and have the added adjustment of a change in geographical location, supports, treatment professionals, and increased stressors of academic performance, internships, late-night study sessions, parties and independent decision-making.

Yet there are things students and families can do to prepare and set the student up for the best success for school and recovery if the treatment team (medical doctor, therapist, and dietitian) have all agreed that a return to school is indicated.

Some Tips to Protect Recovery for Students on Campus 

  • Organize the Team: Ensure there is a treatment team in place. If the student is in high school, the parents might consider meeting with the school counselor and/or nurse to provide education on their child’s illness and give information on how to help. Discuss what kind of on-going communication throughout the school year would be helpful between the parents and the school. Find out what mental health resources and supports are present at the school. If the student is going away to college, ensure the team is set up there and appointments are scheduled for the first week back. Consider whether the on-campus resources will be utilized or off-campus providers will be a part of the team. Perhaps a combination of both on-campus and off-campus providers will be used. If so, collaboration and a coordinated treatment plan is of utmost importance.
  • Anticipate the Struggle and Be Prepared: It is important for students, parents and treatment professionals to work together to discuss all the potential areas of returning to school that may impact the work of eating disorder recovery. Have open, loving, and honest conversation that leaves no stone unturned. From this conversation, create a plan for each area. Even if it doesn’t seem like the student will find a specific aspect to be an area of difficulty, it is better to have done the good work of preparation and not need the resource then to be surprised and not ready. Work with the team you have organized to be ready to support the student and intervene if necessary.
  • Build Connections and Community: Eating disorders thrive in isolation. Recovery needs people. This is true both for the one suffering from the eating disorder and also for the loved ones who care for the person. Dr. Michael Berrett, Founder and CEO of Center for Change, has called social supports the “cradle” in which recovery takes place. We need to both give and receive support to and from others. Consider groups you might attend, reconnecting with a church or social club, or family and friends with whom you can share openly with about what is happening in your life. We need one another and we need places to feel nonjudgmental acceptance. Make this a priority for both the student and their loved ones. Utilize technology if there is a lack of local social supports. Facetime with a friend or loved one or join a virtual support group.
  • Make Self-Care a Part of Every Day: For both students and parents or carers, self- care is an essential part of the recovery process. Ask yourself each day, what is one thing I can do today to take care of myself? This doesn’t have to be an expensive massage or getaway, but something as simple as lighting a candle, taking a bath, listening to a favorite song, sitting in a restorative yoga pose or drinking tea with a friend.

Every recovery journey looks different. For students, it is important to consider the resources available to them at their school, on campus or in the community in which they live. It is also of utmost importance to seek the counsel of a multidisciplinary team which would include an MD, therapist, and dietitian to determine appropriateness for a return to school for a student who is struggling with an eating disorder.