College Readiness and Eating Disorder Recovery

Starting college is one of the biggest transitions in young adult life and can be particularly challenging for people with eating disorders.  Moving on to college means dramatic shifts in routines, structure, and support and then throw in the academic and social pressures, it’s understandable why this period of transition can be destabilizing.  It’s impossible not to consider the impact of such a novel landscape when it comes to food and eating – dining halls, cafeterias, late night studying and unpredictable schedules – all especially unsettling for individuals working on eating disorder recovery.  

Stressful life events more generally are associated with disordered eating behaviors, such as extreme dieting, binge eating and purging.  These behaviors are understood as methods of dulling or avoiding negative emotions when alternative, more sustainable and health reinforcing methods are seemingly unavailable.  It’s worth noting that there are also temperament features that impact how someone will fare during times of stress or transition.  There are some people who just prefer familiar over novel, predictable over spontaneous, so when things get shifted and stirred, they can become particularly unsettled.  This personality profile is quite common in folks with anorexia in particular.

So what can one do to increase the likelihood of a successful transition to college?

Start with a solid foundation in the recovery process.

As outlined in Columbus Park’s Guide to College Readiness, there are benchmarks in the recovery process that ideally have been achieved at least several months before departing for college.  Chances of maintaining recovery once at school increase dramatically if primary features of recovery have been achieved: full weight restoration, ability to eat with flexibility in a variety of settings, cessation of all compensatory behaviors, confidence in a range of skills to manage challenging emotions and events.

Plan Ahead.

Before landing at school, it’s important to understand the terrain when it comes to food and eating.  Try to get clarity about the dining options and settings available, dorm room food storage options, and where can you go for support as needed.  

Exposure to novelty.

Practice spontaneity! Go out to eat and order off the menu without preparing ahead. 

Dine in a variety of settings.  Practice accepting foods that may not be the most desirable but will give you the fuel you need in a pinch.  Go out to meals with others and let them pick the restaurants so you get experience in giving up that control.  

Prepare for a regular eating schedule.

Be sure you’re in the habit of eating every 3-4 hours well before you go and then practice maintaining this frequency in different settings and with shifting activities and schedules.  This can improve your flexibility so you can be sure that an erratic or unpredictable schedule at school doesn’t throw you off.

Set up a local team.

For those going out of state, it may mean setting up a new treatment provider[s] at school.  Start early!  You don’t want to land on a waitlist for the start of school.  Familiarize yourself with the counseling and health services at school.  Do they have support groups, dieticians, psychiatry?  Identify contacts who can be your go-to by phone if you need help.  If your treatment involved weight restoration, it’s essential to set up a method for tracking your weight at school to be sure you catch any weight loss quickly and have a plan in place to help you back on target. 

As always, practice your skills.

Transitions can lead to setbacks because when the going gets tough, the skills for coping can get going!  Be sure to identify and practice, practice, practice clear and accessible methods of coping that can help you through if you’re having a tough time.  Consider strategies that are “portable” and available to you anywhere (bubble bath and candles are not going to happen at college!).  Consider journaling, meditation, music, gentle walks, deep breathing, distraction…

Emergency plan.

Have a clear plan in place just in case you start to slide.  Establish exactly what to look for to know that you’re on shaky ground.  It’s essential to catch setbacks early so they don’t escalate.  Be clear about what to look for and how to increase support and points of contact until you are back on solid ground.

Be realistic and honest with yourself.

If you’re not sure you’re ready (see our College Readiness Document to guide your assessment of this), remember that college will not be going anywhere.  As devastating as it can be, waiting a semester or two can make all the difference.  You want the best possible experience at school and your chances for this increase the more steady you feel in your recovery.  At school you’ll have a knapsack on your back; you don’t need ED, too.

Columbus Park College Readiness Checklist